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No Budget, No Jobs. SA Public Health Sectors Comes up Short
Time to read: 02:26
Published: 16 March 2025
In his 2025 budget, Finance Minister Enoch Godongwana allocated funds which he said would address part of the severe public sector doctor shortage.
But the allocation falls woefully short of what our ailing healthcare system needs; only an additional 800 doctors will be employed.
South Africa's public health sector faces alarming vacancy rates, ranging from 5.48% in the Western Cape to 22.4% in the Free State.
Despite the increased number of medical graduates—now 3,600 annually, up from 1,200 in 2011—South Africa faces challenges in providing them with community service placements, essential for fulfilling their training requirements. Once their community service is completed, many graduates remain unemployed because the government cannot afford to employ them due to ongoing economic struggles.
While the health budget is projected to grow from R277 billion in 2024/25 to R329 billion by 2027/28, and a substantial portion of this increase is earmarked for hiring doctors and healthcare workers, as things stand, the government cannot employ the remaining 1,000 doctors currently without work due to what it says are "budget constraints.
To make things worse, the public health sector experienced the loss of nearly 9,000 health workers over the past year: the state indicated it lacked the resources to replace them, even after reprioritising funds meant for consumables and medicines.
In his speech, Godongwana emphasized the country’s significant debt servicing burden, which amounts to R389.6 million in the 2024/25 fiscal year. These debt obligations absorb 22 cents of every rand raised in revenue, surpassing the combined spending on health, police, and education. Additionally, unpaid invoices from previous years, currently approaching R22 billion, worsen the cashflow crisis in public healthcare.
In terms of doctor compensation, some health officials suggest that South Africa's doctors earn disproportionately high salaries compared to other professions. Speaking to Bhekissia, the department's Percy Mahlathi says that when you add in overtime, doctors in the public system can earn up to R80,000 to R90,000 per month, much higher than the salaries of many other professionals, including those in the legal field.
But SAMA s vice chairperson Ames Dhai says the fault does not lie with the doctors, but rather it is the current salary structure, established in 2009 under the occupation-specific dispensation, that has contributed to the high cost of employing doctors. The framework was intended to retain skilled professionals in government service but has resulted in doctors being paid at a level higher than their counterparts in countries like Kenya and Nigeria. With this in mind, officials propose redistributing some of the overtime pay to hire additional doctors, potentially addressing both the need for more staff and the high demand for overtime work. Some provinces have already begun restricting overtime hours, which could save a significant portion of the overtime budget.
Health Minister Aaron Motsoaledi acknowledged that the economic difficulties have impeded the government’s ability to absorb new doctors into the workforce, which has exacerbated the shortage of healthcare professionals. According to healthcare experts, this failure to employ new doctors is a significant issue, as the state has not met its obligations to provide adequate healthcare. The inability to retain and hire necessary medical professionals is seen as a failure in the healthcare system, affecting the delivery of quality care to the population in need.
This article was compiled with information obtained from various sources including:
12 March 2025 | Bhekissia | Budget 2025: Jobs for only 800 of 1 800 unemployed doctors
7 February 2024 | Business Live | This is why the health department cannot employ new doctors
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