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Sunday, 16 February, 2025
HomeFocusMinister under fire as number of jobless doctors grows

Minister under fire as number of jobless doctors grows

Doctors groups are warning that the rising number of unemployed junior doctors requires urgent action – with the South African Medical Association threatening legal action if the issue remains unresolved – but the Health Minister says the state is not obliged to employ them, writes MedicalBrief.

Minister Aaron Motsoaledi's reaction to the call for help and protest action by doctors in the Eastern Cape, has been widely slammed. Motsoaledi said that while the government sympathised with unemployed doctors and would like to hire them all, it has no money.

They were welcome, he said, to go into private practice or to “go and practise elsewhere”.

His remarks have been slammed by the South African Medical Association Trade Union (Samatu), which had sounded the alarm over the hundreds who have completed their statutory community service but remain unemployed, and which coincided with a statement released by the SA Medical Association (SAMA) regarding the jobless junior doctors.

Motsoaledi said the government has no obligation to employ every unemployed doctor who has completed the internship and statutory community service phases.

“After community service you are a free person, you are a fully-fledged doctor, you can go anywhere,” he said. “If the state advertises posts, you can apply. If the post is in the private sector, you can apply. If you want to open your own private private practice, you can do so. If you want to work elsewhere, you can.

“Now I hear words like absorption. After community service, there is nothing like absorption, you apply for a job like any other job-seeker or graduate.

“There is no special deal for some people because they are doctors. We also have unemployed nurses, unemployed social workers – all of them unfortunately, because of austerity measures and budgetary constraints.”

Samatu told IOL the numbers of doctors who had finished community service and were still jobless were increasing.

“Each year, successive Health Ministers have acknowledged the gravity of this situation and the need to develop concrete strategies to resolve the issue. But we are yet to see a plan from the National Department of Health to address the problem,” said the union’s general secretary, Dr Cedric Sihlangu as more than 1 800 doctors protested outside Eastern Cape Premier Oscar Mabuyane's office in Bhisho, pleading with the Health Department for placement after completing community service.

Sihlangu called for urgent action, condemning Motsoaledi for his comments that the government was “not obliged” to employ the doctors.

The picketing doctors said they wanted the department to permanently absorb them as per the bursary agreement, which states they will be employed once they have completed their one-year compulsory community service.

Dr Chuma Malangeni, who completed her community service at Glen Grey Hospital in Cacadu (formerly Lady Frere), said: “As bursary holders, we signed a contract with the provincial Health Department that binds us to serve here for the duration of years they funded us. This excludes community service.

“One of the clauses in the contract is that we cannot seek work in another province up until we have served our time in the Eastern Cape,” added Malangeni, who studied at the University of Pretoria.

Dr Asemahle Siswana, a dentist who studied at the University of Western Cape, said: “I have been sitting at home since 2023 after completing my community service. I am 32-years-old, and … I am still being fed by my family when I am supposed to be the one helping them out.”

Dr Philisiwe Ngcai, a Walter Sisulu University graduate, told News24 on Friday that they had met Health MEC Ntandokazi Capa the previous day, where they were told the department was facing financial challenges.

“They presented a detailed proposal, which they plan to present to the Premier and the Treasury for funding. The department also requested a temporary suspension of the ongoing demonstration.

“While we welcome the proposed plan of action, we firmly reject the request to suspend our demonstration. We will continue our peaceful protest at the Premier’s Office until we receive employment letters.”

Survey 

SAMA said it was deeply concerned about the issue, which affects more than 1 800 doctors across the country.

It has urged medical staff to complete a survey (details below) that will help provide accurate information on the depths of the crisis undermining the country’s health system.

In its statement, the organisation cited the latest development in the Eastern Cape as being one example, where the provincial Department of Health released a circular (Departmental Circular No: 31/2024) stating that it cannot provide employment for doctors who have completed their community service.

This is a glaring reminder of the crisis facing the healthcare system in general, especially in a province that admits struggling with a shortage of doctors, said the statement.

It said it found it unacceptable that SA was unable to provide employment opportunities for these dedicated and highly skilled professionals, and more so, for services that are critically needed by our communities.

The consequences of this situation are far-reaching and have significant implications for the delivery of healthcare services, SAMA warned.

It exacerbates the existing shortage of medical personnel, leading to overworked and burnt-out healthcare professionals, which in turn, compromises the quality of care provided to patients and puts a strain on the already overburdened healthcare system.

