The public health sector needs as many health professionals as possible, but budgets are tight

On Monday 22 January 2024, Daily Maverick published an article by Dr Sunhera Sukdeo, a graduate of my alma mater, the University of KwaZulu-Natal. Her article “I’m an unemployed doctor, like many medical peers, despite SA’s health skills shortage”, highlights the difficulty of provincial Departments of Health to employ all medical doctors.

This follows a claim by the South African Medical Association Trade Union (Samatu) that there are 800 unemployed doctors. This unverified figure has since been quoted by many in the public media.

The National Department of Health has requested concrete data on this. This was based on the January 2023 experience where this organisation claimed to possess a database of more than 1,000 unemployed doctors. What we found then was that the figure was grossly exaggerated. At present, the SA Medical Association (Sama) reports a list of less than 400 doctors who say they are unemployed.

It should be noted that indeed the National Department of Health would wish every health facility to be appropriately staffed. The struggle to get adequate budgets allocated for the employment of professionals affects every health professional group, not just doctors. The rehabilitation professionals are hardest hit.

When government employs a doctor, it seeks a doctor irrespective of racial descent. We are alarmed by Dr Sukdeo’s statement that when she applied for a post, she learnt that it was reserved for “African males”. One would appreciate receiving proof of this so that it can be investigated and formally addressed.

What we wish to avoid is to reduce a genuine problem of youth unemployment in the health sector to a statistical contestation. However, it is necessary that we share with the public facts from the government’s recent employment records. Appointments of medical doctors normally take place during January, March, and July. This is aligned to completion periods as not all doctors complete community service or internship in the same month.

During the years 2021, 2022 and 2023, a total of 3,976, 4,698, and 5,006 respectively were employed. This number includes medical interns, community service officers and medical officers. The table below shows the new employment as of December 2023.



Provinces have since advertised and are in the process of advertising and/or interviewing applicants. Several of the vacant posts are in rural areas, places that some prefer to sit out for a year rather than venture into unfamiliar territory. This is another yearly problem where some young doctors reject rural placements using a variety of reasons.

There is no doubt that more health professionals should be employed. However, what will not be done is to employ a health professional against an unfunded post. This has happened previously and will not, under any circumstances, be repeated.

It is important that we address certain principles that underlie the employment of medical doctors. They are obliged to undergo a two-year internship training programme upon successfully completing their undergraduate studies. This is a prerequisite for registration for independent practice. This is followed by a year of community service. Upon completion of compulsory community service, the doctor is free to seek employment anywhere.

Budgeting constraints