Poor working conditions and staff shortages are driving specialists away, threatening the future of NHI.
The exodus of specialist doctors would not affect the implementation of the National Health Insurance (NHI) in primary health care, while it would do so at tertiary hospital services where the service of specialists is required, says Dr Rebonethato Lesupi, secretary of the South African Medical Association Trade Union (Samatu) registrars committee.
“The government must come up with a solution to stop the loss of doctors by fixing everything that is a cause of this problem.
“The loss of specialist doctors from the public sector poses a serious risk to the success of NHI,” Lesupi said.
“NHI is premised on a strong, functional public health system with adequate specialist capacity. When specialists leave state hospitals, the system loses clinical expertise, supervision for trainees and institutional memory.”
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Lesupi said without addressing working conditions, staffing shortages and morale of health care workers, NHI risks becoming a financing reform without the clinical capacity to deliver quality care.
“The implementation of NHI will be delayed without specialist doctors providing training and expertise for services that could be fully covered by NHIs.”
He said for NHI to succeed, it would need to attract doctors through fair contracting, safe working environments, adequate remuneration and respect.
