And the safety and security of their families is the chief factor that drives them out of the country.
These are among the findings of a survey of 2 229 doctors by the Colleges of Medicine of South Africa‚ reported in this month’s edition of the South African Medical Journal.
Money was often suggested as the main reason doctors left the public sector or emigrated‚ said researchers Zephne van der Spuy‚ Tuviah Zabow and Andrew Good.
But “better remuneration” was third behind “better working environment” and “better workplace security” when doctors were asked why they wanted to go into private practice. And it was second only to “no suitable posts” among the least important reasons for emigrating.
Working conditions and workplace security were the biggest gripes in the public sector. “The need for a better working environment is the main consideration for over half of the respondents across both the public and the private sector‚” said the researchers.
“From a policy perspective‚ this sends a clear message. Workplace conditions must be considered as an integral part of any initiative to retain doctors in the public sector.”
However‚ doctors’ views on critical areas of the working environment differed sharply in the public and private sectors:
- 61% in the public sector said availability of medicine and supplies was inadequate (10% in the private sector);
- 66% in the public sector said there was a shortage of equipment and infrastructure (20%);
- 48% in the public sector said nursing and other support staff were inadequate (21%); and
- 39% in the public sector said hygiene and management were not of a good general standard (5%).
The researchers said it wasn’t all bad news. “South African doctors find their work satisfying and rewarding‚ with only a slight difference in private sector doctors being more positive in this regard. Doctors also reported having good working relationships with their colleagues and reasonable senior support.”
Almost 600 doctors — more than a quarter in the survey — said they had worked internationally at some stage. “We need to guard against the view that doctors who work overseas are permanently lost to South African health‚” said the researchers.
Doctors were not convinced that the introduction of National Health Insurance would improve healthcare‚ supporting last month’s claim by the SA Private Practitioners Forum that South Africa could face an exodus of doctors if NHI is implemented in its current format.