Despite doctors being outnumbered two-to-one by Department of Health administrative staff, medical posts are being frozen.
There are more payroll clerks, managers and human resources officers in the department than doctors. The number of administrative employees increased by 12%, according to the SA Medical Journal, from 34 284 in 2012 to 37 336 in September last year.
But the number of doctors employed increased by only 3.5% during the same period, from 18701 to 19352, according to the journal.
The situation is likely to get worse, with medical posts being frozen in Mpumalanga, Free State, North West, Eastern Cape and KwaZulu-Natal, according to the SA Medical Association.
Doctors at Cape Town’s Groote Schuur Hospital have said medical departments are considering cutting costs, leading to fears that doctors will not be hired to replace those resigning.
Compounding the problem is that the Health Professions’ Training and Development Grant, and the National Tertiary Services Grant – made to universities for the training of registrars, the future specialists – has barely increased, by just over 4%, this year.
Mark Sonderup, vice-chairman of the SA Medical Association, fears that more doctors’ posts will be frozen: “The most expedient mechanism to achieve budget cuts is to freeze posts.”
The KwaZulu-Natal health department trained only 39 specialists in 2014 compared to 165 in the previous year.
A source in KwaZulu-Natal said: “Registrar posts have been frozen for 18 months. I don’t understand why doctors don’t protest.”
The freeze means there are 150 fewer specialists produced each year on average. The average age of specialists is 55, which means a crisis will develop when those now in practice retire.
DA KwaZulu-Natal health spokesman Imraan Keeka said it was not known if any registrars would be trained this year.
He said 9783 health department posts were vacant for 2015-2016.
These include 2827 nursing posts, 17 CEO posts and positions for 14 dentists, 25 dieticians, 259 general practitioners, 179 specialists, 86 radiographers and 88 pharmacy assistants.
Only nine human resources manager posts are vacant.
KwaZulu-Natal health spokes- man Sam Mkhwanazi said: “The policy on the freezing and unfreezing of posts aims to control the process of recruitment and filling of vacant posts to ensure critical and essential ones are filled.”
But a Durban doctor said it took months to unfreeze a post. Medical Association chairman Mzukisi Grootboom said a lack of hospital and clinic medical staff could add to the rising number of lawsuits.
Daygan Eagar, spokesman for the Rural Health Advocacy Project, said budgets in provincial health departments had “flat-lined”.
His organisation has been told that Eastern Cape does not have money to employ newly qualified doctors who were recipients of provincial bursaries and are obligated to work for the department.
Eagar said Mpumalanga’s health department had said it would be able to start hiring community-service doctors in the new financial year.
He said North West hospitals were badly affected by the freeze.
“Things are bad. Non-emergency surgeries, such as knee replacements, have been cancelled.”
The Eastern Cape’s Zithulele Hospital, once a beacon of hope among failed state hospitals, is unable to hire the five community-service doctors it needs.
Although the Health Department is training 1900 doctors a year, up from 1400 a few years ago, it is not known how it will be possible to place them.
Doctors cannot qualify without completing a period of state service.
Eagar said that, although the department had accelerated the training of medical staff, it did not appear able to employ them.
Health Department spokesman Joe Maila said: “There is no policy decision to freeze posts.
“The filling of posts is based on prioritisation in terms of service needs balanced against the availability of funds.
“On this basis, clinical, nursing and technical posts are prioritised. The financial space to fill posts has become tighter in view of global economic pressures.
“Delegated authority to make decisions on filling posts in some provinces has been elevated to senior levels. This has sometimes been interpreted as ‘freezing of posts’. Registrar posts in KwaZulu-Natal have not been frozen,” Maila said.
Western Cape health department spokesman Marika Champion said: “When faced with budget constraints, the department has developed a system giving institutions’ heads the opportunity to prioritise.”
Written by Katharine Child
Published Times Live