The South African Medical Association (SAMA) has expressed its disappointment and concern over remarks by Health Minister Dr Aaron Motsoaledi regarding the uptake of posts by doctors.

Last week during a press briefing on the employment status of doctors and pharmacists in South Africa, Dr Motsoaledi noted that most medical doctors, including interns, are unhappy with facilities selected for community service due to their rural nature.

“While we are pleased that the Minister acknowledged that there are issues around the unemployment of doctors in three categories, which we first raised with the Department of Health (DoH) four months ago, his remarks on certain issues are problematic,” said Chairperson of SAMA, Dr Mzukisi Grootboom.

The three categories of concern currently for SAMA are interns, community service doctors and post-community service doctors.

“This often repeated argument that posts are not taken up by doctors because they are picky is simply incorrect. Furthermore, to suggest that people get married in November of the preceding year to avoid placement in certain areas is outrageous and, quite frankly, doesn’t warrant a response. It is an affront to all doctors in the country, and the Minister should reconsider his comments,” said Dr Grootboom.

Dr Grootboom also noted that the Minister’s statement lacks context. “20 years ago community service for doctors was introduced; we were the first of all the professions to agree to this deployment post internships. It was negotiated on a set of principles that have since been progressively disregarded,” said Dr Grootboom.

Dr Grootboom added that when community service was introduced, it was at a time when internships lasted for one year. It has since increased to two years. This means that all doctors – every single one who completes his or her degree – must now also complete three years of compulsory service before being able to register as a full practitioner. This is unique to the medical profession and is not a requirement for any other profession.

“Doctors should, among other things, be afforded the courtesy, as originally agreed to, of having a say on what their choices are regarding their internships, and community service placements. And, these choices should be respected,” said Dr Grootboom.

He said instead of this happening, SAMA is left to deal with the fallout created by the lack of proper administration in the DoH, a situation that has again occurred in 2016.

“In the spirit of cooperation, SAMA, and the Junior Doctors Association (JUDASA), have worked tirelessly to gather information on those affected and provided this information to the DoH.  The response is nothing short of a massive disappointment in the Minister’s response,” said Dr Grootboom.

In addition, Dr Grootboom said the DoH has no mechanism to inform doctors of available jobs after community service.  He said it is preposterous to suggest the DoH has no obligation to doctors in this regard, especially in a country where the doctor/patient ratio falls well below the World Health Organisation (WHO) standards, and where the proposed National Health Insurance (NHI) looks toward a greater workforce to deal with South Africa’s quadruple burden of disease.

“There is no process where people seeking employment can access information about available jobs. In a time of information technology this is perplexing, and outdated. Instead we have to learn from a media conference that there are 147 available posts,” said Dr Grootboom.

Dr Grootboom said SAMA will continue to assist its members, and doctors, in being appropriately placed, and to access information for them. In addition, he said, it is perhaps time that the medical profession re-examines its commitment to the entire principle of community service.

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