Why I support the Doctor's Strike

I support the Doctor's strike.

Today I chatted to a friend who is a doctor, and now I support it all the more.

So let me explain why, drawing from my conversation with my friend. She is not on strike herself actually, she says she has too much work to go on strike. At her hospital all of the sections have been organised to run on a skeleton staff, and the rest of the doctors are striking.

Why I Support the Doctor's Strike

Firstly, it needs to be pointed out, the strike is not only about salary increases. The strike is also about conditions in hospitals. Watching the striking doctors on TV, I saw one carrying a placard reading something along the lines of: "fighting for a better health care system." That's is what this is about.

Problems with our health care system? Many. Equipment shortages, medicine shortages. Management. Administration. And as my friend says, "there are roaches, rats, cats!"

But one of the biggest problems: staff shortages (just a quick search leads to examples here, here, here, here, here, here, here, here, here). Because of the staff shortages, doctors are having to work longer hours. Twenty-four, thirty, thirty-six hour shifts are not uncommon, my friend tells me. Working till you are so exhausted you literally are collapsing, unable to work. That is a dangerous state for a doctor to work in.

And staff shortages lead to young inexperienced doctors and interns having to cope with work that is way beyond them. One of the articles above says that "interns are manning the emergency ward part of the time" (here). Out of their depth, and patients suffer.

Staff shortages lead to long queues, sick people who may have travelled hours and hours sitting for hours and hours more in waiting rooms. Some eventually being turned away and having to come back later. Especially in places like East London, people travelling from the far reaches of the rural Eastern Cape to get to the hospital. Very sick people. Then there are just not people to help them.

And as doctors get more and more tired, frustrated, more and more demotivated, unable to work in a crumbling system, burned out, they leave. A friend of mine who wants to work in a public hospital, and did work in a public hospital for several years, eventually went to private practice because he just couldn't take the frustration anymore. Another friend of mine emigrated. Not because he wanted to leave South Africa, but he just couldn't take it anymore.
As one of the articles above puts it: "It's about the push factor now, rather than the pull factor when it comes to emigration. Medical personnel aren't going overseas for better money any more. Many are accepting similar salaries for lesser positions just to get out of this madness and practise ethical, responsible medicine" (here).

The friend I spoke to today told me that of her graduating class, 33-50% admit to having to be on anti-depressants, they just couldn't take the heartache that came along with their jobs. She herself had to go onto anti-depressants, after working in rural KZN. She was in charge of a paediatrics ward, and months of caring for dying babies broke her heart.

And ironically, in the face of these huge staff shortages, when doctors leave their posts are frozen. So no one can be hired to replace them. Instead, more HR staff are being hired. Which would perhaps make sense if the HR/admin staff were fixing the system. But they aren't. My friend tells me that at her hospital complex every time a doctor leaves the doctor's position is frozen and the money is allocated to a HR position, which is then opened.

My friend worked in Baragwanath Hospital in Joburg for a while. There were 120 positions for interns there, she said. Only 60 positions were filled. Because nobody wants to work there - conditions are just too horrible. In her own words: "Its... its basically like hell on earth."

We are in the middle of a global recession, yes. But this problem with doctors salaries is a problem of the employer's (the government) own making. Doctors were promised a wage increase last year which wasn't followed through with. It wasn't even budgeted for - indicating that the state had no intention of making good on it's promise.

Doctor's have not been getting routine yearly increases for years and years. As for the increases the government have proposed now, because of the strike, they do increase doctor's basic salaries. But they take away overtime pay and they take away scare skills benefits. Which means the increase they are offering only amounts to about 2%.

Our public health service has many challenges. All of which need to be addressed. One of the primary problems is these chronic staff shortages. We need to treat our doctors properly if we are going to keep them. Part of treating them properly is paying them properly. It also means government must stick to their word and honour wage increases that they have promised.

I am not a believer in big government. I am not a believer in a carer state that dolls out free health care and education and social grants. I am not a believer in the state as a solution to all our problems: the government must fix this, the government must fix that, the government must provide. And I know that this is the worst possible time for doctors be asking for more money.

But as my friend says, the stick bends and bends and bends, but eventually it will break. And now it is breaking.

Our public health health system is in a major major crisis. And it needs to be fixed. It needs to be fixed yesterday actually, but today will have to do.

ANC spokesperson Jesse Duarte has said, "that while the party empathised with the striking doctors, public health care and patients suffered as a result of the strike" (here). The ANC and COSATU have also accused the doctor's strike of killing patients (here).

The public have suffered for a week or two as a result of this strike, yes. But the public have suffered for years and years as a result of the ever decaying state of the public health care system. Which is not the fault of doctors. It is the fault of their employers, the state. And the public suffering will continue, and will become more extreme, if the system isn't fixed.