HOSPERSA: Unemployed doctors can remedy South Africa's healthcare crisis

An overburdened South African healthcare system may find relief in its pool of unemployed doctors, according to medical organizations. Existing doctors are struggling with excessive workloads, extended shifts, and overtime demands, hampering service delivery and patient care. Nhlanhla Mthize, Gauteng provincial secretary of the Health and Other Public Sector Employees’ Union of South Africa (HOSPERSA), highlighted the contradiction between qualified but unemployed doctors and persistent shortages of physicians in the public healthcare system.

Mthize emphasized that the issue extends beyond employment challenges to patient safety concerns, as sustained pressure could lead to fatigue and burnout, hampering the retention of experienced doctors. Overworked doctors may experience reduced concentration, clinical judgement, and decision-making, increasing the risk of medical errors.

HOSPERSA questioned the effectiveness of relying on overtime to address persistent vacancies, suggesting the government should consider employing available qualified doctors to fill identified staffing gaps instead of paying existing doctors for additional hours.

The union’s concerns extend to other healthcare professionals, including nurses, allied health workers, and administrative staff, who face increased workloads when medical staffing is inadequate. This results in longer waiting times, delayed assessments, and treatment delays, particularly in facilities with a shortage of doctors. For instance, Gauteng Forensic Pathology has facilities with only one appointed doctor, making it impossible to conduct post-mortems during the doctor's absence, causing service delivery backlogs.

South Africa also risks losing trained doctors to the private sector or abroad due to the lack of employment opportunities, resulting in a loss of skills after substantial public investment in their education and training. Dr Mzulungile Theo Nodikida, CEO of the South African Medical Association (SAMA), warned that doctor unemployment and shortages threaten the country's future specialist workforce.

Doctors need continuous clinical exposure to remain competitive for registrar positions, and prolonged periods outside clinical practice could complicate specialist training.

Both HOSPERSA and SAMA stressed that unemployed doctors cannot be arbitrarily placed into any available position. Recruitment must consider funded posts, qualifications, registration requirements, specialization, and the operational needs of individual facilities. They called for a comprehensive assessment of doctor vacancies and staffing requirements across the public healthcare system, including specialized services like Forensic Pathology.

This assessment aims to identify genuine vacancies and the necessary qualifications and specializations. The organizations urged the government to develop an integrated workforce plan that addresses medical education, internship, community service, post-community service employment, and specialist training, along with increased investment in registrar posts and specialist training capacity.