The exodus of skilled medical professionals from South Africa has left the country with a dearth of critical healthcare workers, and currently, the skills base across both public and private healthcare remain on life support.
That’s the warning from Craig Comrie, chief executive officer of the medical scheme Profmed, who says the narrowing skills base is pushing up the price of healthcare, reports Business Tech.
“Not only is there a major shortage of doctors, but there is a critical need for more nurses as well. This has a cascading effect on the rest of the healthcare sector, right down the value chain through to the citizen’s pockets.
“This is not about the available facilities but the skills and management of this scarce resource. We are simply not creating an attractive value proposition to retain existing doctors and nurses in our system and to create more supply of skills for people to access.”
He said skills in the medical industry have been aggressively targeted by developed countries, and that the shortage of highly skilled and experienced healthcare workers is a global problem placing huge strain on health systems.
“Developed markets are poaching highly skilled medical practitioners and specialists in South Africa, and we have seen a large exit over the past three to five years, leaving us with a dearth of fundamental skills,” said Comrie. “The sad reality is that South Africa’s abilities to produce quality medical specialists has also deteriorated over time as a result of emigration, leaving fewer opportunities for specialised training.”
South Africa has 28,000 registered doctors – not all practising – and produces around 2,500 doctors annually. These registered doctors include retired doctors who work well into their 70s because the demand for health skills is so great.
He called for a stronger value proposition to keep healthcare professionals in the country.
“Instead of increasing the supply of doctors, we need to retain the skilled doctors we already have by creating and maintaining favourable and secure working conditions with market-related remuneration, cultivating interest and opportunities for more medical graduates in the public and private healthcare space.”
SA also has a major shortage of specialised doctors.
“This space will suffer initially because ‘super specialists’ like paediatric oncologists and electro physiologists – specialists in cardiology devices such as pacemakers etc. – are so few and far between. The public and private sectors will have to partner with many of these services just so that patients have access to them.”
The basic economic sum of supply and demand means that there are fewer doctors who do not charge traditional medical scheme rates as they have enough patients who pay cash upfront for their services.
“This leaves a funding gap for private patients, whether they belong to a medical scheme or are paying from their own pockets for services from reduced pool doctors that remain in South Africa. Many of these same specialists have their appointment books full for more than six months unless you have an emergency.”
In the ongoing NHI reforms, little has been done to retain specialists where the bulk of their remuneration is funded by medical schemes or private payers.
In the run-up to the NHI, Comrie said many doctors will continue to exit the country as they feel insecure about the sustainability of their lifestyles if the bulk of their remuneration is planned to come from NHI.
“A large percentage of members leaving Profmed are emigrating. It’s a huge concern.”
To bridge the gap between public and private healthcare skills, there needs to be an environment of collaboration in the health space where medical practitioners offer their services to both private and public facilities, he added. “There is, however, room for improvement in partnership and there is far too little of this at the moment.”
“Producing efficient nurses and filling current vacancy rates estimated to be just more than 20,000 roles in the public sector would be a crucial start to improving the resource base. We need to look at larger portions of the healthcare budget being allocated to these previous unfunded vacancies.”
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