Only one doctor had registered in certain specialist levels such as obstetricians for critical care, fast-track pediatrics and several others in the council’s register for active medical specialists by October 1, showing the health sector’s perennial problem with brain drain.
South Africa’s medical qualification and retention trends indicate that doctors are leaving to work in other countries as soon as they finish their community service.
According to data from the Health Professions Council of SA (HPCSA), there are 1 621 doctors registered on the council’s roll for anaesthesiology and only 28 of those are for critical care. A total of 1 136 doctors are registered for obstetrics and gynaecology.
Even though not all doctors are registered with the HPCSA, the roll gives a good indication of the shortage, as most health professionals are registered.
The chairman of the specialist private practice committee at the SA Medical Association, Mzukisi Grootboom, said there was an air of uncertainty among South African specialist doctors, which was pushing them to look for alternatives.
Their main concern was the lack of appreciation by the government and constant questioning of their ethics.
“Here in KwaZulu-Natal, a doctor finishes training and gets a letter that says ‘your time has finished you need to go’. You are just told to get out as if this country has a crowd of doctors,” Grootboom said.
He said if the Department of Health identified posts for newly qualified specialists, they would get a sense of job security and appreciation, which was not the case at the moment.
Public hospitals have seen a massive migration of specialist doctors to private practices and this has left fewer doctors available to train doctors who want to specialise.
Joe Maila, the Department of Health’s ministerial spokesman, said it had not been possible to train enough specialists because when there were fewer doctors to begin with, the department could not take them away from hospitals to conduct training.
“It is true that provinces are also having difficulties to create as many training posts as needed because of budget constraints,” Maila said.
Last week, Health Minister Aaron Motsoaledi said that the country was facing chronic shortages of gynaecologists as most of them felt that it was not worth practising in this profession in South Africa.
Maila said the severity of the shortage was discovered when the department began putting together the district specialist teams for the National Health Insurance pilots.
The pilot sites were supposed to have seven categories of medical specialists but Maila said they had managed to get three, on average.
“We are finding that it’s extremely difficult to attract them, especially the paediatricians, anaesthetists and advanced paediatric nurses,” Maila said.
Maila said the department’s assessment showed that these doctors could be leaving the country or they did not want to work in the public sector.
Grootboom said even in the private sector, the shortage of specialists was a problem right across all disciplines.
But what made things worse in the public sector was that even if doctors had an interest to practise there, there was nothing to attract them.
“When you get to the theatre at 8am, there are no nurses by the time you arrive. Operations start at 10am when you could have done three or four in the private sector. You have no scrubs, no gloves sometimes, and you have to put everything on hold,” Grootboom said.
He said that, looking at the rate at which doctors were produced in South Africa and the fact that most only stayed for two years of internship and two years of community service and then left, it would take the country a long time to get to a point where it would have sufficient specialists.