800 doctors available, government hospitals not hiring

Connie Queline

800 doctors available, government hospitals not hiring

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JEREMY MAGGS: The South African Medical Association Trade Union (Samatu) is calling for the Department of Health to employ hundreds of qualified, unemployed medical officers. The body is claiming today that over 800 qualified doctors remain unemployed following the completion of their two years of medical internship and one year of community service. More on that now from Dr Cedric Sihlangu, who is the general secretary of the organisation. So doctor, just how bad is the situation?

CEDRIC SIHLANGU: Ja, it’s a recurring problem for the past couple of years now, I think we are probably beyond five years of the same thing happening. It did start off with a lack of funded posts for interns some years back, which was resolved to the extent that this year there are very few interns that haven’t been placed.

Then it went on to affect community service doctors, where even though doctors would’ve finished their two years of internship, then for the year these doctors were told there are fiscal constraints, there’s no money in the coffers, and they couldn’t find funding to absorb those (community services), which are statutory years that they must serve. But now what has happened is the doctors have finished their two years community service, so two years internship, one year community service.

Now they are post-community service, so these are fully qualified independent medical practitioners ready to serve the nation and registered as such, and unfortunately, now they can’t find jobs in the government sector where they are mostly needed. If you recall, the balance of the population, over 80% utilises the public healthcare system, and it’s only a minute portion that uses the private healthcare system because, of course, our people literally can’t afford healthcare.

As a result, these doctors who are now meant to go to the far-flung communities to serve the poor and the marginalised, can’t access them because they’re simply out of jobs.

JEREMY MAGGS: The upshot of that is what, could we lose them to posts overseas?

CEDRIC SIHLANGU: Well, it goes without saying, remember at the end of the day, when you are at the level of post-community service, you would’ve worked for three years, and the chances are these doctors have committed themselves, some of them have bonds, some of them have purchased cars via credit, and for them it’s do or die.

They have to find a solution or get out of the country just to make ends meet and sustain their families. So that’s what we are seeing.

But also, some of them want to go to the private sector, they open GP practices here and there just so that they can be able to make a living. The problem with that is the bulk of the population cannot afford private healthcare, and it creates a situation, like I indicated, that these doctors become inaccessible.

JEREMY MAGGS: So how then do you assess the Department of Health’s handling of the situation?

CEDRIC SIHLANGU: It has been very poor on the basis that this is a recurring problem, and you’d expect a government that is conscious of the problems of the country to put systems in place, proper planning to avert such occurrences. We wrote to the department late last year, towards the end of November, early December, indicating that this has been an ongoing problem and we do not want such a situation to recur in 2024.

We requested from the departments, all nine provincial departments and the National Department of Health to say, what plans have been put in place to avert this occurrence. And I kid you not, we did not receive even an acknowledgement of our correspondences.

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It shows you the lethargy that the Department of Health, the nine provincial departments, and the national department for that matter, that they’re operating at, there’s really no eagerness or zeal to solve the problems of this country.

JEREMY MAGGS: So it seems to me that you’re at a crucial crossroads. Now, what’s your next step?

CEDRIC SIHLANGU: We believe that health by constitutional right and by legislation, the authority that is to ensure there’s adequate provisioning of healthcare services is the ministry of health. But more importantly, (we take a dim view of) a minister (Joe Phaahla) that says, well, I do not have money, the money is with the minister of finance (Enoch Godongwana) and pointing fingers to another arm of government, as it were.

Read: Budget woes mean SA doctors jobless while hospitals battle Covid [Jan 2021]

We believe that the ultimate person to account when everything is said and done is the president of the republic (Cyril Ramaphosa) and if there’s a failing healthcare system, ultimately, the president must account because a minister of health who points to a minister of finance who points to thin air does not serve in solving the problem. Our position now is that the president must account on a failing healthcare system, on how this problem will be resolved.

JEREMY MAGGS: How close are we, given what you’ve just outlined, are we to a collapse in the rural health system in this country?

CEDRIC SIHLANGU: I would go as far as saying we are experiencing a collapse because when you go to a facility in the rural areas, the outskirts, ordinarily now you find only one doctor rotating per week. Already that means that all these conditions are becoming more and more chronic, and a simple condition that could have been resolved at a preventative stage or at an early intervention stage becomes all these types of cancers that are far advanced that we can’t do anything about.

Literally, people are being subjected to a conviction to death, if you would want to use those harsh terms because the system is simply not coping in the rural areas, and people are dying, and that’s the unfortunate reality.

JEREMY MAGGS: Dr Cedric Sihlangu, thank you very much indeed.

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