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Why Specialist Doctors Are Leaving South Africa’s Public Hospitals
When Specialists Walk Away, the System Feels It
In hospital corridors across South Africa, the signs are becoming harder to ignore. Senior specialists are handing in their resignations. Junior doctors are stretched thinner by the week. Patients wait longer, sometimes far longer, for care that once felt routine.
This quiet but steady exit from public hospitals is now one of the biggest threats facing the country’s health system, just as National Health Insurance moves closer to reality.
According to national health department figures, more than 12,700 doctors have left the public sector since 2013. Nearly 59,000 nurses, over 1,300 pharmacists, and close to 24,000 administrative staff have also resigned in the same period. These are not abstract numbers. They translate directly into empty posts, exhausted teams, and delayed treatment.
Inside a System Under Pressure
Health expert Dr Atiya Mosam describes the current wave of resignations as a warning signal from a system under real strain. Frozen posts, austerity budgets, and ever heavier workloads mean fewer doctors are doing more work, often without proper support or supervision.
The knock-on effect is serious. Quality of care suffers. Inequality between public and private healthcare widens. Training pipelines for future specialists begin to weaken.
Mosam warns that National Health Insurance depends on a functioning public health system with enough specialist capacity to support referrals, governance, and continuity of care. When primary healthcare falters, patients arrive at specialist clinics with conditions that should have been prevented or managed earlier. That unnecessary pressure pushes specialists closer to burnout and out of the system entirely.
Baragwanath Was a Warning, Not an Exception
The recent departure of cardiologists and ear, nose, and throat specialists from Chris Hani Baragwanath Hospital sent shockwaves through the medical community. But according to the South African Medical Association, this was not an isolated incident.
Dr Mzulungile Nodikida says the exodus reflects a national crisis that has been allowed to drag on for years. Chronic staff shortages, unfilled funded posts, crumbling infrastructure, delayed overtime payments, and salaries that have not kept pace with inflation have steadily eroded morale.
For many specialists, the decision to leave is no longer about ambition. It is about survival.
Why This Matters for National Health Insurance
On paper, National Health Insurance promises fairer access to healthcare for all South Africans. In practice, experts warn that no financing framework can work without the people needed to deliver care on the ground.
As specialists leave, service capacity weakens. Waiting times grow. Clinical outcomes deteriorate. Training platforms at academic and tertiary hospitals are shrinking, threatening the next generation of doctors that the system will desperately need.
Medical leaders argue that this reveals a sequencing problem. Large-scale reform cannot succeed when the foundation is unstable. Workforce retention, governance, and working conditions must be fixed before expanding accreditation and purchasing under NHI.
The Political and Social Backdrop
Opposition voices have been blunt. Gauteng health spokesperson Dr Jack Bloom has described the loss of specialists as devastating, blaming mismanagement and corruption in most provincial health departments. He argues that without major revision and credible funding, NHI risks driving even more doctors to emigrate.
Civil society groups echo the concern. Positive Women’s Network health expert Lindiwe Mahlangu warns that understaffing and overcrowding deepen inequalities in access to quality care, placing added pressure on those who remain in the system.
On social media, healthcare workers have shared stories of unpaid overtime, broken equipment, and emotional burnout. Many South Africans watching from the outside are asking the same question. If experienced doctors cannot cope in public hospitals now, what happens when demand increases under NHI?
What Needs to Change Before It Is Too Late
Medical organisations are calling for immediate action. That includes filling critical specialist posts, stabilising employment conditions, honouring overtime agreements, and engaging meaningfully with healthcare professionals on long-term retention strategies.
The message from experts is consistent. Retaining specialists is not a secondary issue or a future problem. It is a prerequisite for any successful reform.
If the public health system continues to lose its most skilled professionals, National Health Insurance risks becoming a promise that exists on paper only, while patients wait in crowded wards for care that never comes.
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Source: The Citizen
Featured Image: Daily Investor
