SA’s public healthcare system is understaffed, but is unable to meet demand due to underfunding. [Picture: Hospital News]
The public healthcare system is in tatters. Hospitals and clinics have snaking queues not unlike those experienced at Home Affairs offices. Overworked doctors and nurses run from patient to patient – while nearly 1 000 qualified doctors sit at home, unemployed and uncertain.
According to University of KwaZulu-Natal (UKZN) graduate Dr Sunhera Sukdeo MBChB, writing in the Daily Maverick, “There are currently almost 800 unemployed medical doctors in South Africa while the people of our country are travelling for two to three hours and sitting in queues for five to six hours waiting to see a doctor”.
As she understood it, a lack of funding meant that the department of health was unable to ensure critical posts in the public sector were filled. This led to a yawning gap between the number of doctors serving the sector and the number needed to meet demand.
“In 2022 our doctor-patient ratio was 1:3,198. The recommended ratio by the World Health Organization is 1:1,000,” she wrote, after detailing the strife she and her family had to undergo to get her through medical school, only to remain unemployed.
Shortage in public sector
While a lack of funding may be the reason why positions remain vacant, it is the resultant shortage of doctors that has rendered the public healthcare sector unable to meet the growing needs of a growing population, the majority of which relies on the sector for their healthcare needs.
Job posts listed on the Critical Skills List, compiled by the department of home affairs, include registered nurses, medical practitioners – specialising in anaesthesiology, cardiothoracic surgery, clinical pharmacology and public health, and paediatrics, among others, and dentists.
“There is a dire shortage in the public sector,” said Dr. Mvuyisi Mzukwa, chairperson of the South African Medical Association (SAMA), in a recent interview on Salaamedia. But, he puts the shortage down to “poor planning” and “a government that does not communicate”.
He said the nine provincial health departments, left to their own devices by the national department, were all acting in ways that led to a “fragmented state of affairs”. Some sent learners abroad on scholarships, others imported skills from abroad.
“Our government is the one that are [sic] driving doctors outside of our country, outside of the public sector, by poor planning. That is why we continue to have challenges in the public sector.”
Effects on doctors
The result of poor planning, as suggested by Dr Mzukwa, and a lack of funds, as suggested by Dr Sukdeo, was that skilled graduates were unable to fill important vacancies.
Said Dr Mzukwa: “The doctors we are talking about are those that have already completed their internship, they have done their community service, they are independent doctors. In other words, they can work without supervision. Those are the doctors who are unemployed.”
Doctors presently working in the public sector were hit hard by this lack of skills.
“They’re suffering from burn-out because of the low numbers. There are long queues. There’s a backlog in terms of operations because there’s shortages. On top of that, you’ve got these unworkable working conditions, where you find that hospitals are dilapidated, there’s broken equipment and there’s security threats to our healthcare workers,” he said.
The effect of this served only to worsen the crisis in the public sector, he said. “Most of these experienced specialists, who are training other specialists to come on board, are leaving the state [healthcare system] because of conditions … that are not being attended to and they are going to the private sector; some of them are going to other countries, like New Zealand.”
Dr Sukdeo, in the same article, also mulled the various options before her. One of them: leave the country.
“If I knew then what I know now, would I still have chosen the path I have? After sacrificing nine years of my life to be sitting unemployed, would I still have accepted the offer to study medicine?” she asked.
Until Dr Joe Phaahla’s health department gets its priorities in line, far too many unemployed medical school graduates like Dr Sukdeo will have either entered the private sector or left the country. Patients at Helen Joseph Hospital cannot count on the state to give them efficient, crucial healthcare.