To better understand the scope of the crisis, SAMA is launching the survey to gather data on the allocation and filling of vacancies in hospitals across South Africa.

The organisation urges all doctors and hospitals to participate in the survey by CLICKING HERE (https://forms.office.com/r/anTiHgRfiF). The survey will provide valuable insights into the number of posts allocated and filled in each hospital, allowing SAMA to better understand the extent of the crisis and its impact on healthcare services delivery.

For example, at Groote Schuur Hospital, SAMA was informed that the number of intern posts had decreased dramatically over the past few years, from 120 in 2022 to 34 in 2025. This is a stark reminder of the devastating impact of the crisis on junior doctors and the healthcare system.

SAMA calls on healthcare professionals and hospitals to participate in this survey and provide accurate information on the allocation and filling of vacancies.

The statement added that SAMA is calling on the government to:

1. Provide immediate employment opportunities for junior doctors who have completed their community service.
2. Increase funding for healthcare services to address the shortage of medical personnel.
3. Develop a comprehensive plan to address the root causes of the crisis and ensure that our healthcare system is sustainable and equitable.

If the unemployment of junior doctors is not resolved in earnest, SAMA will consider taking legal action.

No specialising

The Junior Doctors Association of SA (Judasa) warns that a consequence of the current crisis will be that fewer specialists will be trained.

With no money to appoint new and fully qualified medical personnel, including doctors, how will doctors wanting to specialise be trained? For this, they have to work under qualified specialists.

Foster Mohale, the department’s spokesperson, confirmed that there are no positions available for the 1 800 medics who have just completed their community service.

Eastern Cape Health had already announced late last year that no doctors and nurses who had completed their community service would be hired this year.

“All community service personnel’s service contracts will thus expire due to a lack of funds. In past financial years, the department could offer work to successful candidates in funded, vacant positions after community service. However, in the 2024/25 financial year, the department is still unable to make provision for this due to severe fiscal constraints,” read a letter signed by Dr Rolene Wagner, HoD.

Dr Ruhann Botha, Judasa chairperson, said that in the SAMA survey being conducted at the moment, at least 900 doctors have already indicated they are unemployed.

Mohale told News24 the recruitment processes are “at various stages” in the respective provinces and an announcement would be made once there was progress.

“Cost-saving measures and budget cuts across the public sector have not only affected the recruitment of health workers, including doctors, but also other aspects of service delivery. The department … is working to find a long-term solution.”

The population was growing, but the budgets were decreasing, he added, and state employment was determined by the available budgets.

“Once the doctors have completed their internships and community year, they are free to apply for any position, like other graduates, in both the public and private sector. However, it remains our priority to retain as many as possible,” Mohale added.

In April last year, there were 2 000 vacant positions nationwide in state institutions but no funding for those posts. Government needed R2.5bn to fill those positions. Botha said a comprehensive audit of positions and spending in the state’s health services must be done.

“People leave their positions, go abroad or move to another province, and no one is placed in those jobs. My questions are: where did the funding for that position go? Why wasn’t anyone new appointed to the post?”

Botha also emphasised that doctors wanted to work in state hospitals so they could specialise. “You cannot specialise privately. Otherwise, you cannot really advance your medical career; you are stuck.”

He warned that, with the current situation, fewer specialists would be trained. “Today, the established specialists are fighting alongside us, because, if the junior positions are not filled, they don’t have a department to work with.”

On why he could not open a practice, Botha said not all doctors wanted to be general practitioners. “My dream is not to sit in a consultation room. My dream is to be a surgeon. I want to operate (on patients) and, similarly, you have someone who wants to be a paediatrician or wants to do radiology or anaesthesia.”

For that, he added, you first have to work in the state health institutions.

 

 

News24 article – No state funding as major shortage of doctors looms (Retricted access)

 

News24 article – 'Employ us': Unemployed Eastern Cape doctors reject province's request to suspend picket (Restricted access)

 

IOL article – 'We have unemployed nurses too': Motsoaledi says government can't hire every unemployed doctor (Open access)

 

 See more from MedicalBrief archives:

 

Only 270 out of 800 unemployed doctors placed

 

Doctors without jobs as health purse tightens

 

Not our job to place young doctors, says Health Department

 

Western Cape experts appeal for end to health budget cuts

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