SA’s doctors are jumping ship – Premiers, MECs, hospital CEOs are to blame

The crisis-ridden South African public healthcare sector might see an exodus of doctors to the private sector, with some seeking greener pastures abroad, due to bad working conditions and the muzzling of medical practitioners from speaking out on the poor state of public hospitals.

A young Cape Town general practitioner – among many doctors frustrated by the country’s public health system – has tweeted about her experiences and her plans to open a private practice in the city’s Loop Street later this year.

She said: “It’s embarrassing to work in the public healthcare services in South Africa because nothing is ever improved to a new standard – everything is just lip service, with [no] actionable and real change.

“Remember Dr Tim de Maayer from last week? There are many more doctors like him.”

De Maayer was suspended recently for speaking out against the poor conditions at the Rahima Moosa Mother and Child Hospital on the West Rand which, he said, directly caused the deaths and disabilities of children.

The Cape Town GP has described De Maayer’s treatment by his bosses as “trying to hush up a dedicated doctor who just wanted to expose the atrocious conditions that we serve our patients in”.

“The reason for the outcry from healthcare workers is because we could all relate – it’s truly awful here.

“You work for three to four years to become a specialist: paid or unpaid, whichever way you manage it, still no public work. What do you do? Private practice.

“Let’s take it a step further, you want to specialise in an area of interest. Again, no registrar posts to begin with. There is fighting and competition.

“Let me let the secret out: doctors [in the public sector] are working for free, so that they can specialise – creating a new cycle.

“Our healthcare services aren’t just doctors: it’s nurses, radiographers, pharmacists, physio, administration and cleaning staff.

“We’re a living organism with a failing system of management – a shocked gastro with no resus equipment during load shedding.”

ALSO READ: Suspension lifted for doctor who blew whistle on state of Rahima Moosa Hospital

Agreeing about the public healthcare sector being “in a state of disaster”, SA Medical Association chief executive Dr Vusumuzi Nhlapho conceded the exodus of doctors from the public sector was driven by the poor work environment.

“It would certainly be a factor,” said Nhlapho.

“Their work environment is poor, lack of resources, including medical equipment, inadequate security resulting in the attack of medical doctors, patients and other healthcare workers.

“There is a staff shortage, leading to excessive overtime worked by medical doctors.

“We also see unsubstantiated and unfounded disciplinary action taken against medical doctors, like Dr De Maayer.”

Sama said the De Maayer incident was “nothing more than a vindictive attempt by hospital authorities to silence a critic of their poor administration”.

Dr Angelique Coetzee, of the of the Solidarity Doctors Network Advisory Committee, said: “We cannot afford doctors and nurses to keep quiet when they see everything is going down the drain. When healthcare workers resort to speaking out is when they have already exhausted recommended channels. [It is] an obligation to … patients.

“You cannot treat patients if there is no running water or there is lack of medicine, generators.

“Doctors have an ethical obligation towards their patients to make sure they get the right care.

“Doctors leave the country, not because there is no career progression, but because of the poor state of hospitals and clinics, where they work.

“It is now enough. The premiers, MECs and CEOs of hospitals have to take full responsibility.”