More health professionals for rural areas

Scope of community service to widen

The health department's controversial compulsory community service for newly qualified medical professionals would be expanded massively to include seven more categories of practitioners, Health Minister Manto Tshabalala-Msimang said yesterday.

The present community service system for newly qualified doctors, dentists and pharmacists was implemented in spite of broad criticism, particularly from young doctors. It is government's mechanism to try to alleviate the drastic shortage of health practitioners in rural areas.

Introducing her budget vote yesterday, Tshabalala-Msimang said the system it would be expanded next year to include physiotherapists, radiographers, occupational therapists, speech and hearing therapists, clinical psychologists, dieticians and environmental health officers.

One of the reasons for community service is that government pays significant amounts for the training of each doctor, dentist and pharmacist, and student fees do not cover this.

The minister did not explain how this applies to the new categories.

Tshabalala-Msimang said in the National Assembly that the system of community service was providing significant relief when it came to the shortages in rural areas.

It was estimated that 26% of public sector dental posts and 31% of pharmacy posts were filled through community service in 2001. This year the programme will put no fewer than 1742 young doctors, dentists and pharmacists into the field."

She said the department was also working hard to improve the quality of supervision for new practitioners in the rural areas.

We harvest our first crop of nine graduates in our Cuban medical training programme in September. Candidates were recruited largely from rural provinces and are contracted to work in (those provinces) for 10 years. At present we have 252 students in Cuba and a further 71 will depart this year, said Tshabalala-Msimang.

Democratic Alliance health spokesman Mike Ellis said public hospitals had experienced enormous problems in retaining staff as a result of slashed budgets and a moratorium on recruitment.

At the same time many doctors and nurses continue to leave for the private sector and overseas. The 2002 SA health review identified various problems as contributing to low morale amongst healthcare providers, including huge demands, difficulties in prioritising, inadequate management skills, lack of rewards for competence or sanctions for incompetence and hierarchies that are too rigid.

Ellis said that community service had failed to alleviate the crisis in rural hospitals, with 83% of those doing community service going to urban hospitals.

New National Party (NNP) MP Kobus Gous said the brain drain was of concern because recent figures showed that 33% of all newly qualified doctors were leaving the country. (Source: Business Day, 5 June 2002)