Hundreds of foreign docs working in SA
In a written reply to a question in the National Assembly, she said altogether 507 doctors - predominantly from developing countries - were on record as having been placed in specific institutions around SA since November 2006.
A further 515 had been endorsed towards sitting for the medical board exams with the Health Professions Council of SA (HPCSA), and 216 were rejected through the departments of health and home affairs screening process in compliance with the Immigration Act.
Of the 507 appointed, 364 were from developing countries, including 317 from Africa - mainly the Democratic Republic of Congo (137), Nigeria (133) and Zimbabwe (12).
Of the 114 doctors from developed countries, 61 were from the United Kingdom, 15 from the Netherlands, 11 from Germany, seven from Sweden, and five each from Australia and Belgium.
Commenting on Tshabalala-Msimang's reply, DA spokesperson Mike Waters called for a policy review.
On the one hand Tshabalala-Msimang claimed to enforce a policy of not allowing health professionals from other developing countries to work in South Africa, and on the other hand this policy was blatantly ignored in practice.
The policy was implemented as a way to prevent the exacerbation of the brain drain problem in other poorer countries.
"But 137 doctors working in South Africa are from the DRC, which has one of the lowest ratios of doctors to patients in the world."
The policy of not encouraging doctors from developing countries to work in South Africa did not make practical sense and needed to be reviewed, he said. - Sapa
Public health system 'falling apart'
Doctors at state hospitals say their patient load is so high that they don't have enough time to do a proper diagnosis. This, they say, is endangering patients' lives.
The complaint follows the recent death of a four-year-old girl with a heart condition after she was allegedly discharged from hospital too soon.
A patient in the advanced stages of Aids was also discharged from hospital.
At the Hillbrow community walk-in clinic in Johannesburg doctors see an average of 60 patients a day and have just seven minutes to assess each patient.
Doctors say the situation is aggravated by limited facilities and a lack of medicines.
An official at the clinic, who wished to remain anonymous, said the bureaucrats who ran the hospitals were oblivious to the state of public hospitals and didn't know what it was like to work under such appalling conditions.
"Things are falling apart in the public health system, which does not have patients' interests at heart," he said.
The very sick are referred to Johannesburg Hospital, where patients are seen by specialists.
But too often, patients are referred back to the Hillbrow clinic, such as the case of the desperately ill Aids patient.
According to the official, the child with the heart condition was discharged from Johannesburg Hospital last week and told to return for a check-up in six weeks. She died the following day.
He said unless the patient load decreased substantially, doctors' diagnoses would be compromised and more patients would be at risk of being discharged too early, sometimes with fatal results.
Wits University's Medical School professor of rural health Ian Couper, said the UK's National Health System set the minimum consultation time with a patient at nine minutes.
But, he said, even that was probably too little time.
Ideally, he suggested, a doctor should never see more than 40 patients in an eight-hour day, allowing about 12 minutes per patient.
Dr Joop Laubscher, who was superintendent of Germiston Provincial Hospital from 1989 to 1999 and is now in private practice, said he knew of at least one doctor who dealt with 60 patients per day and only had seven minutes to assess a patient.
He compared the situation to working "on a factory production line".
"In an assessment, a doctor has to check a patient's vital signs such as blood pressure, heart rate and test sugar levels, and a thorough assessment can't be done properly in such a short time.
"In my view, a doctor needs between 15 to 30 minutes to properly assess a patient and make a diagnosis," Laubscher said.
However, Johannesburg Hospital chief executive Sagie Pillay said seven minutes was sufficient time and denied that the public health system was falling apart.
- This article was originally published on page 4 of The Pretoria News on March 03, 2008