The UK’s National Health Service, with its drastic personnel shortage, is actively recruiting staff, and with South Africa’s highly valued work ethic and medical qualifications, mass migration of skilled personnel could be a reality if the NHI is accepted in its current form, experts warn.
“It is already becoming a challenge to recruit medical staff for a clinic because nobody wants to be here when the NHI hits the fan. Because it will, and not only patients will be at the short end of the stick,” said Medicare’s Mike van Wyk.
While people who currently have medical aid may have to pay twice – in premiums to the scheme and in taxation for the NHI – there was a possibility medical aids could disappear entirely with time or be forced to deliver much reduced coverage.
Although the government has said it will not prescribe where people can go to a GP, it is probable that waiting times will be hugely increased, because, according to Van Wyk, GPs will be forced to take on extra patients just to make ends meet, reports The Citizen.
“Government will replace medical funders as primary debtor and, in all likelihood, terms of 90 days plus will be implemented.
“At a base price of about R350 per consultation, doctors will be expected to pay salaries, bills and consumables from money that will somehow magically appear, and then, still wait to receive payment from authorities for who knows how long.
“There is no logic in spending more than a million rands attaining a medical degree, let alone specialisation, and then being up to your ears in study debt while trying to build a practice and put food on the table. It’s just not going to happen.”
And it’s not only doctors, he added. “It’s clinical associates, nurses, you name it. They’re all going to leave before it’s too late.”
Van Wyk also speculated that medical students are likely to graduate, complete their community service and then head to another market where it would be possible to carve out a future financially and professionally.
Mass migration
The South African Medical Association (Sama) cautioned government more than a year ago that it estimated a third or more of doctors presently practising in South Africa would leave, and reaffirmed this last month when it objected to the NHI Bill’s passing in Parliament.
It said medical professionals have been put on a critical skills shortage list by the UK Government, meaning they can get residence visas in Britain fast-tracked.
Sources from various medical associations have said that as South African doctors exit, an influx of healthcare practitioners from other African countries can be expected.
More Cuban doctors were also likely to be imported to compensate for the exodus of local doctors, said Van Wyk.
An additional concern was that NHI would be digitised, and appointments loaded for doctors by the state. These patients would be linked to an online file, detailing their medical history as best captured by a previous consulting party.
Van Wyk said doctors will be unable to manage their own time, as government might pack in as many consults in a day as possible, resulting in long queues in waiting rooms and affecting quality of care.
This was echoed by Maureen Litchfield of the Health Funders Association (HFA), which represents at least 73% of open medical schemes and 50% of total medical scheme memberships.
The HFA also believes the NHI “will undermine … the objective of moving towards universal health coverage in SA”, she said.
See more from MedicalBrief archives:
NHI not being built on any one country’s model – Crisp
SA nursing under threat as UK, Canada lure staff to address crippling shortages
NHI pilots point to critical fault lines
NHI ‘will lead to emigration, corruption’