Spin Doctors vs Medical Doctors – When it comes to corruption in our healthcare system, whose side are you on?
As I write, that’s the number of newly qualified South African doctors currently looking for jobs.
In a country like South Africa, where the public health sector is circling the drain, you would think a batch of freshly minted medical professionals would be like catnip to the Department of Health.
Not so.
In an article in The Daily Maverick, the South African Medical Association Trade Union (Samatu) is quoted as saying, “Annually, the department cites budget constraints as a barrier to hiring qualified medical doctors, yet no substantial measures are evident to solve the funding dilemma. This contributes immensely to the web of factors that prompt the continuous emigration of qualified doctors.”
Jeanette Hunter, the acting director-general of the Department of Health, responded by saying, “Provinces are continually putting out adverts for doctors – we want to employ all qualified and registered doctors. The department doesn’t have enough doctors and unemployed professionals should come forward with their registration numbers so that it can arrange jobs for them.”
Sadly, this doesn’t seem to gel with the countless stories from the young, eager, and highly competent new doctors who say they’ve sent off countless applications without success.
Dr Sunhera Sukdeo (MBChB) graduated cum laude in medicine from the University of KwaZulu-Natal. Having completed her community service, she now wants to specialise in paediatrics. She has so far applied for eight posts in Kwazulu-Natal and two in Gauteng.
She hasn’t heard anything from any of them.
The newspapers are filled with similar stories from similarly disillusioned medical graduates. And yet, in what can only be described as a miracle cure, Health Minister Dr Joe Phaahla recently announced that unemployed doctors who are keen to work in the public sector will be hired by April.
He is apparently working closely with finance minister Enoch Godongwana, to find the requisite funding.
“Our national teams are working with the National Treasury team to thrash out the details and working with provincial health departments to speed up the process so that by April 1 2024, all those doctors who wish to work in the public sector, all those doctors who want to work, will be able to get jobs,” he said.
At the time, he said the budget speech would detail how this would be financed, but the plan was for “many of the provinces to bring forward some of the funding, starting in March, so that by April those doctors will be working.”
Well, the budget speech was made on February 21 – the day on which I’m writing this – and there was no specific mention of this at all. The main reference I can see is that the government will boost spending by R251.3 billion to make sure the salaries of teachers, doctors, nurses and police are fully funded.
What’s not clear is whether that money is to pay the salaries of existing people in these roles, many of whom haven’t been paid for months, or whether the funds will be made available for new hires.
What Minister Phaahla was very eager to make abundantly clear, however, was this: “Hard luck to those who were wishing to use this as a political football in the election campaign … thinking that there’s a discourse because of the national health insurance and that we won’t be able to employ doctors.”
And there’s the rub.
This is an election year, so of course there is suddenly, magically, an extra R250 billion in the coffers to pay for essential public sector workers.
While medical doctors remain unemployed, the Health Department’s spin doctors are very hard at work, scrambling to come up with a narrative that somehow manages to gloss over the glaring fraud and corruption that has robbed the healthcare sector of billions of desperately needed Rands.
Surely, if corruption were not so absolutely engrained into our society, there wouldn’t be the need to work out short-term, papering-over-the-cracks strategies designed to limp the ruling party across the election finish line.
Scrambling for money is not a sustainable, long-term plan, but it would appear to be the only option while billions in lost revenue continue to go into well-connected pockets instead of into our struggling healthcare system.
This is an ongoing fight that people have lost their lives over.
On August 23, 2021, Babita Deokaran was assassinated outside her home – just days after exposing large-scale suspected corruption at Tembisa Hospital on Gauteng’s East Rand.
As the chief director of financial accounting at Gauteng’s health department, she flagged over R800 million in what she thought were fraudulent transactions and tried to stop a further R100 million in upcoming suspicious payments from being processed.
Two years later, the six men involved in the assassination were sentenced in the Johannesburg High Court to a combined 95 years imprisonment.
As far as I’m aware, however, the people responsible for the fraudulent practices over which Babita lost her life have not faced any kind of prosecution, and the corruption no doubt continues unabated.
I wonder how many new doctors’ salaries that R900 million would pay. And remember – that’s just the loss from one hospital…
Then, of course, there’s the most recent elephant in the room – the hotly debated National Health Insurance (NHI) scheme.
Wits School of Governance Professor Alex van den Heever believes that the NHI is a threat to both the public and private healthcare systems.
“It is extremely controversial and potentially very prejudicial to the health system as a whole, both the public sector and private sector,” he said. “The Bill has not been amended despite multiple submissions showing several flaws.”
“The possibilities for corruption are endless. People are concerned because they feel this is not intended to improve healthcare – it is about the vested interests [of people] who have an interest in capturing parts of the state.”
In my humble opinion, because the people making the policies about our public health system don’t even use it (they have access to the best and most expensive private medical care), their interest is not in finding a way to make it work for the people – it’s finding a way to make it make money for themselves.