The medical negligence claims of close to R900 million paid out in only one province in a recent financial year would have been enough to employ the countrys 694 unemployed doctors, Health Minister Joe Phaahla announced on Monday during a press conference.
Although Phaahla didnt name the province, a 2023 report from the auditor general shows that in 2021, the Eastern Cape paid out almost R867 million in claims , while the salary bill for 694 newly qualified doctors (in 2023) would have been about R838 million.
But Phaahla did admit: It is a paradox. On the one hand, were dealing with amounts of money being paid out for claims, while at the same time were unable to employ people who help to reduce this.
In 2024, the South African Medical Association Trade Union , the watchdog for health practitioners rights, told Phaahla that they had at least 800 unemployed medical doctors on their records. Phaahla said this number dropped to 694 after the list was double-checked against the states employee database, which showed that these doctors had completed their community service on 31 December .
One example was Sunhera Sukdeo, who graduated cum laude from the University of KwaZulu-Natal in 2023. In early January, she wrote in the Daily Maverick : It is now January 2024. I am a cum laude medical doctor. I am sitting at home unemployed. But I am not alone most of my peers are in the same boat as I am.
To this, the deputy director for human resources in the national health department, Percy Mahlathi, responded : The problem that primary employers, the provincial departments of health, face is the struggle to receive adequate budgets. The current financial squeeze felt by every government sector and the country impacts on the resourcing of health services.
Phaahla says 239 medical officer positions have now been advertised and 400 more will follow in the next few months. (A medical officer is an entry-level GP who works in the public health sector). Most of the positions are in Gauteng, Mpumalanga, Free State and the Eastern Cape.
Ironically, universities have, in less than a decade, increased the number of medical interns theyve trained by about 60% from 1 470 to 2 365, Phaahla said to address the doctor shortage in government hospitals and clinics, but the treasury has not increased provincial health departments budgets at the same pace . As a result, they dont have budgets to employ the increasing number of graduates, despite many vacant positions. (Medical interns are medical students who have completed their degrees but still have to complete two practical years in a government health facility under the supervision of staff who work at a state hospital.)
Provincial health departments spend 70% of their budgets on health worker salaries, but its not nearly enough, according to Phaahla.
In 2021, about one in seven doctors positions in hospitals were unfilled, while one in five positions for doctors were vacant at clinics. Given this shortage of professionals in the public sector and that more than 70% of South Africans use government facilities, there are about three doctors for every 10 000 patients .
Because of the increase in the number of medical students universities trained from 2018 to 2023, the state had to find that money to pay 895 more interns within five years, which, according to Phaahla, amounted to just over R800 million at a salary of R900 000 per intern a year (this includes overtime).
The number of community service doctors, who earn about R1.2 million a year (R1.3 million if they work in a rural area), grew by almost 60% too between 2020 and 2024 (from 1 340 to 2 101), which meant the government had to fork out an extra R913 million for their salaries.
Phaahla warns that the pressure on the health departments purse is made worse by a 7.5% increase in public health worker salaries, negotiated between the government and trade unions in 2023, which means fewer new workers can be appointed.
We received around 65% of the additional costs [caused by the salary hike
