No money to hire new doctors in South Africa

 ·13 Jan 2025

The South African Medical Association (SAMA) has raised its concerns about at least 1,800 junior doctors nationwide who have completed their community service but remain jobless—while the health department says it has no budget to hire them.

“South Africa is having a serious problem with the number of doctors per population… at 0.3 per thousand… way less than what is recommended by the World Health Organisation” of at least 2.5, SAMA chairperson Dr Mvuyisi Mzukwa told the SABC.

He added that, as an example, the crisis is further underscored by the drastic decline in intern posts at Groote Schuur Hospital, which has plummeted from 120 in 2022 to 34 in 2025.

Public Interest SA called this “both a national disgrace and an indictment of the inefficiencies within our healthcare system.”

“Such developments are symptomatic of a public healthcare system teetering on the brink of collapse,” added the group.

Health department officials alerted Parliament last year that budget cuts had impacted hiring at both national and provincial levels, with significant consequences.

National Treasury allocated R267.3 billion for health expenditure in 2023/24, increasing to R271.9 billion in 2024/25, R281.1 billion in 2025/26, and R295.2 billion in the outer year.

However, this represents a 3.4% nominal increase, falling short of the forecast inflation rate of 4.7% for the same period.

Health Minister Dr Aaron Motsoaledi said that unemployment is not exclusive to the medical field and that budget constraints have tied their hands.

“The issue of unemployed graduates has been ongoing for a while, and it’s not only doctors. Yes, there is a shortage of doctors in 90% of the world, but to hire them, you need resources,” Motsoaledi told Newzroom Afrika.

“We are facing very serious austerity measures and crippling budget cuts, which affect our ability to hire doctors and perform many other functions.

“We do understand the grievances of doctors, but in the final analysis, you cannot hire someone if you don’t have the means to pay them, and that’s the situation we are in,” added the Minister.

Mzukwa strongly rebuked this, saying that this is an example of a “government that is unable to plan” and claiming that it “is not caring for its population.”

The SAMA chairperson referred to the programmes in which South African medical students are sent to Cuba and Russia for training, and vice-versa, at a price tag double that of studying locally.

He said that it is unacceptable to have 1,800 unemployed doctors in a country already facing a healthcare shortage, contributing to poor service delivery and affecting other healthcare professionals as well.

Mzukwa said that doctors are going to leave and go to other countries—taken by Canada, New Zealand, the UK.

“This means the government is wasting taxpayers’ money, training doctors for other countries instead of training them for their own,” said Mzukwa.

“These young doctors are highly skilled, highly educated, and you cannot allow that skill to be wasted without absorbing them into the system,” he added.

Motsoaledi said that any job, whether for doctors, nurses, or teachers, requires a budget, and jobs must be advertised.

“There’s no ‘absorption’ — it’s about applying for advertised positions,” said the Health Minister.

He said that the Department is having regular discussions with Treasury about our needs in health, especially due to austerity measures

NHI ready?

Health Minister Dr. Aaron Motsoaledi

Critics argue that with the government pushing for the rollout of the National Health Insurance (NHI), the current situation does not bode well for it.

Motsoaledi said that “many people don’t understand that NHI is not a health system that’s implemented once we have all the doctors and facilities.

“NHI is a healthcare financing system that aims to address the very issues they are raising, like the uneven distribution of resources,” said the Minister.

According to the WHO, a country must spend at least 5% of its GDP on healthcare to provide good services. South Africa already spends 8.5%, which is comparable to European countries.

However, he said that the problem is how that money is distributed — 51% of it goes to support only 14% of the population, while 86% of the population is left with the remaining 49%.

“NHI is designed to address this inequity in health financing.”

When asked whether the NHI would be able to address the issue of unemployed doctors and doctor-to-patient ratios, Motsoaledi confidently proclaimed that it will be.

“Once resources are distributed equitably, we will be in a better position to address the shortage of doctors.

“While no country has fully solved this issue, the goal of NHI is to redistribute resources more fairly and ensure that healthcare is available to everyone, not just the wealthier 14%,” said Motsoaledi.


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