Organisations representing medical professionals were fuming over the government’s move to import specialist doctors and nurses to work in the public health sector.
Some detractors said the sector was already on “life support” and the shortage of specialist doctors and nurses was due to the government’s negligence, lack of foresight and ignoring role players’ warnings.
This comes as the Department of Home Affairs published a “critical skills” notice which was gazetted last week. This meant that foreign doctors would now be needed to fill the skills deficit.
Specialist doctors in more than 30 medical disciplines were listed as wanted, including surgery, dentistry, anaesthesiology, pathology, obstetrics and gynaecology.
The country also lacked specialist personnel skilled in five nursing disciplines such as paediatrics, intensive and trauma care.
The DHA initially published their critical skills list in February.
However, after engagements with the health ministry, South African Nursing Council, Health Professions Council of South Africa, and other bodies and experts, the DHA revised the previous list and gazetted the latest version last week.
Dr Aaron Motsoaledi, the Minister of Home Affairs, who was the former health minister, said the latest listings would contribute positively towards the country’s skills deficit.
Christopher Tsatsawane, the HPCSA’s spokesperson, singled out the “production rate” of specialists as the key reason for the shortages.
“Training institutions have not increased their capacity to produce specialists in line with the population growth. We also lack the right infrastructure for training advanced specialists,” he said.
Foster Mohale, the health department’s spokesperson said the biggest challenge was retaining skilled medical professionals as many were lured into emigration or private practice.
“This is a concern. Attractive salary package offers makes it difficult to retain some of them,” he said.
Mohale said they had a strategy to retain scarce skills but conceded that it wouldn’t completely stop the brain drain.
He said they hoped that the roll-out of the “National Health Insurance Model” and the recently signed “Human Resources for Health 2030 Strategy” would alleviate such challenges.
The department’s equitable share and human resources training grants provided opportunities for general practitioners (medical and nursing) to enlist for their registrarship and qualify as specialists in scarce fields of study, Mohale said.
He said his department strived towards building healthcare capacity to match the demand, and that the existing medical universities produced enough skills.
Sibongiseni Delihlazo from the Democratic Nursing Organisation of SA said they were “extremely angry that we have to import specialist nurses because of the government's actions.”
Delihlazo accused the government of neglecting nursing for a long time.
“The number of nurses the country produces each year continually decreases instead of increasing, and numerous nursing colleges have been shut,” he said.
He said the World Health Organization had done studies on the state of nursing around the world, in April 2020, and concluded there would be a 10 million worldwide shortage of nurses by 2030.
For all countries to avoid catastrophic consequence they needed to produce 8% more nurses each year.
“Our country has not adhered to the warning, but has done the opposite,” he said.
Delihlazo said most nursing students were funded by the government, which has been reduced, yet the population continues to grow and more people relied on the public healthcare system.
He noticed health departments were reluctant to release nurses in their employ for specialist training, which happened over a year.
“They are not in a position to let go of the nurses for training as their respective systems will crumble due to nursing shortages. Nurses are being held to ransom,” he said.
Delihlazo said the country’s nurses were targeted by first world nations, and some recruitment agencies were permanently positioned in the country, scouting for local nurses.
“We could have produced our own nurses in a country with serious unemployment issues. The government doesn't have a strategy to keep our nurses,” he said.
Dr Anil Bramdev, spokesperson for the KZN Specialist Network also took aim at the lack of registrar training posts.
“Specialists can only be trained in State institutions. Unfortunately, there are no private training facilities. There have been efforts to open private institutions, but they were not given the required licences.
“We are totally dependent on public institutions attached to universities to train specialists. Registrar posts have been restricted in numbers and in terms of racial quotas,” he said.
Bramdev said in some provinces, especially in KZN, specialist posts were frozen if candidates were not of a particular race group.
“It was very frustrating for young doctors who were on the waiting list and we lost skills in that way,” he said.
Bramdev said his organisation had offered assistance to the public sector over the years, but they were not received by health officials.
Claude Naiker, the Public Servants Associations’ national manager said they had previously criticised the health department when Cuban doctors were “shipped” in to assist the countries predominantly public hospitals while a number of newly qualified local doctors were overlooked for placement at the very same institutions that the Cubans were placed.
Naiker said given the country’s high unemployment figures, employing foreigners will only worsen this problem and place the country in a deeper crisis situation.
He suggested that the government reconsider their decision and make an urgent effort to first consider skills that are available in this country before going abroad.
Zanele Bikitsha, the South African Medical Association’s KZN spokesperson, said they addressed their concerns with the health department a while ago but they were not adhered to.
Narend Singh, the IFP’s chief whip, said the critical skills list “shocked them”.
“We have hundreds of South African foreign-qualified medical professionals awaiting integration into our public healthcare system. While we recognise the difference between a medical specialist and a newly qualified medical doctor, the situation still points to a serious incapacity in the country in respect of adequate medical training facilities for our own medical professionals,” he said.
Michele Clarke, the DA’s spokesperson on health said the skills shortage was “unbelievable”.
“We should make available more training facilities, especially for nurses, and the government should look at partnering with the private sector regarding training.
“Public healthcare in our country is on life support,” Clarke said.
SUNDAY TRIBUNE