The health department says the problems with placements are overstated but experts wonder if provincial budgets are coping with rising costs.
Health Minister Aaron Motsoaledi has denied that problems with placing new medical graduates are widespread.
Earlier this week, Bhekisisa reported that more than 200 doctors and pharmacists around the country were waiting for their permanent or community service positions to be confirmed. Newly graduated medical professionals must complete at least one year of community service before they can register with professional bodies and practise. Doctors must also complete an additional two years as interns.
Speaking to the media on Thursday, Motsoaledi said that all new medical graduates in need of community service positions or internships have been placed.
Motsoaledi also disputed the accuracy of a list of 135 newly graduated doctors in need of internships or community service positions. The list has been circulated by the Junior Doctors Association of South Africa (Judasa) and was widely quoted in media reports.
The health department compared the list with its online database and found that 13 doctors had already been placed. Another 12 physicians were among 22 doctors nationally who had declined their assigned community service positions, he said.
Motsoaledi said there are currently 147 permanent positions open for doctors in the country’s public health system.
Professional bodies such as Judasa and the Pharmaceutical Society of South Africa also alleged that a new electronic system introduced to help streamline placements had added to delays. Motsoaledi acknowledged the system had caused some delays. But he stressed that health professionals continue to shun placements in under-resourced rural areas in favour of cities and that this complicates the placement process.
The minister said the conflicting information about the numbers of doctors not placed may stem from the fact that available posts may not necessarily be in facilities that doctors prefer. “However, we select these facilities according to the needs of the population,” he said.
Bhekisisa previously reported that some pharmacists would complete community service in the private sector because of a shortage of traditional community service positions for all the new graduate pharmacists. Although the move has sparked controversy, Motsoaledi says that these pharmacists will serve in the public sector as part of the department’s public-private partnership to distribute chronic medication outside clinics and closer to patients’ homes.
The health systems and policy manager at the Rural Health Advocacy Project, Russell Rensburg, says the delays in placements may also be attributed to austerity measures.
Rensburg told Bhekisisa earlier this week that provincial health budgets have almost doubled in the past 15 years, yet have not kept up with the rising cost of employing people. Employee compensation now accounts for about 65 % of provincial health expenditure, according to a 2016 working paper released by the project.
This results in fewer posts being available for health practitioners as provinces enforce staffing moratorium both officially and unofficially, he says. Unofficial hiring freezes may be hidden in changes to hiring processes, he explained.
Rensburg cautioned that, although it is easy to smooth over problems on a national level, provincial budgets are likely to continue to fall short as health departments struggle with rising costs and mounting debt.