Durban — The SA Medical Association Trade Union (Samatu) has noted the budget vote delivered by Health Minister Dr Joe Phaahla. However, it said it was deeply concerned with the many concessions made by the minister without a clear plan to address the problems in the sector. General secretary Dr Cedric Sihlangu said they have on many occasions raised the plight of unemployed doctors, but the department has been alleging ignorance of such facts.
Sihlangu’s comments follow after Phaahla said provinces had sometimes not been able to absorb medical officers due to budget constraints. He said this on Tuesday when he tabled the health budget vote for the financial year 2023/24.
“The minister concedes without a real clear and convincing solution to this ongoing problem. The state of infrastructure in various health facilities is deplorable and the government is fully aware of this. It’s a song sung at every occasion; however no change is forthcoming. Samatu, therefore, is not moved by today’s (Tuesday) budget vote,” said Sihlangu.
Phaahla said the budget allocation for the National Department of Health showed a decline of R4.4 billion from R64.5bn in 2022/23 to R60.1bn in 2023/24. He said even though the R4.4bn decline could be attributed to discontinuation of conditional grants which were allocated for the fight against Covid-19, including vaccination, the fact was that there was not even adjustment for inflation and there were also reductions in allocations to existing programmes.
“National Treasury acknowledges that the health sector is underfunded to a minimum of R11bn, but we believe cumulatively it is much higher.
“Some 89.2% of our budget is transferred to provinces and in the current budget the transfers and subsidies to provinces are at R56.2bn of the R60.1bn. R10 million per year over the next two years will go to the no fault scheme to cover adverse events following Covid-19 vaccination,” he said.
Phaahla added that over the last 10 years there had been a significant increase in the training of doctors by their medical schools, added to by graduates from Cuba.
“As a result, the number of medical interns increased from 500 in 2015 to 2 625 in 2022 while medical conserves increased from 1 322 to 2 369 over the same period,” he said.
Phaahla added that they were working with Samatu to make sure that doctors who want to work in the public sector were assisted to get posts.
He said over the medium-term expenditure framework R7.8bn has been allocated to support provinces for interns and conserves. A further R8.7bn within the HR grant has been allocated for specialists training over the three years.
Phaahla said it was common cause that many of their facilities required attention for maintenance, refurbishment, upgrades or replacements, but they also needed new infrastructure.
To support provinces in this regard, he said they have allocated R7.2bn over three years for direct transfer based on approved plans.
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