Lack of medical personnel plagues rural hospitals

Anso Thom

Rural hospitals in SA are facing a serious shortage of doctors this year as a result of delays in registering foreign qualified doctors and the failure to place community service doctors in underserved hospitals.

Many of the foreign qualified doctors who provide essential medical care in remote and rural parts of SA are from the developed world (UK, Europe, Canada, US, Australia and New Zealand) and their training and experience are considered equivalent to that of SA-trained doctors.

They can be registered here without passing extra examinations.

But several rural hospitals are facing the prospect of severe doctor shortages as the “non-exam track” foreign qualified doctors have to wait many months to be registered by the Health Professions Council of SA (HPCSA).

There are increasingly time-consuming bureaucratic requirements, resulting from concerns about bogus doctors.

Madwaleni Hospital, a 180-bed district hospital in the Eastern Cape, has four foreign qualified doctors, three from the Netherlands and one from the UK. They’re willing to work at Madwaleni and have been waiting several months to be registered, despite the hospital not being allocated any community service doctors for this year.

As a result, the hospital has only four doctors, and two senior doctors are leaving next month. Unless they are replaced by senior doctors, the two junior doctors have indicated that would have no option but to leave too.

Madwaleni has 14 posts for doctors and, until recently, it had a stable workforce of between eight and 10 doctors. Over the past six years, 18 foreign doctors have contributed years of service to vastly improving the healthcare provided to a deep rural community.

The hospital has seven wards, an outpatients department, and an HIV wellness and antiretroviral unit, which in the past has been held up as a best-practice model.

Marije Versteeg of the Rural Health Advocacy Project said the Madwaleni situation would never have been allowed to happen in an urban hospital, and that even though this was an extreme case, it was not isolated.

She said there was an urgent need for community service doctors to be allocated where the need was greatest – in rural hospitals.

“You have a situation where there are many community service doctors placed in the Eastern Cape urban hospitals, but very few or none in the rural hospitals,” she said.

Versteeg said foreign qualified doctors would go to other parts of the world if the perception was that SA did not want them.

HPCSA acting registrar and chief executive Dr Kgosi Letlape said the delays in registering doctors were due to non-compliance with the HPCSA process by the applicants. Versteeg said putting patient safety and quality of care first was non-negotiable. – Health-e News Service.


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