There was good news from the Health Minister this week with the announcement that more than R2bn has been allocated for the hiring of new doctors and healthcare professionals. However, nursing unions say not enough has been set aside to fill the huge nursing shortage.
The funds have been apportioned by the National Health Council to hire 1 650 doctors and other healthcare professionals, according to Health Minister Aaron Motsoaledi – the Council being the highest decision-making body in health and which includes the Minister and provincial Health MECs, as well as representatives from local government and the military.
Also on the list of priorities is the employment of 200 nurses as well as the purchase of hospital beds and mattresses, baby cots and linen.
While the announcement will be met with relief from unemployed doctors, hundreds of whom protested earlier this year at the lack of public sector jobs, nursing union Denosa is angry that more nurses are not being hired, calling the 200 “a token gesture”.
It has not been made clear whether the funds will be made available for the 2025/26 fiscal year.
Business Day reports that Parliament passed the fiscal framework by only a narrow margin last week, as parties in the government of national unity (GNU) wrangled over Finance Minister Enoch Godongwana’s plan to hike VAT over the next two years.
After the DA refused to support the fiscal framework, the ANC turned to parties outside the GNU to secure the votes it needed to get the Bill approved.
The proposed Budget tabled by Godongwana on 12 March included an extra R29.9bn for health over the medium term to cover wage increases, hire 800 unemployed post-community service doctors, and pay for goods and services.
However, this addition to the baseline was contingent on the revenue-raising measures contained in the Budget, which included raising VAT from 15% to 15.5% this year, and then to 16% next year.
Complicating matters further is that the extra R29.9bn was a provisional allocation, which the National Treasury said in March would be made available only if departments “demonstrated readiness or met specific conditions”.
The NHC had approved the advertisement of 1 200 posts for doctors, 200 posts for nurses and 250 posts for other disciplines, but no provincial breakdown of the posts was available, as the NHC had worked with the provisional figures announced by the Finance Minister in his Budget speech, said Foster Mohale, Health Department spokesperson.
“Until this is formally allocated we don’t know the breakdown per province,” he said.
The NHC also approved the purchase of 25 000 hospital beds, 80 000 mattresses, more than 76 000 baby bassinets, and 1.25m items of linen to the value of R1.346bn, according to the Minister.
“One of the most embarrassing experiences the public health sector had to endure is the shortage of simple things,” he added.
Insulting
Denosa (the Democratic Nursing Organisation of South Africa), meanwhile, is livid that only 200 nurses will be recruited – despite 20 000 trained nurses being unemployed.
“With a nationwide crisis of nurse shortages, this is not only shockingly inadequate but downright insulting,” said spokesperson Sonia Mabunda-Kaziboni.
She told IOL the Department of Health had failed to respond meaningfully to the dire shortage and criticised Motsoaledi for treating the recruitment of just 200 nurses as though it were a significant breakthrough.
“This token gesture… after repeated calls for urgent and large-scale investment into nursing human resources, is a slap in the face to the thousands of nurses who are already stretched beyond capacity,” she said.
“It is an affront to those working under impossible conditions, often without rest, proper compensation, or adequate support.”
She called the nursing shortage a national crisis.
“The Free State alone faces a 28% vacancy rate, and similar figures are reflected in other provinces, like the Eastern Cape,” said Mabunda-Kaziboni.
It is estimated that South Africa could be short of more than 100 000 nurses by 2030 if urgent steps are not taken.
Rural doctors
Also calling for its voice to be heard is the Rural Doctors Association of Southern Africa (RuDASA), which has urged the department to prioritise the filling of vacant healthcare posts in rural areas.
RuDASA, which comprises healthcare professionals predominantly from rural facilities and university-affiliated rural health centres, said it was acutely aware of the challenges faced by doctors working in underserved regions.
Like the Public Servants Association (PSA), the South African Medical Association Trade Union (Samatu), and the Congress of South African Trade Unions (Cosatu), it has applauded the news, but also expressed disappointment at the filling of just 200 nursing posts.
This, it said, was “a drop in the ocean, especially since the withdrawal of overseas development assistance led to a loss of 2 000 nurses in 27 priority districts”.
“Many of these districts were rural. Two hundred posts for nurses will not fill the gaps left by those programmes, even before we consider the loss of nurses at rural district hospitals leaving vacant posts that were not advertised.”
However, it added that the emplyoment of more doctors would be a great relief to many hospitals.
“We hope rural posts will be prioritised and are heartened to hear that six doctors were appointed to Zithulele Hospital in the Eastern Cape this month,” said the RuDASA executive committee.
Doctor-patient ratios alarming
Motsoaledi’s announcement is “an acknowledgement of the unwavering dedication displayed by fellow doctors who have retained their ambition to serve the vulnerable communities”, said Samatu general secretary Dr Cedric Sihlangu.
The union has been vocal about the rising unemployment of doctors and the growing shortage in public hospitals, resulting in an alarming doctor-to-patient ratio in public healthcare facilities.
In February, answering a parliamentary question, Motsoaledi said there was, on average, one doctor for every 2 000 patients in the state healthcare system. In the Eastern Cape, there were only three doctors for every 10 000 patients, while Limpopo and Mpumalanga had 2.7 and 2.5 doctors, respectively, for every 10 000 patients.
In Gauteng, the ratio was 4.7 doctors to every 10 000 patients, and in Western Cape 4.5 doctors for every 10 000 patients.
Sihlangu said appointing 1 200 doctors would reduce waiting periods for patients and advance the implementation of the NHI, reports Daily Maverick.
Business Day PressReader article – Health Council agrees to hire another 1 650 (Open access)
IOL article – Denosa slams ‘insulting’ Motsoaledi’s plan to recruit only 200 nurses (Open access)
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