South Africa, already battling a shortage of medical personnel at government hospitals, hasn’t hired more than 800 qualified doctors for public-health posts because of a lack of funds – which is contributing to the continuous emigration of these professionals, a medical union says.
“Annually, the department cites budget constraints as a barrier to hiring, yet no substantial measures are evident to solve the funding dilemma,” said the SA Medical Association Trade Union (Samatu) last week.
Jeanette Hunter, acting director-general of the Department of Health, said provinces were constantly trying to recruit doctors, highlighting eight vacancies advertised in the Free State a fortnight ago.
The department doesn’t have enough doctors, and unemployed professionals “should come forward with their registration numbers so that it can arrange jobs for them”, she added.
The national Health Department, however, yesterday announced that 2 101 eligible community service personnel and 2 210 medical interns had been placed at various facilities across the country as of last week.
However, about 220 applicants for community service doctors were not eligible to commence duty in January 2024 due to starting their internship late and will only be allocated posts later in the year.
A junior doctor who was placed in the North West told TimesLIVE they were given accommodation that was not well-resourced or furnished and often ran out of water.
“It’s far from the hospital and shops. Because it’s rural you can’t really get a place in the village, options are few. Load-shedding is a problem nationwide so you make do but the water often runs out and we have to collect it in buckets, even if you had a long shift and are tired.
“There’s a shower and geyser but the water is not always hot,” said the junior.
According to the department, 53 eligible community service doctors did not start their duties because they rejected posts for a number of reasons, including location. They have since lodged appeals.
“The department is attending to all appeals and the outcomes will be communicated to each appellant in due course,” said the department.
A number of doctors under hashtag #UnemployedDoctors2024 laid bare their struggles with accommodation across the country. One posted pictures of filthy and dilapidated lodgings.
Another doctor, placed in a hospital in rural Limpopo, said: “The state of the accommodation was terrible when we arrived, and none of us (chose) it (this hospital) to work at. Aside from the accommodation, the hospital is severely understaffed as only five out of the 11 community service doctors allocated to the hospital pitched up,” said the doctor, who asked not to be named.
“This means we have only eight doctors (five community service doctors and three medical officers including the clinical manager) running a district hospital of 270 beds. We feel that this is deeply compromising the quality of care we are providing for our patients, with dire consequences,” he added.
Dr Angelique Coetzee of the South African Medical Association said though they sympathised with the doctors, there was no clear obligation for provinces to provide accommodation for community service doctors.
“A lot would need to find their own accommodation (but) some provinces might give them housing. They need to look at the province's policy regarding accommodation.
“Sometimes the province tries to help them,” she said.
Shortages of doctors and nurses are not unique to South Africa, according to a Bloomberg report in Daily Maverick.
The problem is even worse in many other African countries. In the UK, chronic staff shortages in the NHS have left some hospitals near breaking point.
The South African Medical Association (SAMA) also highlighted the lack of public-sector posts for newly qualified doctors.
“There’s a huge shortage countrywide,” said Akhtar Hussain, chairman of the employed doctors’ advocacy forum at SAMA. “They end up going to the private sector or ultimately, they leave the country.”
Hunter said that at the end of 2023, the department had 2 451 posts available for internships but had only 2 358 applicants.
Somatu criticised the lack of strategy for keeping doctors in public service after completing their training. Poor working conditions are the most common reason given by doctors for leaving the public sector.
“The spectre of unemployment of post-community-service doctors not only squanders their accumulated experience, but also symbolises a broader neglect of healthcare priorities,” the union said.
“Swift integration of these professionals into positions where their skills can be utilised is not just expedient, it is an ethical imperative.”
TimesLIVE – Junior doctors in rural hospitals unimpressed by 'filthy, broken' accommodation
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