The flight of specialist doctors from the public health sector in Gauteng points to another looming crisis that will affect patients, staff and those training to be specialists. A spate of resignations in recent months has seen three cardiologists call it a day at Chris Hani Baragwanath Hospital, the largest hospital in the southern hemisphere. In addition to losing all its cardiologists by the end of December, the hospital has also seen the exodus of three of the ear, nose and throat (ENT) specialists of the four in the department.
The Gauteng Department of Health insists that the resignations will not cause a disruption of service in cardiology or the ENT department, and that the positions are being filled. “The hospital has already initiated a full recruitment and selection process to ensure that the vacant specialist posts are filled by 2 January 2026. This ensures smooth transition and no disruption in the delivery of quality healthcare services,” the department said to Daily Maverick.
A hospital insider speaking to Daily Maverickis unconvinced that this will be the case come 2 January. He said: “Where is the evidence the posts were actually advertised? They’ve also talked about filling some of these posts on six-month contracts, but it’s unlikely this will materialise.” The crisis of a shedding of specialists is ripping through departments and through hospitals in the province.
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Concerns remain that as posts become vacant they will not be filled timeously, or be funded. There are questions about the lack of a proper human resources strategy and management for the long-term retention of specialists in the public sector. Specialists at the province’s academic hospitals have a dual role of teaching and supervising registrars undergoing specialist training.
Without being able to offer trainees supervision and training, the accreditation status of medical schools is in jeopardy. Professor Shabir Madhi, Dean of the Faculty of Health Sciences at Wits University, says functioning specialist units at academic training hospitals should have a specialists staff complement that was compliant with HPCSA (Health Professions Council of South Africa) accreditation requirements. “You need continuity of care that comes with full-time staff and integrated, efficient services to manage patients,” he said.
Madhi acknowledged that Wits’ training programme for specialists and undergraduate training stood to be affected by the resignations. “The university will not be able to register new registrars or fellows for specialists training in disciplines that do not meet the HPCSA requirements for adequate supervisory capacity. For the training of specialists the university requires one consultant for every four people who are in training,” he said.
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