The number of doctors working in the public healthcare system in the Free State has dropped from 716 in 2014 to 539 this year. This amounts to a loss of 177 doctors – a 24% reduction in the number of doctors. The province also has 28 fewer medical specialists than a year ago.

The figures were published in the 2015 SA Health Review which was launched yesterday evening. The SA Health Review sourced the information from the Personal and Salary Administration System (Persil), Treasury’s central system that pays public sector salaries.

According to the SA Health Review the Free State now has 23.3 doctors per 100,000 patients. Only Mpumalanga and the Northern Cape have lower ratios. Aside from the Free State, Mpumalanga is the only other province that has fewer doctors now than a year ago (a marginal drop from 875 to 836).

“Under MEC Benny Malakoane the public healthcare system in the Free State is falling apart,” says Anele Yawa, General Secretary of the Treatment Action Campaign (TAC). “On the one hand the system is collapsing, but on the other hand if you speak out or try to do something about this collapse you are persecuted and accused of racism or having a political agenda. We cannot blame these doctors for fleeing the province given the unbearable atmosphere MEC Malakoane has created.”

In February this year whistle-blower doctors from the Free State published an open letter on the GroundUp News website highlighting the extremely difficult conditions under which they are forced to work in the province. They highlighted a number of shocking management failures for which the the provincial Department of Health and the office of MEC for Health Benny Malakoane must ultimately take responsibility. The doctors asked the South African Human Rights Commission to investigate the situation.

At the time the doctors warned that “the standards in Bongani Regional Hospital in Welkom have dropped so low that it is at risk of losing its accreditation to employ and train interns should it not adhere to an ultimatum from the Health Professions Council of South Africa (HPCSA) to meet minimum standards.” It appears their appeals fell on deaf ears. Last week media reported that five babies died at the hospital due to Klebsiella – later the Department of Health retracted this statement and said the deaths were due to pulmonary haemorrhage.

In his response to the open letter from the whistle-blower doctors Free State Premier Ace Magashule failed to address any of the issues raised by the doctors. Instead he attempted to shift the debate by blaming, among others, “racial attitudes, dealing with insecurities of personnel, victimization of various categories of staff and the general ineptitude of some professionals who are clearly not committed at times to sustaining non-racial provision of health services.”

“When you lose a quarter of your doctors in one year you have a very serious crisis,” says Yawa. “Ultimately it is the people on the ground who suffer. We are deeply disillusioned by the way in which the government and the ANC has allowed this situation to unravel under their eyes. We have spoken with both the Minister of Health and the Deputy President about the situation in the Free State. We also raised it in a meeting with ANC leadership at Luthuli House last September. They have all failed to intervene on behalf of the people of the Free State. Through their silence they have betrayed the people.”

The exodus of public sector doctors from the Free State comes in the context of the dismissal and persecution of community healthcare workers who took part in a peaceful night vigil in July last year after having been dismissed earlier in 2014. After seven court appearances the so-called Bophelo House 94 were finally convicted in the Bloemfontein Magistrate’s Court last month for participating in a prohibited gathering. We expect this judgement to be overturned on appeal.

On November 10 the report of the ‘People’s Commission of Inquiry into the Free State Healthcare System’ will be launched in Bloemfontein. While the inquiry process was facilitated by TAC, the three commissioners – Thembeka Gwagwa, Bishop Paul Verryn and Thokozile Madonko – were given full independence and authority in managing the process of conducting the hearings and authoring the report. It is our hope that their report will help point a way in the increasingly desperate situation in the Free State.

For more information and to arrange interviews contact:
Lotti Rutter // 081 818 8493 // lotti.rutter@tac.org.za