Privatise SA’s tertiary medical education facilities

SA continues to suffer from a chronic shortage of skilled health care professionals. This threatens the ability of health care providers, including government, to provide health care to those who need it. Last year, the Minister of Health, Manto Tshabalala-Msimang released the final draft of a discussion document entitled, ‘A National Human Resources Plan for Health’, which largely responded to a report that an estimated 23,407 SA-born health care professionals were working in five OECD countries.

Given the inadequate numbers of health personnel and increasing burden of disease, particularly the onslaught of the HI virus, fears are growing that patients will be subjected to increasing risk. Indeed, the Health Systems Trust estimates that SA will require an additional 3,200 doctors and 2,400 nurses by 2009 in order to care for its large number of HIV infected patients. The doctors and nurses who have decided to work elsewhere cannot be blamed for the looming crisis. The free movement of labour is a fundamental and inalienable right of individuals, irrespective of the circumstances they leave behind.

So what needs to be done to increase the supply of skilled health personnel in South Africa? The immediate response would be to let skilled foreign health professionals practise in SA to partially address the current shortage. A long-term strategy would require the government, and more specifically the department of education, to relax the controls on tertiary education facilities, make entrance to these facilities less restrictive, and allow the private sector to provide a large percentage of tertiary medical education.

If this is done, a significant part of the burden currently faced by the public sector will be eliminated. SA private hospitals are well-established centres of excellence and world-renowned for their high levels of care. Privately run education facilities, if conducted in co-operation with these hospitals, will thus attract a significant number of internationally recognised lecturers, which will increase the available pool of knowledge, as well as international students, who potentially will remain to work in SA.

To reverse the so-called brain drain, the SA government should allow the private sector to relieve some of the burden currently placed on public sector education facilities. The private medical schools could operate on either a for-profit or non-profit basis.

The private sector generally provides services that are superior to those provided by the state because it is subject to the disciplines imposed by competition and consumer choice, and the education and training of students within private sector tertiary institutions would benefit from such disciplines. Privately run medical schools will not solve the chronic medical staff shortage overnight but will certainly aid the long term efforts to increase the numbers of medical professionals in SA.

Author: Jasson Urbach is an economist with the Free Market Foundation. This article may be republished without prior consent but with acknowledgement to the author. The views expressed in the article are the author’s and are not necessarily shared by the members of the Free Market Foundation.

FMF Feature Article/03 April 2007 - Policy Bulletin / 25 August 2009

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