Years of studying and hard work have not paid off for more than 800 doctors who cannot find jobs throughout the country. Health Minister Dr Joe Phaahla says there are budgetary constraints when it comes to the employment of doctors who wish to remain in the public service after completing community service and the Department of Health is working to address this.
“We are working with the provincial Health Departments, to mobilise resources to fund vacant posts, especially in health facilities in underserved communities,” Dr Phaahla said.
Dr Phaahla recently addressed media on issues related to the employment of medical doctors and other health professionals in the country following the ongoing public outcry over doctors who have completed statutory community service programmes but remain unemployed.
He said doctors play a valuable role in the public health system of the country and explained that all graduates from medical school must do a two-year internship training in designated health facilities accredited by the Health Professions Council of South Africa (HPCSA). Once they have completed their internship, they must do a one-year community service in health facilities.
“As of now, all those graduates who were eligible for placement to do internship have been placed. Equally, all those who finished the internship and were eligible to start community service have been placed,” said Dr Phaahla.
He also explained that once a doctor has finished community service, they are registered with the HPCSA in the category of medical officer independent practice. This means they can work on their own without supervision, including as a single private practitioner.
“We appreciate the fact that there are many medical officers who are now registered for independent practice, who prefer to stay in the public service. Unlike internship and community service, which are a statutory requirement and are subject to placement by the Department of Health, independent practitioners have an individual choice of where to go. We are unable to know how many wish to stay in the public service,” Dr Phaahla said.
However, he said, the trade union had submitted a list of 825 unemployed medical doctors in January 2023. The department has since found that out of the 825 doctors on the list, 694 had completed their community service on December 31, 2023. Most of these doctors have applied for medical officer posts in the various provinces.
“The provinces place adverts at varying times, depending on several factors, especially budget availability,” Dr Phaahla said. “Some doctors on the list still needed to complete their community service obligations.”
Dr Phaahla touched on the extremely high cost of employment, which can be up to 65% of annual budgets in some instances. He also noted that the salary increases of 7.5% and benefits such as overtime put pressure on the fiscus. According to the minister, an entry-level community service doctor earns about R1.2 million a year, while a chief specialist can earn R3 million a year.
“Given the fiscus challenges the country is facing, the department has had several bilateral engagements with National Treasury to find creative ways to shield the healthcare service and the frontline workforce,” said Dr Phaahla.
In addition, Dr Phaahla noted the rising numbers of unemployed graduates across many sectors. However, in the public health sector, the employment of health professionals has been on a steady increase, from 1 472 medical interns appointed in 2018 to 2 101 in 2024.
“These increases over these years have happened despite the funding constraints,” he said.
“Since October 2023 to date, 564 medical officer posts were filled, 239 posts are currently advertised in the media, and 375 will be advertised in the next six months,” the minister said.
“It is important that I emphasise that doctors would need to apply like any other person wishing to join the public service. In addition, we are looking at a review of the current dispensation for the employment of doctors, especially medical officers and specialists.”
