YOUNG doctors are leaving the Eastern Cape in droves because budgets are simply too inadequate to cover the basic costs of quality equipment and the maintenance of medical facilities.
According to a Human Resources for Health report from October last year the Eastern Cape has just over half the density of health professionals per 10 000 compared to that of Gauteng and the Western Cape – an indication young doctors believed serving at state institutions in the province was not worth their while.
DA MPL John Cupido said the medical industry was suffering because the health department failed to supply the basic requirements for “an adequate environment of learning”.
“Doctors need to be able to concentrate on the experience and learning aspect from the in-hospital training. How can they focus on this if there are no medical supplies and equipment does not function and when they are worried if they are going to cover rent, their student loans and eat because their salaries are not being paid? They are only human,” he said.
This comes in spite of an announcement by the Eastern Cape health department this week that more than R1-billion has been allocated for the upgrading of infrastructure which will benefit five hospitals – Cecilia Makiwane in Mdantsane, St Patrick’s in Bizana, Frontier in Queenstown, St Elizabeth’s in Lusikisiki and Madwaleni in Elliotdale.
Cupido said doctors were leaving because health care infrastructure – from buildings to essential medical equipment – was in a “terrible state” and the backlog too great.
“They know that the last and incoming budgets do not address this, meaning it will only get worse and because they do not know if next month’s salary will be paid.
“The only way to address this is to streamline the excessively bloated administration of the health department, refocus financing on maintaining essential infrastructure and decreasing the backlog and filling the vacancies of the essential clinical staff, while ensuring that their salaries are paid on time.”
The report indicates that in the Eastern Cape there are only 1.7 doctors for every 10 000 patients in the public sector, meaning the province relies heavily on the presence of foreign doctors.
Retired doctor Costa Gazi revealed there was “a huge shortage” of about 4 000 doctors in the province and that there appeared to be no solution in sight.
Gazi said although doctors were trained in many disciplines, it was family medicine that was now generally recognised as being the priority.
“In fact, specialties for family medicine are the specialties that need to be developed to improve the health of the country’s population. The fault lies largely in the fact that too many medical students are trained for hospital practice rather than as generalists working in the communities,” he said.
Cupido said according to the report, which was based on 2010 figures, “across the board” in the 14 most important clinical professions there were more than 27 000 vacancies in the Eastern Cape.
“To fill these positions alone would cost the department just over R9.2-billion, which is almost two thirds of the R15.1-billion incoming budget for the provincial health department.
“We will never be able to fill these vacancies at this rate, and with infrastructure going backwards health care is degrading at an exponential rate in the province.”
Cupido said the department was “directly responsible” for ensuring there were sufficient doctors to meet the country’s needs and that “several policies” had been put in place to stop the active recruitment of South African doctors by other countries.
Cupido added the loss of “intellectual skill” resulted in a loss of valuable skill transference to medical students and young doctors. This in turn added pressure on the remaining skilled professionals who had to compensate with greater time and effort.
“Poorer training could result in less competent doctors if they are unable to compensate.”
Another threat to the province’s health sector is the fact that in two years’ time (2014) there will be 200 fewer interns because the University of Kwazulu-natal is changing its medical curriculum from five to six years. “We should be prepared for this shortage in advance,” Cupido said.