Public Health News South Africa

National plan needed to address critical doctor shortages

Speakers at the Hospital Association of South Africa (HASA) annual conference indicated that unless South Africa's critical shortage of doctors is addressed, South Africa's healthcare system will not remain sustainable.
National plan needed to address critical doctor shortages
© Luis Louro – 123RF.com

Executive government and stakeholder relations at Medi-Clinic, Dr Nkaki Matlala said a national plan would require political will from all sides. "Whether from the public or private healthcare sector, we have come to realise that we are all serving the same population and our ideas need to converge on this issue."

With just six doctors per 10,000 people versus a global average of 15, South Africa was well below its peers. About half of all doctors registered with the Health Professions Council of South Africa (HPCSA) are working outside South Africa.

"Over the past twenty years, there has been a rapid increase in demand for healthcare in South Africa but there hasn't been a shift in supply of doctors," said Jonathan Lowick, Group executive: Business Development & International at Life Healthcare.

Regulatory and bureaucratic forces limited the number of doctors to meet demand. As a result, doctors migrated out of the public sector into the private sector and overseas.

Lowick said draconian restrictions on registering foreign doctors should be lifted and plans for more doctors and nurses trained put in place. He said just 1,409 doctors were trained in 2014 in eight state-run medical colleges, a small increase from the 1,229 trained in 2001.

"We should really look critically at our regulations and what they are doing to restrict training of doctors. Until then we are just tinkering with the system, and not addressing the fundamental problems."

Regulations prohibiting corporates from employing doctors should also be reviewed and were not global best practice.

"When institutions can't employ doctors, the result is expensive, uncoordinated care," said Lowick. "It also complicates the development of centres of excellence and inhibits innovation."

Chairman of JMH, Dr Ramesh Bhoola, said there was a severe shortage of training posts in the public sector for doctors who wanted to specialise. There were also limited opportunities and supporting infrastructure for doctors to conduct research. "Local universities could collaborate with overseas universities and doctors could do their clinical work in South Africa. In this way we could easily increase the number of medical graduates."

He added that private sector hospitals had capacity to train doctors but establishing private medical colleges would need buy in from a range of institutions.

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