The number of clerks in public healthcare is rocketing while the number of doctors is falling. The Sunday Times asked Minister of Health Dr Aaron Motsoaledi . . .Why are we short of doctors?It's a global phenomenon.Why in South Africa is there a freeze on new appointments?I'm chairing a meeting of MECs and HRDs [human resource directors], who are discussing it. Two weeks ago, I said publicly that I want a list of any doctor who is out of a job.According to research, seven out of nine provinces have frozen posts, but you're denying it?Rather than just making claims, give me a doctor who doesn't have a job. We'll put them in a job immediately. What we can't do is put doctors in hospitals where they'd like to be. And most of them choose the city.Why have provincial health departments been hiring so many clerks?story_article_left1I wouldn't know. But in a study commissioned in 2008 - I'm the one, by the way, who brought this to the attention of the nation.Why didn't you do anything about it? In the past three years the number of admin staff has increased by 12%.We are trying our best to stop it.Why haven't you been able to stop it?You are aware that in the constitution, health is a competency of the provinces, and the HR function of hiring doctors is also a competency of the provinces.But you say you'll ensure doctors get hired. How come you have the power to do that?Because the MECs themselves who are being accused of this moratorium promised they would hire them. I asked them. It's the MECs themselves, it's not my power. I do have powers of persuasion, but not the legal power.Your powers of persuasion are clearly not strong enough because the hiring of unnecessary admin staff has continued.My power of persuasion is strong enough to have influenced that there be a moratorium to stop the hiring of clerks.It's clearly been ignored, hasn't it?We've now told the Treasury that the only way to ensure it does not get ignored is that they must directly be involved. In the past they [provinces] were given this control but we've now said the Treasury must put up a team that makes sure they stop hiring these clerks unless it has been approved by the Treasury.Another example of failing to act until too late?That's your impression. It's not my impression.That's the impression of the development policy research unit at the University of Cape Town.I haven't seen their research. I'm relying on the facts I know.The facts being told to you by the health MECs? How reliable are they?In your mind the MECs can easily lie and your researchers are the ones who are right all the time. If I confront an MEC and say, "Can I bring a doctor here now who has got no job?" And the MEC says, "Yes, bring them ..." The only way to prove the MEC was lying is for you to bring a doctor here and I am not able to give that doctor a job.How can National Health Insurance work if there are not enough doctors?In all parts of the world it has never been based on the fact that there are enough doctors. Part of the reason we have NHI is to utilise as many doctors as possible even in the private sector. NHI is a solution to try and bring more services and more doctors.Can it work in an environment of maladministration and corruption?It cannot.So how is it going to work?If you read the NHI white paper, it says NHI is a significant policy shift that will necessitate a massive reorganisation of the healthcare system.Surely the government has demonstrated that it doesn't have the capacity to organise or run a healthcare system?That's your impression.It's one of the worst in the world, isn't it?That is outrageous. It is not true and is completely outrageous. If it's the worst in the world, why are so many people rushing to South Africa for their healthcare?Are they rushing to use our public healthcare or our private healthcare?story_article_right2I know there are problems in our public healthcare, but the statement you have just made is completely outrageous.According to the World Health Organisation, our maternity mortality ratio is among the highest in the world. Isn't this indicative of the state of our public healthcare?You are very wrong. Absolutely, scientifically wrong. It's not a reflection on the public health system, it's a reflection on the whole healthcare system in the country. That's why we want to change it.Do you have the capacity to change it?Of course we do.So why hasn't it been used to change the public healthcare system?You can't change it overnight.How can you change it if you're going to rely on the same people?Where is it written that we're going to rely on the same people? We want to rely on skills around the whole country...