Brain drain warning for South Africa as medical specialist shortage flagged

South Africa faces a high vacancy of nurses and other medical specialists, placing an increasing strain on the country’s overburdened health sector.

This was revealed in a parliamentary Q&A between the opposition Democratic Alliance and the Department of Health. Data provided by the department show South Africa currently has a vacancy rate of 18.6% for specialist medical personnel and 13.7% for nurses.

The province worst affected is the Free State, with a vacancy rate of 25.3%. The total number of vacancies for nurses is 21,453. When looking at vacancies for specialist medical personnel, the province with the highest number is the Northern Cape, at a staggering 46%.

Vacancy rates as high as this undoubtedly affect the provision of quality healthcare.

The DA’s Michele Clarke said she will write to parliament’s portfolio committee to request the department come and present the following:

  • The reasons for such high vacancy rates;
  • Plans on how these vacancies will be filled;
  • How the Department plans to strengthen training nursing colleges;
  • If the department has communicated such vacancies to Home Affairs to encourage the department to include nurses and specialist medical personnel in the critical skills list; and
  • If the Department has made any strides in forming PPPs with the private sectors with regard to the training of nurses.

“In March this year, thousands of temporary Covid staff were let go. The reason for this is that Provincial Health Departments lacked the funds to retain staff after the peak of the pandemic. Challenges in the healthcare sector include a shortage of medical skills and a shortage of funds to absorb these critical skills into the system,” Clarke said.

“It is clear that the ANC government cannot currently fill critical health vacancies. It is therefore doubtful that they will be able to do so when the National Health Insurance (NHI) will inevitably lead to a brain drain.”

Impact of the NHI

Health stakeholders have previously raised concerns that South Africa could see an exodus of doctors and other critical medical personnel ahead of the planned introduction of the NHI scheme.

There is also a growing concern that the country could lose valuable training skills as professionals look to leave.

Briefing parliament on the scheme at the end of March 2022, the Department of Health noted these concerns, adding that the NHI will need skilled personnel to function. It said that this was not limited to healthcare professionals, but that general skilled human resources will be central to the health system in the future.

It added that the complex interactions between training, registration compliance and employment can all be substantially improved.

“This is a big ship that will need to be turned, but the framework is in place,” said the acting director-general of health Nicholas Crisp. “We have heard the threats that there will be an exodus of personnel if the NHI is implemented and a brain drain.”

He said that the department is actively responding to this and that a framework is in place to ensure the country has the necessary skills. His department is developing a ‘Human Resources for Health strategy’ before the start of the Covid pandemic.

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