Cape Town - The country's health-care system may be flying blind, as the dire shortage of specialists versus the population growth concerns the medical community.
This is according to Professor Shivani Ranchod, a health systems strategist and senior lecturer in actuarial science at the University of Cape Town, who spoke about the country's human resources health crisis and its quadruple burden of disease at the annual Hospital Association of South Africa (HASA) conference earlier this month.
In her presentation, she mentioned that per 100 000 people, South Africa had seven full-time specialists in the public healthcare sector versus 69 in the private sector.
“We have 16.5 medical specialists in South Africa for every 100,000 people. The Organisation for Economic Co-operation and Development (OECD) average is 274 by comparison. Our most dire shortages are in the surgical disciplines, psychiatry, radiology and otorhinolaryngology (ENTs). We have a crisis looming due to a growing population, an increasing burden of non-communicable diseases and a high emigration rate,” said Ranchod.
She went on to say that the consequences included a lack of access to specialised care, citing long waiting lists for surgery and a lack of access to cancer care as examples.
“There are also issues of equity. One's ability to access a specialist depends on whether you can afford a medical scheme and where in the country you live.
“There are numerous factors that exacerbate the crisis that we face. Political uncertainty, the global demand for medical specialist skills and the lack of posts in the public sector all affect our ability to retain specialists. And in the meanwhile, demand grows as our population grows and ages,” said Ranchod.
Addressing this critical shortage issue, Head of Corporate Affairs at the South African Medical Association (SAMA), Nomonde Süssmann, said that the recurring challenge required a coordinated effort from all key stakeholders.
“There is a global shortage of healthcare professionals, and the WHO, which South Africa is signatory to, expects that the global deficit of health workers will reach 18 million in the next eight years.
“Addressing this critical shortage, SAMA believes the shortage of specialists could be alleviated by Fiscal investments into the training of medical doctors, at both undergraduate and postgraduate levels, as well as into the funding of medical posts in hospitals, not only in cities but also in the rural areas.
“The allocation of more funding to the NDOH to bolster healthcare infrastructure and more resources placed in securing all relevant skills across all healthcare services. The inclusion of the medical skills on the critical skills list by the Department of Home Affairs is a step in the right direction. The skills that are of relevance to SAMA are medical practitioners specialising in anaesthesiology, cardiothoracic surgery, clinical pharmacology, paediatrics, oncology, orthopaedic surgery, urology, and public health, among others.
“The SA healthcare sector is at a critical juncture, with the Covid-19 pandemic having worsened the situation. It is difficult to estimate when the health sector will be well again, but it requires all stakeholders, NDOH primarily, National Treasury for funding and the health fraternity to assist in fixing it,” said Süssmann.