Where have all our doc­tors gone?

Finweek English Edition - - INSIDE -

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


South Africa

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