Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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Blame It On Apartheid
- Joseph . C . Obi (3 September 2004)
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Impossible to return to South Africa
- Andrew C Don-Wauchope (3 September 2004)
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No need to poach (we're scrambling to get there)
- Nicole Karen Fung (MRCPsych) (3 September 2004)
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Joseph . C . Obi, Provost and Emeritus Chair of Nutritional Immunomodulation RCAM (Royal College of Alternative Medicine) www.RoyalCAM.org
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South African Doctors should not be publicly blamed for gleefully emigrating to the United Kingdom , Canada , Cayman , Australia, New Zealand or any other 'Exceedingly Luxurious Parts' of the world where their hard-earned qualifications are reciprocally recognized. During the 'Apartheid Era', most of these (above) countries expediently granted 'Automatic Medical Licenses' to 'White South Africans' who graduated from 'Predominantly White' South African Medical Schools ; while (unfairly) leaving 'Black South Africans' from 'Predominantly Black' South African Medical Schools totally out of the 'Very Merry Picture'. The 'End Result' of such 'Obtuse Racial Bias' on the South African Healthcare System was to be extremely catastrophic indeed ; as the 'Predominantly White' South African Medical Schools were not actually admitting enough 'Black Doctors' to meet South Africa's 'Exponential Healthcare Needs' . At the very same time , 'Predominantly Black' South African Medical Schools were woefully being starved of adequate funding to correct this 'Apartheid-Induced' Anomaly. How then could South Africa ever even dream of having enough 'Indigenous Doctors' to meet it's domestic needs , when it was incessantly turning thousands of 'Intelligent Black Candidates' away from it's 'Half- Full' White Medical Schools ? And who exactly would (then) be managing all of those 'Filthy Little Clinics' in 'Downtown Soweto' and other 'Black Shanty Towns' , when most of the 'White Doctors' vehemently preferred treating their own 'Kind' ? Game Over : It is far too late for the National Health Service (NHS) to 'Honourably Stop' the 'Exodus' now . If Britain sternly shuts the door , another desperate country will cheekily open the window. Do have an Exceedingly Wonderful Autumn ; while I judiciously attempt to squeeze £500million out of an 'Infallible Regulatory Body'. Competing interests: Professor Joseph Chikelue Obi FRCAM (Dublin) FRIPH (UK) FACAM (USA) also supervises an Interdisciplinary Revalidation Initiative (IRI) for Seasoned Practitioners in Complementary and Alternative Medicine. Please kindly visit www.RoyalCAM.org for more details |
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Andrew C Don-Wauchope, SpR Chemical Pathology Edinburgh Royal Infirmary Little France Crescent EH16 4SA
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I have read Pat Sidley's report with some interest as I spent the best part of a year trying to get gainful employment in the South African public sector. Having spent the previous 5 years in the UK I had got used to some of the aspects of UK employment. In particular the employment contracts that are negotiated between the BMA and the NHS. I was offered a contract that I did not think was suitable for a number of reasons. This contract was only tabled after I had started work and I attempted to discuss the issues I had with the contract with the appropriate managers. Approximately a month later I was, in my opinion, unfairly dismissed for not agreeing to sign a contract that I thought was flawed and that the state employer refused to discuss with me. Since then the South African Medical Association have failed to get a hearing at the mediation court and I may be forced into taking the matter to the labour court. The South African Medical Association seems to be a very weak player in contract negotiation and does not have recommended contracts for state employees. They have refused to give written comment on the contract I showed to them and have verbally agreed and disagreed with my points of concern. For doctors who have travelled and been exposed to a different set of standards the South African health service human resources departments are way behind the international norm. It is admirable of the minister of health to try and stop the flow of health care personnel out of South Africa but there are many simple improvements that could be made to retain health care professionals. Further there are others that could be made to attract health care professionals back to South Africa. To attract individuals back she should ensure that the returning doctors are offered conditions of service that are closer to international standards and she should ensure that returning individuals are able to be placed on equivalent pay ranks to their ranks in the country they are currently working in. She should also make the process of recognising international specialist training simpler and allow the South African College of Medicine room to award specialist certification where appropriate. Morale among doctors in South African state hospitals is a little lower now than when I left in 1998 however, the striking difference to me was in the private sector where morale seems to be as low as it could get. The legislation that is being passed in South Africa appears to be destroying the private sector. There are numerous individuals who maintain their standard of living by doing locums outside of South Africa. Another issue is doctors and other health care professionals who are giving up their medical careers, as they see no future in them. South Africa remains a complex and fascinating society I do hope that they learn to treat their health care professionals with some degree of respect as that above all else will encourage them to stay. Competing interests: None declared |
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Nicole Karen Fung (MRCPsych), SHO Psychiatry Queen Elizabeth Psychiatric Hospital, Edgbaston, Birmingham, B15 2TZ
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Recruitment programmes are not required to lure South African doctors to work in the UK. There are many factors that drive doctors out of SA and it is not surprising that almost a third of posts in the public sector are unfilled (Pat Sidley). The remedial measure of compulsory community service itself is a strong push factor for new graduates. Not necessarily because doctors are opposed to it, but because of the non-negotiable way it is imposed and implemented. SA doctors who have come to work in the UK for the “overseas experience”, soon discover the merits of new deal compliant training posts (including protected teaching, research and special interest time and supervision), BMA model contracts and the implementation of the EWTD. Understandably a 1 in 3 on-call rota in an understaffed and under funded hospital is in no competition. It is not only the working lives that pale in comparison. Serious crime, hijacking, murder and rape are a daily occurrence that many are trying to escape. The shortage of doctors in SA public health services cannot be blamed on Recruitment Programmes (or apartheid) alone. It will take more than just curbing international recruitment to stop doctors leaving SA. Competing interests: South African graduate |
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