Skilled nurse shortage could hobble implementation of national health plan
● With the final implementation of National Health Insurance (NHI) fast approaching, the need for skilled nurses is in sharp focus and there is uncertainty on whether SA will be able to fill the gap in time.
Dr Sue Armstrong, a senior nursing lecturer at Wits University, told delegates to the Hospital Association of SA conference on Tuesday that NHI required a functional district health-care system to be effective. This was because prevention, early detection and disease treatment were done in district health systems, which would not run effectively without the required number of nurses.
“The major concern is that the professional nurses are an ageing group. If one takes population growth into consideration, not as many professional nurses are currently being trained as are retiring,” she said.
At the heart of the problem is that there has been a delay in South African Nursing Council (SANC) approvals for private nursing education institutions.
The government trains 73% of SA’s nurses through its colleges, but this is not enough to resolve the shortage.
“Also, the training of enrolled nurses and nursing auxiliaries has been stopped without having in place provision for training of nurses in the new qualifications, which has led to the decline in overall nurse numbers,” said Armstrong.
Enrolled nurses provide limited nursing care, while enrolled nursing auxiliaries perform basic procedures and provide general care for patients. Both these types of nurses are supervised by registered nurses who also have their own nursing duties.
She said SA surpasses the UN’s sustainable development goal (SDG) of 4.45 health professionals to 1,000 people, at 5.1.
However, the World Health Organisation found that countries that provide the best quality care have an average of 8.6 nurses to 1,000 people. Armstrong believes SA should meet that ratio for NHI to be a success.
“If nothing is done to remedy this situation, the number of nurses per population will fall below the SDG requirements by 2022,” she said.
Private hospitals, including Mediclinic, Netcare and Life Healthcare, have committed to training 50,000 new nurses through the Hospital Association of SA. But if private hospitals and institutions manage to start training nurses only in 2022, it would take SA until 2059 to meet the SDG goals. The issue has been exacerbated by the closure of some nursing colleges in the 1990s to ensure racial integration in nursing education.
SANC did not respond to requests for comment.