South Africa’s specialist doctor problem

Fewer specialist doctors are being trained in South Africa as their educators instead choose to prioritise work in the private sector.

Speaking to the Sunday Times, Dr Chris Archer, chief executive officer of specialist doctors group the South African Private Practitioners Forum, said that the issues primarily stem from the Remunerative Work Outside Public Service (RWOPS) policy.

This policy allows specialists on the government’s payroll to work in the private sector. However, this has had the knock-on effect of doctors prioritising their private-sector work over responsibilities such as training students, he said.

Speaking to the paper, consultancy firm Healthman said that in extreme cases it had seen specialists running five private practices while earning a full-time salary from the government.

Dean of the Wits Medical School, Martin Veller, also acknowledged that the policy had caused issues with training.

“It has a (negative) effect on training, particularly in settings where it is not adequately controlled. On the other hand it has also resulted in the retention of some specialists in the public sector,” he said.

The latest statistics show that there are nine specialists for every 100,000 patients in state hospitals. Government has previously set a target of 42.46 specialists for every 100,000 patients.

Doctor shortage

While a possible shortage of specialist doctors is a growing concern, Health minister Dr Zweli Mkhize says South Africa is also facing a general doctor and nurse shortage due to a lack of funding.

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: How government plans to convince private doctors to work in the public sector under the NHI

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South Africa’s specialist doctor problem