A gathering storm has been forming in the South African health-care sector as the country forges ahead with implementing the National Health Insurance. Uncertainty surrounding the scheme’s practical implementation has prompted an exodus of skilled workers, exacerbating the country’s ongoing “brain drain” crisis.
DEVELOPED countries such as Canada and the UK that are battling a severe skills shortage have set their sights on South Africa.
A gathering storm has been forming in the health-care sector as the country forges ahead with implementing the National Health Insurance (NHI).
Uncertainty surrounding the scheme’s practical implementation has prompted an exodus of skilled workers, exacerbating the country’s ongoing “brain drain” crisis.
The brain drain is not only a problem for the health-care sector. South Africa is also losing skilled workers in other fields, such as engineering, IT and finance. This is having a negative impact on the country’s economy and its ability to compete globally.
In addition, the British department of education announced an offering for international relocation payments of about R243,400 to foreign physics and language teachers – with their target set firmly on, among others, South African teachers.
And recently, an immigration report out of Canada revealed that hundreds of South African health-care professionals and IT workers have entered Canada’s newly launched Express Entry pool for permanent residency.
The recent surge in applications for permanent residency by South Africa professionals is in response to the Canadian government’s new category-based selection criteria that will be administered through Canada’s flagship economic immigration programme, Express Entry.
Last month Canada identified close to 80 job types over five key sectors of the economy, with a primary focus on health-care and IT occupations.
“This is essentially the new ‘critical skills’ list that we have been waiting for the last two years,” said Nicholas Avramis, a South African-based Canadian immigration consultant.
According to Avramis, his office has signed up over 150 health-care and IT workers in the last two weeks.
“It used to be that Canada would randomly select applicants in the pool based solely on age, education and English language proficiency, while those things are still important, the system will first filter applicants based on their job type. This is a game changer,” he said.
In the past decade, South Africa has witnessed an alarming emigration of highly trained medical professionals.
The main driving force behind this new exodus is a pervasive sense of distrust.
Doctors are unsure if the government can effectively implement and manage the proposed NHI, said Dr Mzukisi Grootboom, chairman of the South African Medical Association (Sama).
“The reality is that all those South African doctors and nurses going to Canada and to the United Kingdom are going to countries that have their own kind of universal health coverage.
“So basically, there needs to be some reassurance on the part of the government about the ability to manage the local process. And it’s regrettable that nothing has been done, despite the fact that there have been some pilot sites for NHI, but we have not been told what the outcome is.
“The crux of the matter is the trust deficit that exists between the population and doctors in this instance and the government. There’s a huge trust deficit, which the government needs to work on, because their track record is very unfortunate because the people of South Africa deserve better,” he said.
Skilled Professionals Leaving South Africa
A survey conducted by Sama showed that up to 38% of its members plan to emigrate from South Africa due to the planned introduction of the NHI.
The departure of these skilled professionals would have a tangible impact on service delivery.
Already, South Africa has a significantly lower doctor-to-patient ratio than the WHO-recommended threshold, a gap that is expected to widen with this exodus.
Rural communities, which are already under-served, are likely to be the hardest hit.
A shortage of health-care professionals could lead to longer waiting times, poorer patient outcomes, and an overstretched health system teetering on the brink of collapse.
The emigration of skilled professionals also presents a significant economic drain. The country invests a substantial amount in the education and training of medical professionals, but it’s foreign countries that are reaping the benefits.
The resultant knowledge and skills transfer negatively impacts South Africa’s capacity to drive innovation and development in its health sector.
A snapshot of South Africa’s brain drain:
- In 2018, an estimated 10,000 South African professionals emigrated to the UK.
- In 2019, that number increased to 12,000.
- In 2020, the number of South African professionals emigrating to the UK declined to 8,000, due to the Covid-19 pandemic.
- In 2021, the number of South African professionals emigrating to the UK rebounded to 10,000.
- In 2022, the number of South African professionals emigrating to the UK is estimated to be 12,000.
The brain drain to other countries such as Australia, Canada and New Zealand is also significant. In 2022, an estimated 5,000 South African professionals emigrated to each of these countries.
