South Africa has a critical shortage of doctors, with fewer than one doctor to treat 1 000 patients. This was confirmed by the national health minister Joe Phaahla in an answer to a parliamentary question from the Democratic Alliance.
According to the DA, Phaahla revealed that the country’s doctor to patient ratio is 1:3 per 198 patients and 0,31 doctors per 1 000 patients, and the number of doctors is on the decrease.
In 2019, South Africa had 0.79 doctors per 1 000 patients — already poor when compared to the United Kingdom (3,03), India (0,93), Brazil (2,32), and Mexico (2,44).
Michéle Clarke MP — DA Shadow Minister of Health said this shocking state of affairs persists despite the more than 21 000 specialist medical personnel posts which are vacant.
The posts, which the national Department of Health is yet to fill, are vacant across all nine provinces, said Clarke. She said there was a serious issue with the payment of salaries for some of the doctors, nurses and interns in various hospitals, with some being paid late.
She said this raises questions about how the government plans to manage the National Health Insurance (NHI) project when they are unable to make the current universal healthcare system in South Africa work.
NHI ‘a pipedream’
Clarke said government must increase the numbers of qualified medical personnel working in South Africa’s current public health care sector, before beginning to think about the NHI.
“R8,8 billion has already been allocated towards the NHI. Why is this money not used to alleviate the critical shortage of medical personnel? The DA calls for these funds to be redirected towards the training and employment of doctors and nurses, and the development of nursing colleges.” said Clarke.
Clarke said the party is still going to ask follow-up questions about the number of general practitioners and specialist medical personnel there are nationally and in each province, and the ratio per population.
She said they will ask about the average waiting time at hospitals and clinics nationally and per province.
“South Africa’s current healthcare problem cannot be alleviated by pipe dreams. These serious concerns must be addressed head-on with practical and pragmatic solutions,” she said.
Dr Mvuyisi Mzukwa, chairperson of the South African Medical Association, said they are aware of the serious shortage and they have made numerous calls on government to employ more doctors. “It has been like a song now, telling the government that there is a dire need to decrease the shortage of doctors in the country.
“We have even gone as far as indicating the implications of this shortage,” said Mzukwa.
Increased chances of mistakes
Mzukwa said those that remain in the system experience burnout and that increases the chances of litigation.
He said whenever a single doctor sees more than 100 patients, there is an increased chance of that doctor making mistakes due to fatigue.
“The department needs to start looking at this carefully. They are paying more and more for litigation and to address this, they should employ more doctors to limit fatigue.
“There are also several patients being turned away without seeing a doctor after spending a whole day at a health facility. This is because there are just too many patients while there is only one doctor.
“You find that people now get frustrated and take it out on the staff because they think they are lazy and not working, but there is just too much for them to do,” he said.
In every meeting with the department, the issue of the shortage of employed doctors has always been on top of the agenda.
Doctors leaving SA
Mzukwa added that another major cause for the shortage was that doctors are leaving the country to work in other countries due to remuneration, work conditions and safety reasons.
He said the public health facilities are in a bad condition with broken machines, and doctors find themselves being abused and criminalised.
KwaZulu-Natal secretary of the National Education, Health and Allied Workers’ Union (Nehawu), Ayanda Zulu, said the union has been raising the issue of the high vacancy rate in the health sector for a long time.
“Public service is extremely understaffed which affects service delivery in the hospitals and the general functioning of the hospital.
“That’s why Nehawu has been saying if you need to address the crisis in our health system, the most fundamental part is to fill in the existing vacancies prioritising both clinical and non-clinical occupations,” said Zulu.
Zulu said the clinics were the centre for the provision of primary healthcare. He said often, the public will wait for doctors at the clinics yet in other countries there are doctors stationed at the clinic.
Attempts to get hold of the department for comment were unsuccessful.