Is there a doctor in the house?

A shortage of doctors and nurses is a "global crisis" that is being keenly felt in South Africa.

Producing less than half of the doctors needed in the country - - only 1200 doctors graduate annually - South Africa is contributing to a global shortage of 4.3million doctors and nurses.

An article entitled "Global Supply of Health Professionals" in the New England Journal of Medicine, paints a dire picture of how the shortage leaves the poor least likely to get access to doctors and how populations are becoming sicker due to an epidemic of lifestyle diseases.

A major South African medical aid has warned that the shortage of medical professionals will "only get worse" and has called for urgent intervention.

"Something needs to be done in South Africa and soon," said Fedhealth Medical Aid principal officer Peter Jordan.

"We need to act quickly."

He said that South Africans used to want to study medicine "but the profession is viewed negatively now. It is easier to become an actuary."

Department of Health spokesman Joe Maila said the department was "concerned" about the shortage of medical professionals.

"The health minister is on record as having said the global shortage of doctors is worrying. It especially affects countries in Southern Africa."

Sub-Saharan Africa is the region with the fewest doctors and the highest disease burden.

Jordan said the poor treatment of doctors during community service encouraged them to seek work overseas.

"We drive them away," he said.

Also, medical schools do not have the capacity to train more doctors - more than 8000 people applied for 250 first-year places at Wits Medical School this year.

Maila said Health Minister Aaron Motsoaledi had asked universities to increase their annual intake of students.

Many medical experts are of the view that the government could alleviate the problem by allowing private hospitals to train doctors.

Private institutions are banned from doing this training.

Mediclinic Southern Africa's funder relations executive, Roly Buys, said the private sector had a strong role to play.

"Though we recognise that the function of teaching is a state one, we feel that we can support the state by assisting with the training of doctors.''

The managing director of Econex health consultancy, Nicola Theron, said: "If entry is controlled, as it is by the state, then clearly one cannot respond to market forces, so in our case there is an excess demand for doctors, which drives costs higher.

"Many players are considering private training, but will need government approval."

Discovery Health CEO Jonathan Broomberg said: "We believe that the best approach to expanding medical education in South Africa would be to use private GPs and specialists and private hospitals to expand the teaching platforms of our existing medical schools."

The doctor population is ageing, which bodes poorly for the future.

"The average age of a specialist is 55," said Broomberg.

A doctor who used to work for a Johannesburg government hospital said: "Doctors leave the profession because the working hours and stress are very high relative to any personal gain when compared with other sectors."

He said many doctors suffered burn-out because they were badly managed by employers.

And countries compete for the global supply of doctors.

The author of the New England Journal of Medicine article, Nigel Crisp, said: "Health professionals are migrating in what is now effectively a global market for their talent, with patients also travelling for treatment."

Crisp noted that healthcare is a commodity on which 10% of global GDP is spent each year.

The Competition Commission inquiry into private healthcare will be investigating shortage of staff and the ban on private sector training more doctors.