South Africa’s failure to place healthcare interns threatens service delivery

Just weeks after the National Council of Provinces voted for the historic National Health Insurance Bill, paving the way for Universal Health Care in South Africa, the alarm bells have been sounded over the Health Department’s failure to place 182 healthcare interns at government facilities in 2024 which threatens to compromise service delivery, especially in rural areas.

According to a report by Bhekisisa, although all medical interns have been placed for 2024, by December 12, 182 new radiographers, physiotherapists, dietitians, dentists and environmental health practitioners still had no positions – which threatens these students’ qualifications.

Since 1998, South Africa has required newly graduated health workers, including doctors, dentists, and pharmacists, to serve in public hospitals or clinics for one to two years to gain full qualification.

This policy aims to ensure access to specialist and rehabilitation care, especially in rural areas.

Without placements, they won’t be allowed to practise in their fields as they won’t be considered fully qualified.

It comes amid deep budget cuts announced by the National Treasury earlier this year that includes provincial health departments.
The austerity measures have alarmed South African Committees of Dental Deans (SACODD), Healthcare Sciences Deans (SACOHSD), and Medical Deans (SACOMD) who warn it could severely impact the health system in South Africa, particularly in the context of striving for Universal Health Coverage.

On August 31, the National Treasury issued a directive to national departments and provincial treasuries, outlining measures to achieve savings and prevent crippling resource constraints in the latter part of the 2023/2024 financial year.

A statement by the South African Committees of Dental Deans said the budget cuts raises serious concerns about the future of healthcare, especially in rural areas.

The Deans believe the budget cuts could have a profound effect on the already overburdened health system, exacerbating staff burnout and morale issues.

The Deans are particularly worried about the future of academic health platforms across the country, including the National Health Laboratory Service, due to chronic underfunding of health infrastructure and professional education.

They note that despite efforts by the Minister of Health and the National Department of Health, the health system “remains in crisis”, a situation likely to worsen with the recent budget cuts.

The Deans are urging the government to address these systemic failures as a matter of priority.

They emphasise that a well-functioning health system is essential for training and graduating quality health professionals at all levels, including specialists and sub-specialists.

“The constant failure to adequately fund internship and community service placements for graduating health professionals represents a serious human resources challenge,” the Deans, comprising Prof Lionel Green-Thompson, Prof Anthea Rhoda and Prof Londi Shangase wrote in a statement.

Foster Mohale, spokesperson for the National Health Department said that the department, working with provincial departments of health, had ensured that all health professionals that are essential to deliver health services were allocated in positions as of December 12, 2023 for 2024 intake.

“The shortfalls in other areas of need, excluding medical interns and most categories of community service are being addressed as a matter of urgency,” Mohale said.

“These include eight Dentist posts, eight Dietitian posts, 38 Physiotherapist posts, and 118 Environmental Health Practitioners. The department would like to assure all unplaced graduates who meet the minimum requirements that all efforts are being made to have them allocated posts, and they will be kept abreast of the developments,” he said. IOL News