Fed-up and desperate unemployed health graduates are calling for Finance Minister Enoch Godongwana’s head, saying he should be fired for his failure to increase the Health budget.
A group of around 150 jobless doctors marched through Pretoria’s city centre last Friday demanding urgent action from National Treasury – for infrastructure and health facilities to improve, for staff shortages to be addressed, and for jobs for all unemployed doctors, dentists, pharmacists and nurses, reports Silver Sibiya for GroundUp.
Among them was Nobuhle Makhaya, who graduated from the University of KwaZulu-Natal’s medical school in 2021 hoping not only to help her own family but to bring quality healthcare to patients in her community.
But after nine years of training, including a two-year internship and completing her mandatory community service at Standerton Hospital in Mpumalanga in December, she remains unemployed. Makhaya said she has been applying for jobs at hospitals in Gauteng and KwaZulu-Natal with no luck.
“All I want is a job. We know there are patients who don’t have doctors to take care of them because there is a shortage, but here we are, unemployed,” she said. If the government can bail out dysfunctional state enterprises, it should also prioritise the health system, she added.
The march was led by the South African Medical Association Trade Union (Samatu) and supported by Denosa and Cosatu, among others.
Samatu President Tshilidzi Sadiki said: “These funding challenges are man-made – some of them by the Minister. We want President Cyril Ramaphosa to please recall him.”
Stadi Mngomezulu, deputy Director-General of Corporate Services at the National Treasury, promised to respond to the marchers’ memorandum in two weeks.
Percy Mahlathi from the National Department of Health briefly addressed the crowd and said Minister Aaron Motsoaledi had made an appeal to Treasury. “We fully understand and agree that there is a problem, and there is an even bigger problem of youth unemployment in the country,” he told them.
Promises unfulfilled
One of the country’s youngest-ever medical graduates is among them, despite promises of a post-internship job.
Decent Mkhombo (24) was admitted to medical school at the University of Limpopo in 2016 at 15, graduated in 2022 and completed a two-year internship before doing another year of community service at Mapulaneng Hospital in Bushbuckridge.
As part of the first cohort of the medical school at the University of Limpopo, when it opened, it represented a beacon of hope, promising to produce locally trained doctors to serve the community, he told News24.
He received a bursary from the Limpopo Department of Health, which required him to work in the province for six years after completing his degree, but didn’t mind the condition, as he aspired to further his studies there while working.
“My goal is to become an oncologist,” he said.
When Mkhombo and his peers graduated from the university, they completed the mandatory two-year internship and community service required for all medical graduates. However, instead of being offered permanent posts, they were left unemployed.
“For reasons we were never told, no positions were made available to us,” he said.
Despite no longer being considered junior doctors, Mkhombo and his peers cannot open private practices. “The department hasn’t issued us the letters we need to practise privately because we are technically unemployed,” he said.
‘Without posts, there’s not much we can do’
Mkhombo highlighted the dire need for doctors in South African hospitals.
“There’s a high patient load, and doctors are overworked. This leads to burnout,’ he said. “We rely heavily on the government … It’s their responsibility to train doctors and provide opportunities for them to specialise.”
Mkhombo said that after completing his internship, the department told him he was no longer required to serve the six years initially agreed upon because they couldn’t afford to pay him.
“We’re also unable to open private practices because the Department of Public Service & Administration still lists us as government employees. We’re stuck in limbo without a clearance letter.”
He expressed frustration at the “conundrum”, and urged the government to address the critical need for posts.
He added that the plight of unemployed doctors was not just a personal issue but one that affects the entire healthcare system.
“It’s not just about me. It’s about all unemployed doctors and the millions of people who rely on public healthcare. People are dying daily because there aren’t enough doctors to provide care.”
Critical need
Department of Health spokesperson Foster Mohale said the department was actively “mobilising financial resources and strengthening the public health system, including recruiting health professionals like doctors, nurses, and pharmacists”.
He told News24 that once medical doctors complete their community service programme, they qualify as independent practitioners and can apply for public and private jobs.
“There is no automatic absorption or placement; they must apply for advertised positions like any other graduate.”
Samatu secretary Cedric Sihlangu expressed concern about the persistent unemployment of doctors, and said the failing healthcare system needed urgent intervention, as ongoing neglect endangers lives.
“Tragically, it is the poor and indigent who suffer, as they have no alternative but to rely on the failing system.”
He criticised the government’s austerity measures, saying they had led to numerous unfunded critical posts in public healthcare.
“Decision-makers, however, are shielded from the consequences of these policies, as their medical aid schemes provide them with access to world-class private healthcare.”
He called for Ministers, MECs, and all executive members to immediately resign from their medical schemes and use the public healthcare system in solidarity with the masses who elected them.
“Those responsible for public healthcare facilities should, by law, be required to use the same facilities.”
State failure
Professor Alex van den Heever, chairperson for Social Security Systems Administration and Management Studies at Wits University, said there was no legal recourse for medical doctors left unemployed after completing their internships and community service.
He criticised the government’s failure to align their training with the system's capacity to absorb them, both in the public and private sectors.
"This issue stems from the absence of a well-informed healthcare workforce strategy," he said.
Instead of a co-ordinated approach, Van den Heever noted that decision-making happens in isolation, with budgets failing to align with any strategic plan.
“There is a clear disconnect between national government policies and the realities of the broader health system,” he said.
He told News24 that central bargaining chamber decisions – driven more by politics than careful planning – have raised employment conditions beyond available budgets, forcing provincial health departments to cut posts, and reducing the public sector's ability to absorb newly qualified doctors.
GroundUp article – “All I want is a job” pleads unemployed doctor (Creative Commons Licence)
News24 article – Youngest medical student among SA's many unemployed doctors (Restricted access)
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