Where have all our doctors gone?
South Africa has 52m people and 37 500 registered medical doctors according to the Health Professions Council of South Africa’s (HPCSA) registry. Technically that’s one doctor for every 1 387 people in SA. Unfortunately, not all these registered doctors are in the country or even practising medicine anymore. The HPCSA does not keep information relating to South African medical doctors employed abroad as most of them keep dual registration.
The Department of Health also doesn’t know exactly how many doctors are actively practising in SA today but estimates by both entities are that roughly half the registered doctors are not practising medicine in the country.
That means around 19 000 doctors have to deal with 52m potential patients. That’s one doctor for every 2 737 people.
According to the World Health Organisation (WHO) a country like Austria has one doctor
Comparison of HEALTHCARE EXPENDITURE and HEALTH STATUS INDICATORS of selected middle-income countries for every 200 people. Egypt and the UK have three doctors per 1 000 people and the US has one doctor for every 500 people.
What makes matters even worse in SA is that the majority of active doctors are based in and around major urban areas, or close to major hospitals. And this means that the ratio of doctors to patients can be as high as 5 000 to one in rural SA, if not higher. This urbanisation of course, is not unique to SA, and countries like Australia also have huge challenges in this regard. (Many, if not most, SA doctors working in Australia today were specifically recruited to work in rural Australian areas.)
Shortages on the top line are exacerbated lower down with severe shortages in nursing staff, clinicians and other medical professionals.
Minister of Health, Dr Aaron Motsoaledi, says one of the big problems locally is that there’s a limit on the number of doctors South African universities can train annually.
SA currently has eight universities or training facilities where doctors are trained. From these eight facilities, 1 200 doctors qualify in SA every year. This number, should however, at least double every year over the next 10 years to ensure that the