Empty promises from government or will it hire doctors by April?

Connie Queline

Empty promises from government or will it hire doctors by April?

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Interview starts at the 16:00 mark

JEREMY MAGGS: Well, the health minister, Joe Phaahla, has announced government is to hire hundreds of unemployed doctors who’ve completed their community service training. The minister of finance (Enoch Godongwana), so he says, is going to give more details when he tables the budget in parliament next week, Wednesday. So is this feasible, this concept of hiring, where are the risks? Where are the priorities?

Listen/read: 800 doctors available, government hospitals not hiring

Joining me now is Dr Mvuyisi Mzukwa, who is the chairperson of the South African Medical Association (Sama). Dr Mzukwa, welcome to you. So how feasible do you find government’s plan, given previous concerning statements about a lack of funds?

MVUYISI MZUKWA: Well, we just hope as the South African Medical Association, that the minister was not just making a political statement or some sort of electioneering. We hope it was a genuine statement because we know those are young people who are looking for jobs.

But also, we have known in the past that there are statements like this that have been pronounced, but they never came to fruition.

But as the South African Medical Association, we are going to follow up on those statements to make sure that the minister materialises what he promised to the nation.

JEREMY MAGGS: Doctor, what do you see as the potential risks, financial or other, and the difficulties then associated with this hiring plan, and if there are, how would you suggest that they are mitigated?

MVUYISI MZUKWA: Well, I do think that one, we have to make sure that the money that is given out by Treasury is used efficiently by the Department of Health because you’ve noted that in the past, money has been taken back to Treasury because there was underspending in the provinces. So that’s one thing, I think that provinces would need to be capacitated in terms of using monies efficiently.

Read: Alarm over hiring freeze at Western Cape’s largest hospitals

The other thing is, I don’t think we should only be looking at what is happening now in the Department of Health because we don’t believe that this is sustainable. We might need to look at the private sector as well, in terms of making this sustainable in terms of populating those primary health sectors in the communities. Otherwise, if we depend on the state, this might not be sustainable, looking at the numbers that we’re getting out of the medical schools each year.

JEREMY MAGGS: What are your concerns about sustainability? Is it capacity, management or money?

MVUYISI MZUKWA: It is a combination of factors, Jeremy, because if you look at the reports by the Health Ombud and many other institutions that they’ve pronounced on the challenges that we have in the healthcare system, they have mentioned leadership and governance as challenge number one. But the other thing is that we had problems with cadre deployment where you find that we put people who are not capable of leading in those institutions.

Read: Call to stop ‘catastrophic’ healthcare budget cuts

So finances are just one part of it, but the major part is that we’ve been having these problems, but also the inefficiencies that I mentioned earlier and the corruption that is in the system. So those need to be factored in when we are trying to overhaul the healthcare system.

JEREMY MAGGS: So let’s talk a little bit about the provincial side of the dynamic, and it’s important then in order for maximum capacitation to be affected. So how can these departments integrate the new hires into their systems by the target date and make sure that they’re up and running and delivering a service?

MVUYISI MZUKWA: I think the most important part with the provinces is planning. We’ve noted, Jeremy, that there’s poor planning in the system. If you look, for example, what has been happening in the provinces, taking students to other countries abroad and dumping them there because they cannot sustain (them) financially. So I do think things like that need to be corrected.

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Secondly, it can’t be that when a country is planning, there is fragmentation of that plan. Provinces are doing their own thing. National government is doing their own thing. It’s one system, we need to be attending to the Department of Health, that includes the private sector as well. Where there is healthcare delivery, I think all government should be cognisant of those areas.

But what needs to happen now is that provinces must capacitate their leadership and governance. They must make sure that resources are available, especially in the rural areas, and make sure that those posts that are out there are populated.

JEREMY MAGGS: How do you make sure that the young doctors who are potentially placed in these areas are sufficiently motivated and committed?

MVUYISI MZUKWA: It’s always important to, first of all, look at the work environment. The work environment, as you know, we’ve got serious challenges like broken equipment, poor resourcing, these issues are important when you are to support the work of healthcare workers because they can’t deliver quality health services when actually they don’t have these support structures, supporting technologies and stuff like that.

So you do need to make sure that x-rays are working, MRIs are working, but also there’s enough security in those areas.

But the well-being of healthcare workers also is taken into consideration. These are not robots. These are human beings. They need to be taken good care of.

Those Employee Assistance Programmes (EAP), they need to be revived so that if there are any challenges mentally, those young doctors can be assisted, and also make sure that they progress in their careers.

JEREMY MAGGS: Notwithstanding your concerns, would I be correct in saying that there is the possibility that if these doctors are optimally placed, it should have a positive impact on the overall quality and accessibility of healthcare services?

MVUYISI MZUKWA: There is no doubt, Jeremy, because if you look at the report that came from the World Health Organisation (WHO), it tells us that 90% of the universal health coverage interventions happen at a primary health level.

So if you populate those areas, it means already you are advancing the goal of universal health coverage.

So if you get those doctors to populate those areas, I am sure that it would be very good planning, considering if that plan is implemented. If it’s not implemented, it’s just a promise that is not helpful, not only to the doctors, but also to the population at large.

JEREMY MAGGS: You’ve raised a number of concerns about this decision. Do you have any plans to raise this with the health minister?

MVUYISI MZUKWA: Yes, we’ve already had one meeting that we had with the department. There will be a follow-up meeting where we want to especially engage the minister on the plans regarding these healthcare workers who he promised to place, but also many other issues that we want to raise with the minister, especially looking at the deterioration of healthcare infrastructure and many other things that are affecting the healthcare system. As the South African Medical Association, this week from Thursday until Saturday, we are having a conference that looks at the strengthening of the healthcare system in South Africa.

JEREMY MAGGS: I’m going to leave it there. Thank you very much indeed, Dr Mvuyisi Mzukwa from the South African Medical Association, he is the chair.

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