Plan for fewer frontline doctors

2009-04-17 00:00

OVERBURDENED state hospitals in KwaZulu-Natal, already struggling to meet the overwhelming demand for health services, will be hobbled even further if a plan to reduce the number of interns allocated to provincial hospitals in 2010 goes ahead.

The impending crisis prompted the KZN midlands branch of the South African Medical Association (Sama) to pen an open letter this week to national Health Minister Barbara Hogan, asking her to reverse the decision, which will cut the number of KZN interns for 2010 from 739 to 400.

In the Pietermaritzburg hospital complex, which includes Grey’s, Edendale and Northdale hospitals, this will mean a drop in the total number of interns from 212 to 142. Sama estimates that a province the size of KZN should be training about 800 interns.

All medical graduates are required by the Health Professions Council of South Africa (HPCSA) to work as interns in a public facility for two years before they can register as medical practitioners. Interns act as the first line of clinical service for patients and facilitate daily assessments, management and referrals.

The decision to reduce internships, apparently taken by KZN Health Department chief financial officer A.S. Buthelezi, is widely seen as an attempt to cut costs in the wake of last year’s reported R1,5 billion overspend by the provincial department.

The decision was formally tabled at a meeting of the internship subcommittee, held in Pretoria on March 27 and attended by provincial and national health department representatives and representatives of the HPCSA. The sub-committee meets annually to discuss the national allocation of interns.

Signed by outgoing Sama president Dr Jim Muller, the letter to Hogan attributes the overexpenditure on health in the province to “uncontrolled expansion of personnel at head office” at the expense of clinical services.

Muller told Weekend Witness that medical graduates from KZN who could not be allocated to KZN because of fewer positions would be allocated to other provinces.

Another Sama member, second-year intern Dr Lwazi Manzi, told Weekend Witness that the plan spells disaster for Pietermaritzburg hospitals, especially Northdale and Edendale, the latter being among South Africa’s busiest. She described interns at state hospitals as “the foundation of our fraternity”.

“We are already struggling to get the work done. Interns are like the worker bees of the system.

They are the first doctor any patient sees. There is limited senior support because of the massive brain-drain we’ve experienced, so interns, many of whom are brilliant doctors, perform a critical function. It’s just not feasible to reduce their number,”she said.

Mduduzi Masuku from Hogan’s office said the minister had only just received the letter from Sama and was not yet able to comment.

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