Health Minister Dr Joe Phaahla says while there are budgetary constraints when it comes to the employment of doctors who wish to remain in the public service after completing community service, the Department of Health is working around the clock to address this.
"We are doing everything possible, working with the provincial Health Departments, to mobilise resources to fund vacant posts, especially in health facilities in underserved communities," the Minister said on Monday.
Phaahla was addressing media on issues related to the employment of medical doctors and other health professionals in the country.
This follows an ongoing public outcry over doctors who have completed statutory community service programmes but remain unemployed.
Phaahla said doctors play a valuable role in the public health system of the country.
He 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 Phaahla.
However, the Minister clarified 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," the Minister said.
However, he said the trade union 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 just completed their community service on 31 December 2023. Most of these have applied for medical officer posts in the various provinces.
"However, the [provinces] place adverts at varying times, depending on several factors, especially budget availability," Phaahla said, adding that some doctors on the list still needed to complete their community service obligations.
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Phaahla also 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 per annum, while a chief specialist can earn R3 million a year.
"Given the fiscus challenges the country is facing, as alluded to by the Minister of Finance, the department has had several bilateral engagements with National Treasury to find creative ways to shield the healthcare service and the frontline workforce."
In addition, Phaahla noted the rising numbers of unemployed graduates experienced 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, the Minister said 564 medical officer posts were filled, 239 posts are currently advertised in the media, and 375 will be advertised in the next six months.
"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."
