Durban - KwaZulu-Natal is facing a chronic shortage of doctors, with 49 percent of public health jobs not filled, a survey by the SA Institute of Race Relations has revealed.
According to the survey - due to be published this week - the province also has a 26 percent vacancy rate for nurses.
Countrywide, 56 percent of doctor posts are vacant (14 351) and 46 percent (44 780) of nursing jobs unfilled.
Health experts on Monday said the figures were a concern and said more needed to be done to train people.
The figures are based on a Human Resources for Health Strategy for the Health Sector document compiled by the Health Department based on its own assessment of needs.
The survey was conducted in 2010, but according Lerato Moloi, a researcher at the race relations institute, “not much would have changed”.
She said the figures were “very alarming” and with such high vacancies, the government’s National Health Insurance plan was unachievable.
“The three focal points of the NHI scheme are to ensure that every South African has access to quality health services, to decrease the burden of disease and to improve the overall performance of the health system. But with such a high vacancy I can’t see them doing this. The public health system is... in a state of crisis,” she said.
Dr Mzukisi Grootboom, chairman of the SA Medical Association, agreed that the doctor shortage was a major concern.
“There are a lot of our people not being adequately looked after because there is a huge shortage of doctors in rural areas,” he said.
“The sad reality is that many of the doctors who do end up going to rural areas do not stay. The government has tried to intervene by increasing the salaries of health workers - but very few health workers want to work in the rural areas.
“Another factor is that a lot of doctors don’t even choose to stay in South Africa but choose to take jobs out of the country,” Grootboom added.
Dr Olive Shisana, CEO of the Human Sciences Research Council and chair of the Ministerial Advisory Committee on NHI, agreed.
“Doctors tend to work in urban areas. We need to be getting more doctors from rural areas that are under-served so that when they finish they can go and work there,” Shisana said. “There is no need for us to have an over concentration of doctors in urban areas. We need to be able to spread them across the country so that everyone can have access to health care.”
Another factor Shisana said was that too few medical students were being trained.
“There are many students who qualify to study but do not get in (to university). It is not only necessary for us to increase the number of medical schools but also to expand the existing ones by ensuring we have faculties that can teach these students.”
Last year, Health Minister Aaron Motsoaledi revealed a human development strategy that includes plans to increase the number of trained doctors, building a ninth medical school, in Limpopo, rebuilding other training facilities, and increasing SA students training to be doctors in Cuba.
The minister aims to increase the current number of doctors trained in South Africa from 1 200 to 3 600 a year, with the existing medical schools already having upped their intake by 160 in 2012.
Medical schools across the country were flooded with far more applications for places that were available for the 2013 academic year.
The Nelson R Mandela School of Medicine at the University of KZN received 5 500 applications for 210 first year places this year while the University of Cape Town’s Faculty of Health Sciences received 5 380 applications for its first year MBChB programme. Wits University in Johannesburg had 12 928 applications for 600 spots for its first year medical programmes.
UCT Faculty of Health spokeswoman, Linda Rhoda, said that in response to Motsoaledi’s plea the university would take 20 additional students this year.
At Stellenbosch University, intake for its MBChB programme had increased from 188 in 2006 to 235 this year.
One of the more ambitious plans being mooted by the KZN Department of Health is to set up Cuban medical schools here.
Speaking at a Provincial Consultative Health Forum in Pietermaritzburg in November, KZN Health MEC, Dr Sibongiseni Dhlomo, said: “We know that as a country we are not producing enough doctors. The demand far exceeds our current output of doctors each year. We have only eight medical schools serving 52 million of our population while Cuba has 22 medical schools with a population of 11.204 million.
“With access to our own medical schools limited, it makes sense to bring the Cuban model here,” Dhlomo said.