South African Medical Association sends warning to government over doctors and other professionals

 ·12 May 2022

The South African Medical Association (SAMA) says that the government is setting up the country’s healthcare sector to fail by not hiring or training enough doctors or nurses and other healthcare professionals.

Responding to comments made by health minister Joe Phaahla this week that the country currently has a doctor-to-patient ratio of only 1 doctor per 3,198 people. Phaahla described it as a ‘shocking state of affairs’.

SAMA chairperson Dr Mvuyisi Mzukwa said that the figure lays bare South Africa’s healthcare problem – where the sector is understaffed, overworked, and money meant for equipment or patient care is funnelled elsewhere.

“If you allow one doctor to attend to such a large population…the quality of service is going to be compromised, and that can lead to litigation. The money that has been given to provinces won’t be going to services, it will be going to litigation,” he said.

Mzukwa said that, unless the government sorts out the issue of staffing, it won’t solve the “problem on the ground”.

“Healthcare professionals are exhausted. We’re post-pandemic, or still dealing with the pandemic, but we’ve been through this for two years,” Mzukwa said. “They (healthcare workers) are incapacitated. Instead, you get lip service from the health minister, calling them ‘frontline warriors’ – but who is supporting them? Who is capacitating them?”

Phaahla acknowledged the need for more healthcare workers in his budget speech, and announced that at least R7.5 billion had been set aside for the hiring and training of community healthcare workers and medical interns over the next two financial years.

He said that 2,429 medical interns, and community service personnel – amongst them doctors, nurses and pharmacists – were employed during the current financial year.

“Progress has been made with regards to the stability in the employment of more than 47,000 community health workers, even though more work still needs to be done to finalise the nature of their long-term engagement,” he said.

R2.1 billion has been allocated over the next two financial years for medical interns, and a total amount of R5.4 billion has been allocated in the coming financial year to support various aspects of Health Professions training in provinces, including additional personnel where necessary, he said.

Despite this, the Democratic Alliance has pointed out that 21,000 specialist medical personnel posts are still vacant across all nine provinces, which the national Department of Health has yet to fill.

Health stakeholders have previously raised concerns about the number of healthcare professionals in the country, warning that South Africa could see an exodus of doctors and other key medical personnel ahead of the planned introduction of the NHI scheme.

There is also a growing concern that the country could also lose valuable training skills as professionals look to leave.

Briefing parliament in March, the Department of Health noted these concerns, adding that the NHI will need skilled personnel to function. It said that this was not limited to healthcare professionals, but that general skilled human resources will be central to the health system going forward.

It added that the complex interactions between training, registration compliance and employment can all be substantially improved.


To compound matters, health industry experts warned in March that the country could see an exodus of doctors and other key medical personnel ahead of the planned introduction of the National Health Insurance (NHI) scheme.

SAMA warned that thousands of doctors will leave the country ahead of the planned introduction of the NHI.

The not-for-profit group, which represents the interests of more than 12,000 medical doctors in South Africa, said that its members cannot support the NHI in its current form.

This is because of a deep-rooted lack of confidence in the capacity of government and its financial ability to ensure the success of the service, it said.

A survey conducted by SAMA showed that as many as 38% of its members plan to emigrate from South Africa due to the planned introduction of the NHI.

6% of members said that they plan to emigrate for other reasons, while 17% of doctors said that they were unsure about leaving the country.

Read: Government using Covid-19 as a jump pad for the NHI: minister

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