Chronic staffing shortages are adding huge pressure to South Africa’s already over-burdened public health sector, and unions say that unemployed doctors could plug the gaps and lighten the excessive workloads of existing medical professionals, reports IOL.
Medical organisations have warned that currently, doctors are being forced to work extended shifts and unrealistic overtime to keep services functioning, and that sustained pressure leads to fatigue and burnout.
Health and Other Public Sector Employees’ Union of South Africa (HOSPERSA) Gauteng provincial secretary Nhlanhla Mthize said the organisation was concerned about the apparent contradiction between qualified doctors who remain unemployed, and persistent shortages of doctors.
HOSPERSA also warned that fatigue among the the overloaded doctors could affect concentration, clinical judgement, and decision-making, potentially increasing the risk of medical errors.
The union questioned whether continuing to rely on overtime was the best way to address persistent vacancies.
“Instead of continuously paying existing doctors to work additional hours to compensate for vacancies, the government should assess whether available (jobless) qualified doctors can be employed to address persistent staffing gaps,” Mthize said.
The staffing pressure also extends beyond doctors, with nurses, allied health professionals, administrative staff, and other healthcare workers all facing increased workloads.
The union cited longer waiting times, delayed assessments, and delays in treatment, and just as one example, highlighted Gauteng Forensic Pathology, where some facilities, including Springs and Bronkhorstspruit, have only one appointed doctor.
When that doctor is unavailable because of illness or legitimate leave, post-mortems grind to halt, directly affecting service delivery and contributing to backlogs.
South African Medical Association (SAMA) chief executive officer Dr Mzulungile Theo Nodikida said the situation was also putting the country’s future specialist workforce at risk.
Doctors need continued clinical exposure to remain competitive for registrar positions, he said, while prolonged periods outside clinical practice could make specialist training more difficult.
The association identified anaesthetics, surgery, emergency medicine, obstetrics and gynaecology, paediatrics, psychiatry, radiology, and family medicine among areas of particular concern, although shortages vary between provinces and between urban and rural areas.
“Doctor unemployment and doctor shortages are two sides of the same workforce planning problem,” Nodikida said, adding that provinces could have a genuine need for doctors while lacking sufficient funded, approved, or advertised posts.
Both organisations stressed that unemployed doctors could not simply be placed into any available position. Recruitment must consider funded posts, qualifications, registration requirements, specialisation, and the operational needs of individual facilities.
Poor workforce planning can leave a mismatch between areas where doctors are needed and where funded posts are available.
HOSPERSA called for a comprehensive assessment of doctor vacancies and staffing requirements across the public healthcare system, including specialised services such as Forensic Pathology.
SAMA called for an integrated workforce plan linking medical education, internship, community service, post-community service employment, and specialist training, as well as greater investment in registrar posts and specialist training capacity.
The South African Medical Association of Medical Interns and Doctors (SAMATU) said the problem was not a lack of demand for doctors, but structural and administrative hurdles within the system.
It pointed to insufficiently funded positions, saying provincial health departments were operating under constrained and often decreasing budgets, limiting their ability to employ eligible doctors permanently.
“The rising number of qualified doctors who remain unemployed after completing their mandatory community service is an escalating concern, highlighting a disconnect between workforce planning and available funded positions,” it added.
‘No money’
Health Minister Dr Aaron Motsoaledi has previously said the government cannot simply create jobs without the resources to fund them, referencing the country’s austerity measures and budget constraints.
“You cannot give a job for which you don’t have the means to pay such people,” he said.
In July, Motsoaledi also questioned whether there was a reliable figure for doctors who are unemployed after community service, saying that once doctors complete their statutory internship and community service, they enter the broader labour market. Some move into private practice, pursue further studies, or leave medicine, while others may later apply for government positions.
Motsoaledi said the government knows which interns have been placed because their employment is statutory, but it becomes more difficult to establish how many doctors are unemployed after community service.
IOL article – HOSPERSA: Unemployed doctors can remedy South Africa's healthcare crisis (Open access)
IOL article – SA’s doctor unemployment crisis deepens (Open access)
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