Skills shortage logjam loosens.

The longstanding bureaucratic logjam preventing much needed foreign qualified doctors from supplementing local skills shortfalls has been shaken loose while much improved rural and 'scarce skills' allowances are set to flow from July this year. Lobbying of the National Department of Health (DOH) by the Rural Doctors Association of South Africa (RUDASA), plus a court action in May 2001 by the Foreign Qualified Doctors Association against the DOH, the Health Professions Council of South Africa (HPCSA) and the Department of Home Affairs have contributed to a fundamental reappraisal of the status of both incoming and existing foreign doctors. The improved rural and scarce skills allowances (which in some cases double), are the first creative use of an extra R500 million allocated this year to the DOH for vital skills retention and upgrading of local service conditions. Reliable sources say that 'about two years' down the line, medical students will have financial incentives such as generous loan repayment terms and a chance to go onto the public sector payroll during their final undergraduate year. This is expected to help slow the overseas exodus, which JUDASA surveys claim currently applies to the majority of newly qualified doctors. IZINDABA 315 'If we only take the cost of training a new educator and apply it to the replacement of just those 1 700 educators of 49 and under who died of illness in the last four years, we get a figure of R170 million in 'year-2000' Rands,' Badcock-Walters said. This was without adding the costs of writing off the original training and providing temporary replacements. The research team recommended an urgent upgrading of the schools data keeping system, reporting that only 24% of their sample schools kept anything approaching comprehensive and accessible records. The sheer length and complexity of their paper suggested that data and management information was not routinely extracted by the education department which had yet to come to terms with the need for an 'early warning' system consistent with the needs of the HIV/AIDS era. Decisions were therefore not yet routinely evidence-based and data capture and analysis were not yet a key systemic function. The mortality data confirmed a pattern that could 'no longer be wished away'. While their study was not a 'doomsday' scenario it signalled that AIDS-linked mortality was incrementally eroding the capacity of the system and would inevitably have dramatic repercussions for educator recruitment and training. Badcock-Walters added: …