Health Minister Aaron Motsoaledi says most medical doctors, including interns, do not prefer facilities selected for community service due to their rural nature.

The Minister said this on Thursday in a media briefing held in Pretoria on the employment status of doctors and pharmacists in South Africa.

This follows recent inquiries that the National Department of Health received about Doctors and Pharmacists who could not get employment in the Public Service, because the government allegedly failed to place them into posts, or alternatively failed to create posts.

From a number of lists circulating and doing rounds in the media, the Minister said there are two main lists of "unemployed" doctors frequently quoted by the media, which include one by Junior Doctors Association of South Africa (JUDASA) and another one by the National Healthcare Professions Association.

Interns

Minister Motsoaledi said doctors who have just passed from medical schools around the country have to be placed on a two-year internship programme as part of training done under strict supervision.

The Minister said a hospital must first be accredited for a specific number of interns by the Health Professions Council of South Africa (HPCSA) before it can take any candidates in.

“The hospital may not take more than what it is accredited for. Internship training is statutory, hence the state is obliged to place them into these accredited internship positions. Unfortunately, there is a problem in the country.

“An overwhelming number of newly qualified doctors prefer to do internship in mostly four cities: Cape Town, Durban, Johannesburg and Pretoria. A few may opt for Port Elizabeth, East London and Kimberley.

“For this reason, we have decided on a system called Internship Community Service Placement Programme (ICSP) whereby interns apply centrally and are placed in various institutions from the National Department of Health,” said Minister Motsoaledi.

He said South African medical schools train locals and nationals from other countries around the world, especially from the Southern African Development Community (SADC).

He said the department has received a total of 1 499 medical internship applications, made a total of 1 498 offers, and placed about 1 476 interns. However, the Minister also said 22 applicants declined placement and one placement is pending. This makes up a 99.9% placement of interns, according to the Minister.

“There are still 45 positions of internship available. These are the Bloemfontein Complex and Mofumahadi Manapo Mopedi hospital in the Free State as well as Nelson Mandela Academic hospital in Mthatha.

“… We still have 89 foreign nationals who also applied and still need to be placed. While South Africans are worried about which doctor is placed in which job and who is not placed, we must be aware that other countries, especially our neighbours in SADC, have similar worries.

“Of the 89 foreign nationals who have completed their medical studies in South Africa, most are from SADC. The reason that we did not place the 89 foreign students was that we needed to place all South Africans first because this is statutory.”

The Minister said his Ministry is still corresponding with their [foreign nationals] respective countries in terms of the Swaziland agreement. He said Lesotho has responded and requested that all its graduates be sent back home, and this has reduced the number to 74 foreign applications.

Community service

Minister Motsoaledi said the main objective of community service is to ensure improved provision of Health Services to the rural and underserved areas of South Africa.

In the process this also provides young Health Professionals with an opportunity to develop their skills, acquire knowledge, behavioural patterns and critical thinking that will help them in their professional development.

“Unfortunately because of the very rural nature of facilities selected for Community Service, they are not preferred by most doctors.”

He said the department has received a total of 1 064 applications for Community Service Medical Officers, made 1 064 offers, placed 1 057 applicants, while seven applicants declined placement. This, the Minister said, makes a 100% placement in this category.

The Minister said foreign nationals who have completed internship in South Africa and would like to continue with Community Service were 88 and 75 of them have been placed.

“The remaining 13 foreign nationals will still be placed as from today because there are places available for them, since we have completed placement of all South Africans who needed to be placed.”

Over 140 jobs available for Post-Community Service Doctors

The Minister said there is a misconception that the state has got a statutory obligation for doctors who have completed community service, like interns and those who are still doing Community Service.

“After completion of Community Service most doctors have various options. They may go back to University to Specialise; they may go into Private Practice as General Practitioners; or they may also enter anyone of the Private Health Industry like a medical aid scheme, pharmaceuticals, company or any other industry for that matter.

“Unfortunately others may opt to leave the country or leave the profession all together. When they do all these, they have no obligation to inform the Department of Health, so we have no way of knowing them or their numbers.”

However, the Minister said, if these doctors wish to remain in the public sector, the department has at least 147 posts available for them.

Pharmacists

Minister Motsoaledi said about 795 Pharmacists applied for Community Service, of which 716 are South Africans and have all been offered positions.

However, the Minister said three declined to take offers, and the remaining 79 are foreign nationals.

“We have identified 108 positions in which all of them can perform their Community Service. This year, we have even created a new stream of Community Service positions in collaboration with the Private Sector, through the Centralised Chronic Medicine Dispensing and Distribution Programme (CCMDDP).”