By 2011 South Africa will have an estimated shortfall of 19 000 nurses, and while the country trains enough doctors to serve the population, the problem of a huge shortage of doctors in the public sector will probably not be solved in the near future.
These are some of the conclusions in a range of studies on skills development and shortages commissioned or conducted by the HSRC’s Human Resources Development research programme. The studies aim at providing the best empirical overview of the nature and extent of the scarce skills issue and form part of the Human Resources Review 2003, which will be published later this year. This research falls within the ambit of one of the key development challenges facing South Africa, as identified by President Mbeki. Scarce skills constrain international competitiveness, economic growth and poverty reduction, Mbeki believes.
The issue has been taken up elsewhere in the government too, most notably in the development of the new Immigration Act, where a new strategy for attracting such skills from outside the country has been developed. In a preview of the Human Resources Review’s findings in two areas, namely health and engineering, researchers Johan Erasmus and Elsje Hall of the HSRC’s Economic and Employment Policy Research (EEPR) programme, examines the likely extent of shortages of doctors and nurses in the next decade.
Even with recruitment to address the 25% vacancy rate in the public system, Erasmus and Hall predict a shortfall of nearly 19 000 nurses by 2011. Erasmus and Hall found that the supply of new doctors from medical schools is likely to slightly outweigh the loss of staff through retirement, illness and emigration. However, this positive picture needs to be carefully qualified: firstly, recent statements by representatives of junior doctors and medical students suggest that the already high levels of migration of doctors may increase significantly; secondly, the projected growth in supply of doctors would not address the major problem that 27% of posts for doctors in the public sector are unfilled; and thirdly, the projections assume that the current disparities and weaknesses within the health system will not be addressed.
This would leave unchanged a ratio of doctors to overall population and a situation where only 29% of doctors meet the needs of the 84% of the population not covered by medical aid schemes. It would also not redress the massive inter-provincial and rural-urban disparities in the supply of doctors. In the case of the nursing profession, the bulk of nurses have remained within the public system and have more successfully been deployed across the country. The ratio of nurses to overall population is also more favourable.
However, the skills shortage situation here is starker than for doctors. Even with recruitment to address the 25% vacancy rate in the public system, Erasmus and Hall predict a shortfall of nearly 19 000 nurses by 2011. A less serious situation emerges from the study of engineers by Grové Steyn (also EEPR). He shows that engineering is in the process of a major restructuring of their areas of specialisation in the wake of the decline in minerals and military uses of engineering. Instead, there has been a growth in demand for electrical engineers and a shift towards an employer preference for those with postgraduate qualifications. The response of higher education appears to have been relatively prompt and course offerings largely reflect the changes in market demand.
The stagnant overall demand for engineers suggests that there is no scarce skills problem at the moment. However, it is not clear whether there are sufficient learners willing and qualified to take engineering courses if there were to be sustained increases in demand. Steyn highlights the history of poor maths and science performance in historically black schools. However, it is possible that the major attention on this issue by the Department of Education might have had sufficient impact by the time more engineers were needed.
(Source: HSRC Review Vol1 no 2)
Dr Simon McGrath is a research director in the Human Resources Development research programme. The Human Resources Review 2003 will be published towards the end of 2003.