South Africa

MEDIC ALERT: No pay: Annual admin snarl-ups hit junior doctors on community service

Junior doctors across the country should have received their salaries on 31 January 2019, but the day came and went without a cent finding its way into their bank accounts. The ripple effects have been far-reaching as the euphoria of being placed at a medical facility turned to frustration and anger.

Daily Maverick spoke to some of the affected junior doctors, with the intention of finding out how they had been affected by the late payments of their salaries. The pool of doctors spoken to was from KwaZulu-Natal, Gauteng and the Eastern Cape respectively. Daily Maverick also spoke to the South African Medical Association to find out what the general feeling was among its members. Community service doctor *Eric Madonsela, based in Ingwavuma, KwaZulu-Natal said: We have the issue here in KwaZulu-Natal, it’s horrible in the Eastern Cape, but the worst in Gauteng. At the hospital where I am based, we only got a portion of our salaries”. Pushed to elaborate on how the wage issue has affected his way of life, he said: Because of this, I have not been able to pay money into my savings account. I have not paid my car’s insurance, meaning I can’t drive it anywhere since I have to be extra cautious, but more importantly, I was not able to pay for my children’s (my son and my two sisters) school fees, which are paid monthly. I had to prioritise food for them simply because I couldn’t send them to school on an empty stomach. I also had to cancel a trip home, so I basically last saw my family 38 days ago.” This doctor also indicated that he was still owed overtime pay, which he was told by his employers he would receive at the end of February. A first-year intern based in Gauteng said: We didn’t get paid this month. We got no notification whatsoever until we heard rumours from other hospitals… We got worried, went to HR to inquire, only for them to engage us on the payday. The story was there were too many of us, so they had to “create posts” for us, then process the payments. We were confused as to how we can be employed, sign contracts, yet posts are not enough.” She received her salary on 4 February. *Karabo Mthethwa, is a medical officer doing community service in the Eastern Cape. After receiving a bursary from the province, she was obliged to do her two-year internship and her year of community service in the Eastern Cape. She was placed at a hospital in Sterkspruit, a town in Joe Gqabi District Municipality, even though the hospital was not in her choice among five hospitals she had submitted in her application for placement. When she and two colleagues placed in the hospital reported for duty, they were told by officials their posts had not been established. Which essentially meant they were not recognised as employees at that hospital, despite being placed there at the end of 2018. On arrival they were faced with housing issues — they were told that the accommodation allocated to them at the hospital was being renovated, forcing them to live in a B&B near the hospital. The bill for their stay was meant to have been paid by the hospital. — which it failed to do. When we woke up on 1 February, the owner kicked us out. We were told that we cannot be given food anymore, and actually, we should vacate the B&B because the hospital had not paid.” From there they were moved to another B&B, which was only able to offer them a bed. So essentially, they had no food, and no money to buy food. The hospital was forced to instruct them to go home and return when they had been paid. Said Karabo: “It’s important to note that this thing is ongoing, literally every year. When I was in school — I was school in 2016, that was my last year of school — people who had graduated years before me would tell me horror stories of ‘we’ve been going through this for a long time, when I first got to community service, I did not get paid for three months and what-not; you must prepare for the time when you go to community service.’’ Dr Rhulani Ngwenya, a board member of the South African Medical Association (SAMA), spoke to Daily Maverick about the issues their members had faced over the last few weeks. He said even though the national Department of Health said on 9 February that all medical professionals would be paid by 11 February, 5% of young medical professionals were still waiting for payment. Asked by Daily Maverick what the South African Medical Association was doing about the problem, Ngwenya said the association had served the department with an interdict after it had missed the 1 February payment deadline. He said the association held a meeting with the Gauteng health department, which had the highest incidence of non- or late payment (with just less than half of junior doctors not being paid, to discover what the cause of the problem there was. Ngwenya, said the department had not provided an explanation of any substance. The association has written to the national health ministry, requesting that a task team be formed to investigate why incompetence in some provinces bedevils the placement of junior doctors. We have to find out why only three provinces got it right. Mpumalanga, Limpopo and Western Cape got it right. What are they doing differently?” said Ngwenya. SAMA has also said the national health ministry must draft a plan of action, clearly stating how it plans to combat this issue, as well as how it is will make sure those responsible are held accountable. Previously, provincial health departments have masked this incompetence by citing financial constraints. Jack Bloom, an official at the Gauteng Health Department, said that previously financial constraints could be attributed to non-payment of junior doctors, this time a lack of forward-thinking and administrative weaknesses were to blame. This time the province (Gauteng) had the money; they just didn’t create posts on time.” He said it was more a case of bad financial management, rather than an actual lack of funds. “Other provinces got it right. How is that? The national ministry of health must also be held accountable. They are aware of this problem — it’s something that happens every year around this time.” Attempts to obtain the comment from the national health ministry were unsuccessful. DM *Not their real names.