Shortage of doctors is beyond critical

August 5, 2011

According to the Health Professions Council of South Africa, more than 37 300 doctors are registered in the country and almost 12 300 of them are qualified as specialists. But what is not known is how many of these doctors still practise here.

There are also no figures to indicate how many of these practitioners are working abroad, either permanently or temporarily. Estimates vary, but an educated guess by the council is that just more than half of the registered doctors are practising in South Africa.

Needless to say, with the country’s population now well over the 50-million mark, this is a healthcare disaster waiting to happen. In the United States there are 901 nurses and 247 doctors per 100 000 people. South Africa has 393 nurses and 74 doctors per 100 000 people. This translates to 0.57 doctors per 1 000 patients, which is a dire situation, even compared with Brazil’s 1.8 and Mexico’s 1.9 doctors per 1 000 people.

Statistics pertaining to our public health sector make even more grim reading. Only about 30% of all our doctors work in the public sector. The rest earn their living caring for 16% of our population who are fortunate enough to be able to afford private medical insurance or pay for private healthcare when needed.

A survey reported that 23 407 South African-born doctors were practising in Australia, Canada, New Zealand and the US, whereas a mere 11 332 doctors were employed in the South African public sector. Bearing the brunt of this shortage are rural areas, where 46% of the South African population resides.

Healthcare professionals are reluctant to relocate to these areas. Although a few of the posts in our rural state hospitals are filled by -doctors from the United Kingdom, the US and Europe, they are too few and their postings are only temporary.

Alarmingly, vacancies in the public health sector remain high because of difficulties in recruitment and the freezing of posts owing to budget cuts. Almost 35% of medical practitioner positions and 40.3% of professional nurse positions were vacant in 2008. Expect these figures to be far higher today.

In fact, statistics revealed in Parliament recently indicated that South Africa needed an additional 46 000 nurses and 12 500 doctors to treat state patients. Filling these posts is a challenge our eight medical universities have little or no chance of overcoming. To maintain the number of doctors we have now, we should train at least 2 400 new ones a year, but our universities produce no more than 1 200 doctors annually — and it is estimated that half of them will emigrate.

This article originally appeared in the Mail & Guardian newspaper as a sponsored feature

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