THE GOVERNMENT'S reluctance to resolve the crisis over doctors' pay and working conditions could have severe repercussions for the 2010 Fifa World Cup.
Disgruntled doctors in public hospitals, some of whom earn less than bus drivers in Johannesburg, have threatened to intensify their protests around the country. Several doctors said they would continue to protest and would have no qualms about going on strike during the World Cup. "How else can we pressure the government to help us?" one asked.
Research by the South African Medical Association (Sama) shows that doctors are underpaid by as much as 70 percent and their working conditions are a nightmare.
As part of the occupation-specific dispensation (OSD) system, doctors, dentists, pharmacists and emergency care workers were to have been on a similar pay system by June last year. But only nurses in the public service, who went on strike for a month in 2007, got pay hikes of 20 percent, better medical coverage and housing subsidies.
Sama chairwoman Denise White said: "Doctors study for long periods and after qualifying, are saddled with study debt and living expenses. They have lost almost half a decade of earning potential compared to other professionals, but they are asked to work long hours and perform miracles with limited resources."
A doctor, after studying for six years, earns R8 000 a month as an intern. A Metrobus driver who has three years of service gets R8 800 a month. Entry-level nurses get between R10 000 and R12 000. While it is against the law for doctors to strike - they are classified as an essential service - many employed at government hospitals have taken to the streets.
On Friday, doctors marched to Parliament in Cape Town. In the past two months, there have also been marches in KwaZulu-Natal, Mpumalanga, Gauteng, Limpopo and North West.
White said there was one doctor for every 3 846 people in the country. The burden on doctors at state hospitals was severe: because of budgetary cutbacks, 30 percent of posts had been frozen.
"Doctors are under severe stress, and ultimately it is the patient who suffers," said White.
"Doctors are angry and have legitimate grievances. I've heard that as many as 3 000 doctors have applied for certificates from the Health Professions Council of South Africa (HPCSA) that would enable them to work overseas. This would worsen the problem," she said.
"The OSD model is structured to increase salaries based on specific criteria such as performance, qualification, scope of work and experience. The government is being lambasted for its tardiness in implementation, as well as for the insultingly low offers made in the bargaining process thus far."
Other factors leading to the protest action include deteriorating academic facilities, too few doctors being trained, poor working conditions for health professionals in the public sector and the often atrocious conditions facing patients at public health facilities.
"Sama's public and private sector doctors remain committed to ensuring that the OSD becomes a reality, as it is critical to prevent the wholesale walkout of doctors from the public sector and from our country," White said.
Last year, according to the HPCSA, 34 687 doctors were registered in the country. Of those, 10 653 were working in the public sector. The number of medics in community service declined from 1 224 in 2007 to just 295 last year - apparently as a result of poor planning and mismanagement by the national Health Department when it converted the MBChB degree from six years to five and introduced a two-year internship.
Asanda Fongqo, the spokesman for the Democratic Nurses' Association of South Africa, said all healthcare professionals, especially doctors, should be rewarded.
"It is not fair to pay some and not pay others, there is no consistency. We support better pay and working conditions for both nurses and doctors, in addition to tools of the job, like resources, safety and security."
HPCSA registrar and chief executive Boyce Mkhize, has expressed concern about threats of further strike action.
"While we support the need for commensurate remuneration packages and improved working conditions for public service healthcare practitioners, we request all parties to mediate until settlement is reached," he said.
Cosatu spokesman Patrick Craven said: "We are meeting with government (tomorrow) in a bid to sort it out without further delays."
Last month Health Minister Aaron Motsoaledi acknowledged that doctors were poorly paid but said that it might take a year to resolve problems with the new system.
Edwin Naidu: The Sunday Independent, 7 June 2009
