Cape Town - The number of South Africa's doctors and specialists could over the next ten years reduce by 12% and 16% respectively if the shortage of healthcare service suppliers in the country is not resolved.
The insufficiency of medical service suppliers has long been known, but an investigation by the economic research group Econex shows that the number of doctors in the country will decline from 27 431 this year to 23 849 in 2020 if the current state of affairs does not change.
Econex economist Mariné Erasmus said that South Africa had far from sufficient doctors to meet current demand and there was a huge number of vacant posts countrywide. A further decline in the number of doctors would result in loss of service and care for the whole population.
According to Econex the country has 17 801 active general practitioners and 9 630 specialists - a total of 27 431. This means there are 55 doctors for every 100 000 people, which is a very low ratio compared to other countries.
Brazil has 185 doctors for every 100 000 people, the United Kingdom 230, Greece 500, America 256, Australia 247 and Mexico 198.
It's quite clear that South Africa seriously lags countries like America, Greece, the United Kingdom and Australia, and it's concerning that we do not compare favourably with other developing countries like Brazil and Mexico, which have similar economic developmental levels.
South Africa's 55 doctors per 100 000 people is also somewhat unevenly spread across the country. Most practise in the Western Cape and Gauteng. According to Erasmus the distribution is related to both the urban concentration of the population and the location of public training hospitals.
Limpopo has the most (80%) vacant posts for doctors and specialists. Vacant posts across the country reflect 49% for doctors and 44% for specialists. The average overall percentage of vacant posts for specialists and doctors in the South Africa's nine provinces is 42.5%.
She said doctors are also concentrated where members of medical schemes are located - in other words, where there is the most economic activity. The regional distribution needs to be improved because delivery of health services depends on staff availability.
The College of Medicines of South Africa reckons that 25% of the doctors trained in South Africa no longer work here.
Consequently, said Erasmus, one can expect some 25% of the doctors and specialists completing their studies every year to emigrate.
Any decline in the number of available doctors is concerning because demand for medical services will escalate, whether national health insurance is introduced or not.
In her view the final structure of healthcare reform will depend on the requisite level of service providers in the country.
It's unlikely that South Africa will be able to offer adequate levels of care without a significant and sustained increase in resources, she said.
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