Doctors worried that there won’t be registrars in the public service. (File photo)

But while the minister denies the freezing of posts, doctors in the field believe that critical positions are not being filled and working doctors are left overburdened and despairing.

Speaking in Pretoria, Motsoaledi also dismissed a suggestion that the department is unable to pay health professionals who are then forced to seek community service work in the private sector.

Contrary to reports on government’s failure to create posts, the minister told the media that there are several posts available for newly qualified doctors seeking internships and community service. He said there were currently about 45 internship positions going vacant, but some doctors had turned them down because they are not in preferred locations.

“An overwhelming number of newly qualified doctors prefer to do their internship in the big cities: Cape Town, Durban, Johannesburg and Pretoria,” said Motsoaledi, explaining that this was a serious concern for the country.

Memo causing panic

Late last year staff at some hospitals in KwaZulu-Natal went into panic after a memorandum rejecting the filling of some posts begun circulating.  Doctors who feared that such a decision could jeopardise access to primary health care at government institutions said a freeze on posts could compromise patient care. One of the doctors who spoke to Health-e News on condition of anonymity said hospitals have been prohibited from accepting new registrars who want to come in as specialists.

A doctor from Manguzi Hospital lambasted the timing of the posts freeze saying it will prevent future planning and result in the unemployment of young doctors.

“The province has a huge backlog of registrars. There are doctors who are willing to work but are unable to because of the restrictions,” said the doctor.

This allegation was dismissed by Motsoaledi, who said there is still space for doctors wanting to work in the public service as registrars.

“If they wish to remain in the public service, we have at least 147 posts available for them.”

However, he mentioned that placing doctors in some areas is a challenge as they often turn down the offers.

“We can advise them of the available posts. It is up to them to choose from what there is, but they can’t claim to be unemployed.”

In the document sent to the Department of Health in October, the KZN provincial treasury denies permission for the filling of several posts, including seven Pharmacy Assistant vacancies at Christ the King Hospital. Officials at public health facilities said they were told they had to stop filling vacant posts or replacing staff who had left the institutions.

No funding for bursaries

The treasury memo also advised the health department not to offer bursaries to 10 students applying to study medicine in Cuba. On this, Motsoaledi said provinces offered bursaries to the Cuban Doctors’ Programme according to their budgets.

Estimations in the document on the KZN provincial health department’s current budget predicted that the department was set to overspend its current budget by more than R1.1 billion in the 2016/2017 financial year. It also mentions a possibility that the department might not be able to pay staff salaries and its creditors this year.

“This situation has the potential to affect the ability of other provincial departments to meet their financial obligations to their staff and creditors, a situation that is untenable for the province,” read the circular seen by Health-e.

Treasury further imposed a funding ban on new projects in hospitals “until the current situation of budget pressure is fully and satisfactorily resolved”. Health workers at affected institutions described the move as disastrous. Early last year the KZN treasury announced austerity measures for all provincial government departments and state enterprises. The circular allowed departments to fill critical vacant posts, as long as they remain within the reduced baselines and receive permission to fill such posts.

‘Uncertainty and anxiety’

Doctors who spoke to Health-e say the moratorium on posts is causing uncertainty and anxiety among staff members, as hospitals are unable to plan effectively for 2017. The doctors asked that they not be named for fear of victimisation.

A concerned doctor at Don McKenzie TB Hospital says the facility was told it could not replace a doctor who had just recently resigned. The medic says while there are dedicated doctors in government institutions, they could be pushed away by the pressure of smaller teams being left to share the heavy workload. She said she had already updated her own CV and was among several colleagues wondering if it was worth making sacrifices while the department appeared unwilling to help.

“Government says it has made the fight against TB a priority but the decision not to replace doctors who leave the facility means patients will suffer,” said the doctor.

The doctor says they are already witnessing delays that are costing lives, as they are receiving patient referrals from other facilities that are even worse off.

The medics say communications with the department is another cause for concern. They have received no communication or clarity, and the queries they send through go unanswered.

Contacted for comment on the frozen posts, Treasury spokesperson Sibonelo Msomi said while there is a moratorium on filling vacant non-OSD posts, other positions such as teachers at public schools, doctors and nurses at public health facilities were deemed critical posts and would be filled.

“There is no ban against the advertisement of posts. The provincial government took a resolution to freeze vacant non-Occupation Specific Dispensation (OSD) posts. However, departments are allowed to fill critical posts. There is a prescribed process to follow when filling these posts – concerned departments are required to seek permission from Premier and MEC for Finance,” said Msomi. – Health-e News.