South African healthcare workers say they are emigrating because of the NHI

 ·30 Oct 2019

Trade Union Solidarity has released a new report on the incoming National Health Insurance (NHI) and its impact on the healthcare industry.

Nicolien Welthagen, a research psychologist at the Solidarity Research Institute, said that the report is based on questionnaires sent to healthcare practitioners in the private as well as the public sector across the country.

The general feedback shows that healthcare practitioners have huge concerns about the proposed NHI.

“The findings indicate that there is distrust towards the government regarding the way they want to implement and manage the NHI. 80% of respondents are negative or sceptical about the NHI,” said Welthagen.

“According to the results of this report, the respondents do not believe that the NHI will succeed in improving the healthcare system and service delivery.

“Only 15% of respondents believe that it would be possible to successfully implement the NHI, and 84.5% are of the view that the implementation of the NHI could destabilise the healthcare system in South Africa and could harm the high-quality service already being provided by the private sector,” she said.

Welthagen added that the report further highlights the enormous risk that the emigration of health practitioners poses to the future of healthcare in South Africa.

“There are serious concerns about a shortage of healthcare workers, the more so in view of the fact that 20.8% of the respondents indicated that they had already taken steps to emigrate, and a further 41.06% would consider emigrating when the NHI is implemented,” Welthagen said.


In an August interview, Dr Chris Archer, CEO of the South African Private Practitioners Forum, said that his members are extremely concerned and that the bill may drive emigration as “those who want to leave see it as a reason to do so”.

Profmed medical aid CEO Craig Comrie said that health professionals are already emigrating.

Comrie said Profmed’s members are mainly health professionals, of whom 17% leave each year. This rose to 30% in June and July.

Alex van den Heever, Wits School of Governance professor, added that he expects medical professionals to emigrate in their hundreds, joining their countrymen in countries like Dubai and Australia.

Doctor shortage

South Africa is also currently facing a doctor and nurse shortage due to a lack of funding, says health minister Dr Zweli Mkhize.

Responding in a recent parliamentary Q&A session, Mkhize said that the primary reason for this shortage is that the public health sector budget has not increased in real terms for the past 10 years.

This has impacted the number of staff that can be appointed, he said.

Mkhize added that the demand for health services in the country is increasing while there is no additional funding to address the change, which results primarily from immigration into the country and the increasing burden of disease.

“The shortage of health professionals is a global phenomenon and is more pronounced in low and middle-income countries as health workers are more likely to migrate to upper-middle-income countries in search of better living and working conditions,” he said.

Read: South Africa is facing a doctor shortage – here’s why

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