Q&A

DR MZUKISI GROOTBOOM, chairman of the South African Medical Association, which represents doctors, says the public health system is collapsing. Chris Barron asked him . . .

Aren’t you being a bit alarmist?

That was a word used by the ombud.

Is the ombud being alarmist?

I don’t think so, no.

The health minister says it’s just overcrowded?

No, it’s far from that. Yes, there’s overcrowding, but over and above that there has been an exodus of doctors because of a decision not to fill certain posts.

The minister says doctors are not applying for these posts because they’re too picky?

That’s not what I’m being told. The minister’s trying to say the situation is manageable.

Is it?

No, it’s not. For the average person at state hospitals and clinics the challenges are huge.

Why are there so many medical malpractice suits?

That’s the outcome of a system where there is no clinical governance. When there is a collapse of the system this is one of the symptoms. There are no supervisors, no consequences, nobody in a leadership position with experience to guide doctors and nurses.

Because these posts are not filled?

Precisely. In many instances hospitals are not filling those posts.

The minister says doctors don’t want to work in rural clinics?

He’s a minister in denial. We get reports of youngsters who want to stay in these rural areas after finishing their community service, but there are no jobs for them.

Aren’t doctors leaving the public health system because they make more in the private sector?

They’re leaving because the environment, the system, is not encouraging them to stay. Broken equipment, lack of support structures and the kind of development they need to have; bad management across the board.

What’s the answer?

We need to have an honest discussion with the minister about the problems.

Why haven’t you had that yet?

He’s avoiding that. We started trying way back when Kgalema Motlanthe was acting president. We never made any headway.

You’ve never met with the minister?

Only with his officials. Part of the challenge is the devolution of powers, because it is the provinces that are running the health services.

So it’s not the minister’s fault?

I’m not saying that at all. It’s his overall responsibility to make sure that those departments work properly, not to use that as an excuse when we raise these issues.

Does anything come of your meetings with the department?

Lots of promises, but nothing is resolved.

The minister says national health insurance is the answer?

You cannot start a system if you don’t have the basic requirements: a proper level of staffing, accountability and everything that goes with that — systems that run properly and are responsive to the needs of the people. We aim to have this national health service, but we can’t deal with the basic issues we need to deal with to make delivery accessible to our people: the clinics, hospitals, community health centres.