Shortage of 80 000 nurses in South Africa

7 December 2016

The DA has reliable information that alleges South Africa has a shortage 80,000 Professional Nurses (PN).

This alarming news was provided by a senior confidential source part of the professional nursing community.

This new figure is approximately double the estimated shortage of 44,780 (129,015 PNs were employed in 2015) identified as far back as 2010 by the Department of Health, which the University of the Witwatersand’s Professor Laetitia Rispel at the time referred as ‘profound’. Nursing, she said, was a profession ‘in peril’.

The consequence of this massive shortage is deeply compromised patient care. Research shows that a critical mass of PNs in hospitals reduces the risks of patients dying by 8 per cent and significantly cuts the incidence of urinary tract infections, gastro-intestinal bleeding, hospital acquired pneumonia, shock and cardiac arrests. Indeed, a high concentration of PNs is associated with up to 12 per cent a drop in adverse clinical outcomes.

South Africa is not educating enough professional nurses. In fact, the number of nurses trained has tanked. The reasons for this are complex, but it is principally a consequence of poor planning, under-funding, under-staffing of the licensing authorities and shockingly poor coordination between the Department of Higher Education and Training (DHET), the Department of Health (DOH) and the South African Nursing Council (SANC).

South Africa has always relied on the private and public sectors to train our nurses. However, because the licensing authorities (SANC in particular) have been slow to re-license private sector colleges for a new nursing qualifications regime, those not affiliated with large healthcare companies such as Netcare, Mediclinic and Life have been forced to shrink their staff and some have shut down because they cannot take in new students.

The DA believes that the current licensing process is designed for paralysis. The bureaucratic barriers to the rapid re-licensing of private nursing colleges that meet national requirements should be removed at once and an accelerated approval process – a properly staffed one-stop licensing agency –set in place.
With our unemployment crisis it is a national imperative that barriers to human resource development should be removed urgently.

The DA is also deeply alarmed by the growing antipathy against private sector health providers. We have considerable assets in private and public health that should be leveraged to serve the underserved better and not be set against one another as if our era is a remake of the Cold War. In this effort all responsible public representatives and leaders must promote productive cooperation not division.

This is why in the DA’s Our Health Plan (OHP) we propose to work towards:

- Cooperative arrangements between private and public sector health to provide a minimum healthcare package funded by both sectors with a cross-subsidy from the private to the public, eliminating the means test along the way;

- The installation of a national single number emergency service in a nationally run but locally delivered public-private ambulance partnership funded with an additional R1 billion from the cross-subsidy to improve services in rural and other under-served areas;

- The provision for an expanded education and training health platform involving both the private and public sectors by devoting an additional R1 billion (which the private sector should match) in grants to medical, nursing and other health professional training;

- Moving rapidly towards rationally organised regional training zones where public and private academic health and emergency education and training institutions, guided by robust human resource forecasting, clustered at universities and research and development parks.

The fact is that the ANC government has not invested in skilling South Africans in the health domain, one of our greatest legacy strengths, which is why our hospitals are broken, clinics are understaffed, patients have to wait in long lines to be helped and patient care compromised. Considering that the second largest chunk of our national budget is spent on health, this sector should not be in the dire straits it is.

Issued by Wilmot James, DA Shadow Minister of Health, 7 December 2016