POLITICS

Doctors and nurses vacancy rates increasing

Mike Waters says urgent action required on 35% year-on-year increase

The massive nationwide increase in the number of nurse and doctor vacancies over the past year warrants immediate action. In five provinces where data from both 2008 and 2009 has been made available via parliamentary replies, we have seen a 40.5% increase in nursing vacancies and a 4.1% increase in doctor's vacancies. We believe this indicates that the Health Ministry needs to develop a new national recruitment strategy, remove the moratorium on the issuing of visas to health workers from SADC countries, and implement a series of policy changes needed to increase the number of training institutions.

The data now publicly available provides for a comparative analysis of the situation in only the Eastern Cape, Free State, Limpopo, Mpumalanga and the Northern Cape, as the Health Department did not provide data for the other four provinces in both 2008 and 2009. Still, this provides a useful snapshot of the overall picture countrywide.

The number of vacancies for doctors and nurses has increased in the five provinces where comparative data was available from 30,026 in 2008 to 40,592 in 2009. The number of vacancies for nurses has increased from 25,650 to 36,035 - a 40.5% increase. The number of vacancies for doctors has increased by 4.1%, from 4,376 to 4,557.

The problem is most acute in the Eastern Cape, where we have seen a massive year-on-year vacancy increase of 282%. Vacancies for doctors and nurses in the province jumped from 6,492 in 2008 to 27,171 vacancies for both professions in 2009. This points to a severe deterioration of the situation in that province, and demonstrates how significantly the ANC administration in the Eastern Cape is failing to address healthcare problems in that province.

The number of vacancies in 2009 is lowest in the Western Cape, at 158 for doctors and 465 for nurses, though no information from the Western Cape was supplied to the DA question in 2008.

The problem of vacancies needs to be tackled head-on with a dynamic plan to increase the number of doctors and nurses available to our health system and, more importantly, retain them. We need to:

  • Expand partnerships with academic and training institutions and the private sector. At present, private hospitals are constrained by quotas in the number of nurses they may train, and government policy prohibits the creation of private medical schools. The department of health restricts the number of nurses the private sector can train through an old formula of 19:12. The formula makes no concessions to actual need or ability to supply. So although the ability of the state to train nurses has fallen dramatically over the last ten years, and the private sector has ample capacity to improve on its current training levels, it is restricted from doing so by an unfathomable formula.
  • Develop creative mechanisms to support trainee medical staff in the workplace through mentoring, apprenticeship, and ongoing support.
  • Encourage the provision of training by non-government bodies. While a decision taken in the 1990s to close several nursing colleges has recently been reversed, the number of training spaces actually opened as a result is still pitifully small. The DA calculates that the re-opened colleges would in fact only increase the number of nurses trained by a total of 1 580 a year.
  • The state trains, at most, 1 400 doctors every year; not nearly enough to meet demand. The number of medical graduates leaving medical schools has not increased over the past five years and there is no plan to increase the number of medical schools, or the capacity of the existing ones.
  • And we need to develop a national recruitment strategy, and remove the Health Department's moratorium on the issuing of visas to health workers from other African countries.

Failing to address this critical shortage and poor standards will result in an even further increase of the vacancy rate and further reduction of care in our health system. I will be asking parliamentary questions at the earliest opportunity to find out what steps are being taken to address the problem next year and to monitor the situation.  

Statement issued by Mike Waters MP, Democratic Alliance shadow minister of Health, December 15 2009

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