Health deans: spending cut to the bone
The deans of SA’s medical and dental schools have called on the Treasury to protect the health sector from further budget cuts, warning that failure to do so will compromise public health services and jeopardise the next generation of specialists.
The Treasury outlined unprecedented cuts in the medium-term budget on November 1 due to a higherthan-expected wage bill and increased debt servicing costs.
The cuts to the health budget include shaving R1bn from the HIV/Aids conditional grant and R455m from the health facilities infrastructure grant in the last half of the current fiscal year. Details of further cuts over the next three years are expected in the February budget.
The crunch will deepen the crisis confronting SA’s health system and put further strain on the country’s capacity to train healthcare professionals, said SA Committee of Medical Deans chair Lionel Green-Thompson.
The committee represents SA’s nine medical schools. Medical training is partly funded by the clinical training grant channelled through the department of higher education & training and the human resources and training grant overseen by the national health department, Green-Thompson said.
Provinces were already struggling to fund posts for interns, community service doctors and registrars, and could not afford further budget cuts, he said. Registrars are doctors training to become specialists, a process that takes upwards of four years.
“If health is not ring-fenced we will see cuts to registrar posts. Even though they are in training, registrars carry the burden of service delivery [and] if you reduce registrars you reduce the number of specialists in the pipeline,” Green-Thompson said.
“Most training hospitals already have more posts accredited by the Health Professionals Council of SA than the system can afford to employ.” Provincial health departments were already delaying making senior appointments due to budget constraints, he said.
In a joint statement issued on Tuesday, the deans of SA’s medical, dental and health sciences schools said they have grave concerns about the future of academic health platforms across SA, including the National Health Laboratory Service, due to the chronic underfunding of health infrastructure and professional education and training.
The failures of the health system has a disproportionate impact on women, children and people living in rural areas, and increases stress among staff, they said.
“In an already overburdened health system struggling to cope with the health demands of our communities and with existing evidence of staff burnout, staff morale is likely to worsen because of the lack of financial support to the practice, increased stress and feelings of helplessness,” they said.