AHMED BANDERKER: SA is facing a skills crisis in healthcare

Our skills are our economic life force. Nowhere is this more tangible than in the healthcare sector, where skilled doctors, nurses and specialists are a life force that is draining away.

This was made even more tangible when the department of home affairs updated the critical skills list to include 41 specialised healthcare professions. It is a critical problem that needs to be handled with expediency, lest we experience a disabling medical skills shortage.

SA is facing several challenges in the training, recruitment and retention of healthcare workers. Many medical professionals are for various reasons either leaving the country or giving up clinical practice. These critical skills need to be replaced.

To put this into perspective, health minister Joe Phaahla revealed during a recent parliamentary question and answer session that the country has a doctor-to-patient ratio of one to 3,198. When compared with 2019, when that ratio was sitting at one to 1,266, the trajectory is not looking good for healthcare skills, and ultimately healthcare costs, in SA.

What about our nurses, the glue that holds our healthcare sector together, especially in hospitals and clinics? Data from the SA Nursing Council in 2021 revealed that the country has about 280,000 nurses — one for every 213 people. But SA is training fewer nurses than in the past, even though almost half of the existing nursing workforce is set to retire in the next 15 years. Not enough nurses are being trained to replace this ageing workforce.

We are losing experienced healthcare workers, with dire consequences for the delivery of services. This is a huge challenge, and it is the most vulnerable among us who will suffer the consequences if we do not address it. Having a finger on the pulse is all very well, but how are we to bring this sector back to life?

There is hope, as many private healthcare groups are elevating skills development and knowledge transfer to tip the scales back in our favour. The inclusion of specialised healthcare professions in the critical skills should also result in these skills being transferred to locals.

The issue of skills shortages in our healthcare sector affects us all. We all need to understand that more needs to be done to create skills and, more importantly, to keep them in clinical practice and within our borders.

It is ironic that in the public sector, where there is a dire shortage of doctors, budget constraints keep doctors from being hired. Efficient financial control systems within the public sector are needed to ensure money can be channelled in the right direction — specifically hiring and retaining doctors.

Healthcare groups such as ours are pulling out all the stops to encourage healthcare professionals to stay, both in active clinical practice as well as in support of all members of the SA population requiring access to healthcare. They are the foundation of the broadened access to care we strive to achieve in this country, which is why we invest in increasing the pipeline and constantly collaborate with healthcare providers across the sector to ensure they are supported in their focus on delivering optimal patient outcomes.

By educating young doctors and pharmacists and investing in skills development through various education programmes we are doing our utmost to maintain a knowledge base that moves healthcare forward. This is essential for the healthcare sector to sustainably function.

To create a knowledge-based economy our sector not only needs to balance its role of knowledge production (research) and knowledge transmission, but also transfer this knowledge to the benefit of those who can harness the knowledge to further develop the country’s healthcare capability.

As in many other sectors of the economy, one of the main reasons for our shortage of skills is the brain drain. Security, politics, stability, policy uncertainty and future hope for their children are all factors that push people out of our country and into the arms of more developed nations. Unless these concerns are addressed, as well as fears over what future National Health Insurance (NHI) will offer them, and unless we come up with an innovative retention strategy as a country, we will continue to lose skills.

Meanwhile, it is crucial that a commitment to sharing knowledge and creating beneficial environments for practitioners helps stem the tide.

• Banderker is CEO of diversified healthcare group Afrocentric, which includes medical scheme administrator Medscheme in its stable.