Critical doctor shortage in South Africa raises concerns for government’s NHI plans

South Africa has a critical shortage of doctors, with less than one doctor to treat 1,000 patients, says the opposition Democratic Alliance.

This was revealed in a recent parliamentary Q&A with health minister Dr Joe Phaahla, who indicated that the country currently has a doctor-to-patient ratio of 1 to 3,198 (0.32 to 1,000).

In 2019, the country had 0.79 doctors per 1,000 patients (1 to 1,266) – already poor when compared to the United Kingdom (3.03), India (0.93), Brazil (2.32), and Mexico (2.44), the DA said.

“This shocking state of affairs persists despite the more than 21,000 specialist medical personnel posts which are vacant across all nine provinces, and which the national Department of Health have yet to fill,” said the DA’s Michele Clarke.

“The critical shortage was created by the incompetence and corruption of the ANC government which seems unwilling to address these serious concerns. In fact, just last week the Gauteng Health Department failed to pay April salaries to 91 doctors and nurses at the Helen Joseph Hospital. And the interns at the Chris Hani Baragwanath Hospital were also the victims of late payment.”

NHI concerns 

Clarke said these figures are particularly concerning ahead of South Africa’s planned introduction of a National Health Insurance scheme.

“How does the ANC government envision managing the National Health Insurance (NHI) project when they are unable to make the current universal health care system in South Africa work?

“Before the ANC government can even begin to think about the NHI, they must increase the numbers of qualified medical personnel working in South Africa’s current public health care sector.”

Clarke added that R8.8 billion has already been allocated towards the NHI.

“Why is this money not used to alleviate the critical shortage of medical personnel? The DA calls for these funds to be redirected towards the training and employment of doctors and nurses, and the development of nursing colleges.

“South Africa’s current health care problem cannot be alleviated by pipe dreams. These serious concerns must be addressed head-on with practical and pragmatic solutions.”

Exodus of skills 

Health stakeholders have previously raised concerns that South Africa could see an exodus of doctors and other key medical personnel ahead of the planned introduction of the NHI scheme.

There is also a growing concern that the country could lose valuable training skills as professionals look to leave.

Briefing parliament in March, the Department of Health noted these concerns, adding that the NHI will need skilled personnel to function. It said that this was not limited to healthcare professionals, but that general skilled human resources will be central to the health system going forward.

It added that the complex interactions between training, registration compliance and employment can all be substantially improved.

“This is a big ship that will need to be turned, but the framework is in place,” said acting director-general of health Nicholas Crisp. “We have heard the threats that there will be an exodus of personnel if the NHI is implemented and a brain drain.”

He said that the department is actively responding to this and that a framework is in place to ensure the country has the necessary skills, with his department developing a ‘Human Resources for Health strategy’ before the start of the Covid pandemic.

This article was previously published on Business Tech

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