SA’s next generation of healthcare workers hit

Hundreds of health workers may be sitting at home idle as professional bodies report delays in appointments. Budget experts say this may be a symptom of hiring freezes they believe are fuelled by austerity measures.

Mokgadi Mathipa (not her real name) received state funding to study pharmacy and completed her state-mandated community service in December. Like most bursary holders, Mathipa is required to work in the public healthcare sector as part of her bursary contract.

Newly graduated medical professionals must complete at least one year of community service before they can register with professional bodies and practise.

But Mathipa is one of more than 70 pharmacists and former bursary holders who have yet to be permanently placed at a health facility by the Limpopo department of health. Without these posts, these young pharmacists cannot fulfil the legal obligations of their bursaries.

Although the Limpopo health department has given pharmacists letters confirming placements at facilities, Mathipa says the provincial treasury department has not approved the appointments.

She explains: “It is not only us who have this problem. It’s the same story with graduates waiting for internships and the interns waiting for community service placements.”

After completing her community service, Mathipa spent a week at home before being called back to her community service placement.

Limpopo department of health spokesperson Derick Kganyago says Mathipa and others will be paid as permanent staff while they work temporary assignments until they are placed permanently. He says all bursary holders will be absorbed into the health system and added that the department had increased pharmacy posts in the past year to address a pharmacist shortage.

Home to around five million people, Limpopo has about 430 publicsector pharmacists, according to 2014 staffing figures published in the and 2011 census data.

Kganyago described allegations that delays in placements were owed to a lack of funding or poor planning as “baseless”.

Limpopo pharmacists are not the only ones struggling to find a place in the public healthcare system. The Pharmaceutical Society of South Africa says more than 130 pharmacy graduates have still not been placed in community service positions slated to start earlier this month. The Junior Doctors Association of South Africa says 130 doctors who successfully interviewed for jobs at public health facilities have yet to start working because they are awaiting final letters of appointment from provincial health departments.

Although some professional associations are blaming administrative bungles, research organisation the Rural Health Advocacy Project says tight budgets and austerity measures are behind a shortage of placements.

“The problem with placements is a combination of budgetary constraints and administrative troubles. Provincial budgets have not been sufficient to cover the costs of the posts,” says the Pharmaceutical Society’s head of public affairs Lorraine Osman.

The health department recently implemented an electronic system to streamline community service and internship placements, Osman says, but the software was not adequately tested. As a result, appointments for bursary recipients such as Mathipa, who are usually prioritised to allow them to fulfil their contracts, were delayed.

“The system does not recognise bursary holders, so non-bursaryholding interns were allocated to community service posts and were later replaced with a bursary holder, which further slowed the process,” she says. “The software will be fantastic once it is up, but in the meantime, there are a lot of young people that cannot earn a living right now.”

Health systems and policy manager at the Rural Health Advocacy Project Russel Rensburg says the delays in placements can be attributed to austerity measures.

According to Rensburg, provincial health budgets have almost doubled in the past 15 years, but have not kept up with the rising cost of employ-

“Doctors in all major provinces [are] still waiting in anticipation for a call ... to say they can continue work”