As protesting unemployed Eastern Cape doctors threatened to shut down the province’s health-care system if their demands for jobs were not met by Wednesday, premier Oscar Mabuyane has stepped in and ordered the health department to begin recruiting them.
Mabuyane gave the department six weeks from this week to start the process of employing the doctors, using money to be redirected from other programmes in the health budget.
On Monday, about 170 unemployed doctors again marched to Mabuyane’s office in Bhisho, where they have been protesting for weeks, to hand over their memorandum which included threats to collapse the province’s health-care system.
The group claimed to have “the full support of all health-care workers in the province and nationally”.
Mabuyane confirmed meeting department and provincial treasury bosses on Sunday evening and said he would meet the affected doctors’ representatives on Tuesday.
It is understood the department has more than 1,500 vacancies for doctors and other clinical staff.
Mabuyane confirmed he had ordered the department to redirect some of its dwindling budget towards the employment of the doctors before the financial year ends in March.
Other unemployed doctors would be contracted after April 1 when the department received its new budget for the 2025/2026 financial year.
The Sunday meeting happened amid an alleged standoff between the department and the provincial treasury over health’s overtime bill.
It is understood the two departments met last week but could not find common ground on commuted overtime, a system the provincial treasury believes should be scrapped.
Commuted overtime refers to the hours worked in addition to the total number of normal hours of work required by the employer to render a health service in a facility in terms of operational needs.
The Dispatch understands some doctors earn an additional R50,000 to R89,000 a month in commuted overtime.
While the treasury wanted the department to scrap or at least reduce its commuted overtime bill to accommodate the stranded doctors, the department is said to have been adamant that the treasury must find money to employ the doctors.
Mabuyane was roped in after the two departments reached a deadlock.
He said the issue of commuted overtime, which was budgeted at about R1bn, was one of the thorny issues under discussion.
Mabuyane said in that meeting a decision to scrap commuted overtime payments from April 1 was taken.
This means the planned allocation of R960.5m in the 2025/2026 financial year, or R3bn in the medium-term expenditure framework, can be redirected to employ the much-needed additional doctors and other clinical staff.
While he emphasised there was not enough money to hire all these doctors and none of them would be automatically absorbed into the system, they would all have to go through the normal recruitment process and apply for the available jobs.
“There have been meetings and we have teams from the office of the premier and treasury working with the health department to look at how we can find money in the baseline, because there is no new budget,” Mabuyane said.
“Yes, we are in need of doctors in a number of our health institutions and we are working hard on that. But the priority is the [community service] and interns. That one is statutory and we are forced to find them spaces, but they also need supervisors.
“We have been arguing about why health has a huge budget for commuted overtime while we are in desperate need of more doctors.
“There is no budget or money, hence we had been forced to relook at the health budget to see what can we stop to have money to hire these doctors and nurses. But we will ensure that from April 1 there is budgeted money to hire these personnel.
“So these unemployed doctors must bear with us as we cannot collapse public administration by hiring people while we do not have money to pay them.”
Health department spokesperson Mkhululi Ndamase said his department had noted the reported threat to shut down the health-care system after Wednesday.
“While we sympathise with the unemployed doctors and understand their plight, we must state that thousands of health-care workers, from cleaners to specialists, make the health system work daily.
“It is because of the dedication and hard work of these employees that millions of uninsured people continue to receive quality health services.”
Ndamase said all employees, with the exception of those on leave, would report for duty.
“We must also emphasise that when there are vacancies they are advertised so everyone who meets the requirements can apply and go through the recruitment processes.
“The same was explained to the delegation of the unemployed doctors when we met them in East London on January 9,” he said.
One of the affected doctors, Dr Chuma Malangeni, and SA Medical Association Trade Union Eastern Cape chair Dr Mpumelelo Melamane refused to comment on the latest developments, saying they would be in a better position to do so after their scheduled meeting with Mabuyane on Tuesday.
The Democratic Nursing Association of South Africa's provincial secretary Veli Sinqana said practicality and not lip-service was needed.
The trade union needed “a clear and proper plan”.
UDM provincial secretary Bulelani Bobotyane called on the provincial government to “prioritise this crisis”.
Additional employment would significantly alleviate the burden on health-care facilities.
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