SA’s ailing health sector has made itself sick

In a country with an estimated public sector doctor to patient ratio of 2 457 to one, you would expect the government and all its stakeholders to be doing everything in their power to ensure that more doctors are recruited, and that the process is made as easy as possible for competent medical practitioners to enter the workforce.

One would expect that the department of health and the Health Professions Council of South Africa (HPCSA) would be bending over backwards to assist the approximately 1 800 annual medical school graduates, and ensure they can comply with the legal requirements placed on them before they are allowed to practice in the country.

One would expect a similar willingness to assist experienced foreign doctors who are willing to move to SA, despite our massive workloads and relatively meagre salaries.

But this is South Africa! Of course we’re not doing that.

Health Minister Aaron Motsoaledi has in the past bemoaned the slow pace at which we train health professionals, and complained about other countries poaching our doctors, nurses and other healthcare workers.

Meanwhile, this past week I accompanied someone to the HPCSA’s headquarters in Pretoria, where interns and community service doctors are expected to register before being allowed to practice.

Despite us living in 2018, I was surprised to see the registration process is still very much stuck in the 19th century.

Junior doctors were expected to hand in paper logbooks, which were manually verified, while they were made to wait outside for several hours (those who dared wait in the air-conditioned waiting room were chided like children). After a few hours, the applicants were then allowed to pay their registration fee before another wait, after which they were finally given their registration certificates.

Our five hour ordeal was apparently small fry compared to those who chose to use the HPCSA’s provincial roadshows to do their registrations.

We also heard of several people being denied registration, due to “tiny smudges and tears” on pages of their logbooks, with the HPCSA officials’ words being law.

Add to this the recent tales of lauded medical professionals, such as Dr Francoise Louis, without whom South Africa’s HIV treatment protocol would not exist, being forced to leave the country due to the HPCSA’s ineptitude, and one can see why our doctors no longer want to work in South Africa.

But in the words of the great Billy Mays, “That’s not all!”

Interacting with several healthcare workers in recent months, I have heard tales of four doctors being forced to share single beds in call rooms, during 36-hour calls.

I have seen the Canadian health department respond to an enquiry from a local doctor within less than 24 hours, on how they can assist her in emigrating, while she failed for two weeks to reach the local health department’s call centre.

While our skilled doctors are being lured to greener pastures, our health department pats itself on the back for placing 1 465 community service doctors in posts.

All it takes, however, is a cursory glance over the Junior Doctors Association of South Africa’s various social media channels to see complaints from some of these doctors, that their allocated facilities say there is no money to fill these posts, hence they will be unemployed in the new year.

So, in short, we are facing a massive shortage of healthcare professionals, which will only worsen with the planned implementation of the National Health Insurance.

And while the bureaucratic bungling of our regulatory bodies seem to be driving more of our doctors and nurses out of the country, our health department engages in PR exercises. These do nothing to ease the burden, and instead shows them to be as bad at lying as they are at doing their jobs.

Earl Coetzee.

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