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Picture: 123RF/KURHAN
Picture: 123RF/KURHAN

Cash-strapped provincial health departments have sharply scaled back on the number of community service pharmacy posts available next year, raising the prospect that there will not be enough positions to meet demand, SA’s pharmacy industry associations warn.

Without completing 12 months of community service, pharmacists cannot register with the SA Pharmacy Council and are forbidden to practise in their chosen profession. Despite having completed their training, with a four-year degree and a one-year internship under their belts, if they have not met the mandatory community service requirements, the only role open to them is a lower-skilled and much lower-paid job as a pharmacy assistant.

While private sector pharmacies have for several years provided about 10% of SA’s community service posts, they have never been able to completely fill the breach, and the sharp decline in state-funded positions for 2023 is set to make the problem even worse, the Pharmaceutical Society of SA (PSSA) told Business Day.

Provincial health departments have committed to funding 723 community service posts for pharmacists next year, about 150 fewer than they do now, according to the PSSA.

This means the state will be able to absorb only three-quarters of about 950 pharmacists who have applied for community service positions for 2023, PSSA executive director Ivan Kotze said.

Unlike other healthcare professionals, who may do their internships and community service only in the state sector, pharmacy graduates are permitted to do so in either private or state pharmacies. Internships are advertised by provinces and private sector pharmacies, while community service posts are assigned centrally by the national health department.

The Independent Community Pharmacy Association (ICPA) said the shortage of state sector posts for community service pharmacists is more acute than in other fields because the government has grown to depend on the private sector’s role.

Even so, the system is unable to fully cater for the output of SA’s nine pharmacy schools.

“It is a known fact that some graduates stay home. Many are in no-man’s land. Even citizens are left stranded,” said ICPA chair Kgabo Komape, referring to citizens being prioritised over foreign nationals.

Private hospitals

Only a limited number of pharmacies approved by the health department provide community service posts, and the R330,000 remuneration they provide is markedly lower than the state’s R488,000 annual package, Komape said.

The bottleneck in the state sector has an impact beyond individuals’ ability to fulfil the requirements to practise their profession, Kotze said, as the private sector is finding it increasingly difficult to absorb interns and to hire post-community service pharmacists.

Pharmacy Council CEO Vincent Tlala suggested that the government widen pharmacy community service posts to include private hospitals, which already take on pharmacy interns. Large hospital groups such as Netcare, Mediclinic and Life Healthcare could potentially each take on 100 community service pharmacists, he said.

Pharmacy Council data show close to 800 interns wrote exams this year and are likely to require community service posts next year. But the total number of people needing community service positions for 2023 is larger because applications are also made by people who failed to obtain a place this year, according to the PSSA.

The health department’s director for human resources, Victor Khanyile, said all the pharmacists who were eligible for community service when applications closed (on October 4) had been placed.

But the PSSA said his assurance applied only to interns who had written exams in March or August and not those who wrote exams in October and were still waiting for their results.

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