The Zuma year for doctors: An administrative mess

René van der Vyver says it is unacceptable that newly qualified people are confronted with challenges due to incompetence

Zuma year – An administrative mess

3 August 2022

Every year there are cries of distress from graduates in the medical professions field that are all versions of: “Help! I was not placed for my Zuma year.” The administrative mess accompanying the compulsory Zuma year (community service year) for health workers worsens every year. AfriForum Youth received a few complaints from students in this regard and therefore this year they are ready to litigate in instances where young people’s careers are hindered by government’s maladministration.

It is a far-reaching problem that has to be addressed urgently. The administrative mess does not only hinder young medical people’s careers and chances to earn an income, but it also worsens the shortage of health workers in South Africa. This year it was found that South Africa has less than one doctor per 1 000 patients (0.31 doctors per 1 citizen). It is concerning that in 2019 it was double the amount, when the statistics showed 0,79 doctors per 1 000 patients. In comparison, the United Kingdom has 3,03 doctors per 1 000 patients, while Brazil, also a developing country, has 2,32 patients per 1 000.          

So, why the shortage? Firstly most people will give emigration as a reason and unfortunately they are not completely wrong. There is a list of solutions one can offer for this, like doing away with the planned National Health Insurance (NHI), forbidding racial quotas at the selection process and establishing more medical faculties in South Africa. With these suggestions I will be accused of daydreaming, but there is one suggestion that is not supposed to be unfeasible: placing newly qualified health workers for their Zuma year. Unfortunately, it appears that even this simple proposal is impossible for government’s Internship and Community Service Programme (ICSP).

For health workers to be fully qualified and allowed to practise in South Africa, they must serve a compulsory year of community service after the completion of their studies (and in some fields, like doctors, after the completion of an internship). The newly qualified persons must apply via the ICSP portal to be placed. Placements are supposed to happen promptly, so the health workers can report for duty in January.

There is also a so-called half-year cycle where qualified people that were not placed in January (or for other reasons only applied later for a placement), must be placed by July. If a person is moved by government to the half-year cycle, it means that the person was unemployed for seven months as a result of government, because they are not allowed to work before the Zuma year has been completed.

The young health workers must indicate various preferences on the ICSP portal such as town/city and medical needs. It has however come to AfriForum Youth’s attention that those options are not always available to all. A graduate pharmacist informed us that all the benefits, that counted points for the first cycle, fell away with the half-year cycle of 2022. It for example includes that an individual is supposed to be placed within a certain area when this individual has to care for next of kin or is married with a life partner that is already working in a specific town/city.

The Department of Health together with interest groups such as the National and Provincial Department of Health and National Treasury and the Council for Health Professions of South Africa are responsible for placements. There are many reasons why the placements are an administrative mess. Dr Mvuyisi Mzukwa, the Vice Chairman of the South African Medical Association, last year said “it becomes a battle between the provincial departments and Treasury and the National Department of Health.”

There are 18 fields of medical professions that are affected by the administrative mess, from pharmacist, dentists and doctors to physiotherapists, dieticians and occupational therapists. South Africa citizens need the expertise of these newly qualified people. Yet, they are often treated badly by the ICSP.

There is even a disheartened medical doctor, who obtained her qualification with distinction, who had to approach AfriForum Youth, because she has to pay off a study loan, but is unemployed due to the poor administration of the ICSP. She heard from the national office that she was placed at a hospital in the Eastern Cape, but the hospital insists that they do not have an available position for her. This young doctor, like other qualified people who approached AfriForum Youth for assistance, says that communication from the ICSP is completely absent or very delayed.

It is unacceptable that newly qualified people, who are prepared to serve in communities as health workers, are confronted with unnecessary challenges due to the incompetence of the ICSP. AfriForum Youth will not tolerate it further and is ready to litigate.