The majority of medical interns will be denied the opportunity of doing community service in the Western Cape and Gauteng next year, in line with a new health department policy.
Gauteng and the Western Cape have the best health systems in South Africa and about 80 percent of all interns choose hospitals in these provinces as their first choice for community service.
However, according to a report in the South African Medical Journal (SAMJ), the department sent out community service notices in February that did not list any hospitals in Gautengs as options.
Some Western Cape hospitals were listed in the notices, but a covering letter said doctors should not apply to these hospitals unless they were bursary holders. Only about 20 of the 1 200 interns in the province are bursary holders, said Junior Doctors of South Africa (Judasa) chairperson Marietjie Slabbert.
'This is a way of driving more young doctors out of the country' When challenged about the notice, the department added a special dispensation for the Western Cape, and later for Gauteng.
Interns qualifying for special dispensation include those married to somebody who studies or works in a particular place, those who have children at school, Muslims who need to be near a large mosque and those with chronic diseases.
These interns were a small percentage of the total, he said. The junior doctors had to guess which Gauteng posts would be available as these were not listed in the circular. The South African Medical Association, to which Judasa belongs, was told by the department that bursary candidates or those qualifying for the special dispensation should list Gauteng several times on their applications if they wished to work in that province.
They were also required to motivate when applying for Gauteng posts and provide proof of their special circumstances.
'You shouldn't have to give up all your human rights just because you become a doctor'
.Meanwhile Judasa has lashed out at the department for inept communication.
Our main complaint is that this kind of thing adds to the demoralisation of doctors and could be the catalyst for scores more interns simply deciding to go overseas, said Judasa's former vice chairperson Karl le Roux.
Le Roux was reported in the SAMJ as saying that young doctors understood the need for health service delivery in rural areas, but when incompetence was added to the existing poor supervision, inadequate infrastructure and maladministration, they tend to give up.
We are really disappointed. This was a unilateral decision, said Slabbert. It was not discussed at the stakeholders' meeting in February or last September. The department could have asked us to come with a better plan - how to promote the rural areas, or give a rural allowance. It would have been good diplomacy.
But we are being treated like a resource. This is a way of driving more young doctors out of the country, to places where they will be looked after.
You shouldn't automatically have to give up all your human rights just because you become a doctor.
In the rural areas community service doctors frequently worked without supervision, Slabbert said, and even day hospitals in the Western Cape would struggle to cope without community service doctors. The department did not respond to a request for comment. (Source: The Cape Times on July 17, 2003 )
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