Drastic shortage of gynaecologists

In some provinces, one specialist for 300 000 women

THERE is a hospital near Sandton that has more gynaecologists than all the state facilities in Mpumalanga and Limpopo together, Health Minister Aaron Motsoaledi lamented yesterday.

There were six full-time gynaecologists working for the government in Mpumalanga and nine in Limpopo. Three also worked part-time for the state in Limpopo, the minister’s spokesman, Joe Maila, said.

This means that in both Limpopo and Mpumalanga there is one full-time gynaecologist for almost 300 000 women.

Motsoaledi said the fact that most doctors worked in the private sector and serviced about 18% of the population revealed the vast inequality in South Africa’s health system.

Gynaecologist and South African Private Practitioners Forum head Chris Archer said posts for government special- ists had been frozen on and off for years.

This meant that when new gynaecologists qualified, they faced two choices: go overseas or work for themselves in private practice.

He said he had many colleagues who would love to work in the public sector if it were well managed.

“It [the public sector] has politicised management, runs out of drugs or has broken or poorly maintained equipment.”

Wits professor and health economist Alex van den Heever agreed. He said various provinces had faced fiscal crises at different times and had frozen posts.

But he also said that when specialist posts for state hospitals were advertised, doctors did apply for them. “The state pays about R1.5-million a year for a top specialist and offers a huge pension that pays 75% per month of what one earned when working, for the rest of your life.”

It was hard for private doctors’ savings to compete with the government’s pension fund, he said.

He said as it was illegal for hospitals to directly employ specialists, doctors worked for themselves at various hospitals – so even if there were 16 gynaecologists at a Sandton hospital, they may not be there full time.

Motsoaledi was speaking at the UN Secretary-General Africa meeting about a global plan for women, children and adolescents. He said better health of women and children would not happen until there was universal healthcare – his new term for describing national health insurance.

According to the South African Society of Obstetricians and Gynaecologists, of which not every gynaecologist is a member, 400 of its members work in private practice and 98 in state hospitals, while 11 work part time for the government.

According to the society, in the Eastern Cape there are 14 members in private practice and two in the public sector. In Johannesburg, there are 92 members in private practice and 15 in the public sector.

Medpages, a website of doctors’ details, estimates there are about 900 gynaecologists in South Africa.