There were 186,000 nurses working in South Africa in 2019, but a report from the Hospital Association of SA and McKinsey in January showed that there is a shortage of up to 62,000 nurses. This gap is predicted to grow to 178,000 by 2030 because of an ageing workforce and a growing population with more health problems. According to statistics from the SA Nursing Council, almost half of the registered nurses will retire in the next 15 years.

By Staff Reporters

Richard Friedland, the Chief Executive Officer of Netcare, which is the largest private healthcare network in South Africa, has expressed concern regarding the country’s shortage of nurses. He has highlighted that private hospitals are constrained in their capacity to train additional healthcare providers, thereby exacerbating the issue.

“The tragedy is we’ve got tens of thousands of people applying to become nurses every year, and in a country that is beset by such a skill shortage, by such rampant unemployment, it’s almost inexplicable that government isn’t opening the doors to allow the private sector to train,” Friedland told Bloomberg.

The shortage is estimated to be between 26,000 and 62,000 nurses, and it is expected to worsen as a significant number of health workers are set to retire by 2030.

Although some hospitals have their own nursing colleges, only specific universities are authorised to grant professional nursing qualifications, which prevents private hospitals like Netcare from training more nurses, despite the high demand and the large number of people who want to become nurses each year.

“The tragedy is we’ve got tens of thousands of people applying to become nurses every year, and in a country that is beset by such a skill shortage, by such rampant unemployment, it’s almost inexplicable that government isn’t opening the doors to allow the private sector to train.

“We urgently need to fill that pipeline with new nurses, young nurses, and people willing to come into the healthcare sector and to be trained as healthcare workers. There is no excuse not to allow the private sector to train more nurses,’’ said Friedland.

Friedland mentioned that Netcare has the capacity to train more than 3,500 nurses every year, but it has only been given permission to train around 10% of that amount. He explained that Netcare is collaborating with the government and other groups to optimize the surplus capacity of nursing colleges.

“The private sector, through the Hospital Association of South Africa, is galvanised at the moment. We’re exploring all of our options in this regard and we’re not excluding taking legal action.”

For more than a decade, the scarcity of nurses has been a hot topic, with many voices raising concerns about the matter. Friedland is just the latest to join the chorus of those sounding the alarm bells.

According to 2020 data released by the South African Nursing Council (SANC), the age distribution of registered nurses and midwives is significantly imbalanced towards senior professionals, with less than one-third of them being under the age of 40. The statistics revealed that 27% of registered nurses belong to the age group of 50s, 26% to the age group of 40s, and merely 21% to the age group of 30s.

The Democratic Nursing Organisation of South Africa’s (Denosa) national spokesperson, Sibongiseni Delihlazo, issued the following warning: “This is a ticking time bomb that is just waiting to blow up in the face of South Africans.”

SANC also revealed that the current ratio of nursing personnel to the population of South Africa indicates that there is only one nurse available to cater to the needs of every 218 patients.

A year ago, Matshidiso Borifi a practising registered nurse in a Gauteng public hospital told iol.co.za that nurses were overworked and underpaid.

“We are faced with overworked and underpaid nurses who are so unmotivated that a lot of them are delivering poor service. A very large percentage of registered nurses are reaching retirement age and are not being replaced. Most of my colleagues have left – they have either joined private hospitals or have gone to work abroad in countries like England. It’s very tough for us,” said Borifi.

On International Nurses Day, Lerato Maduma-Gova, the president of the Young Nurses Indaba Trade Union (YNITU), expressed concern over the shortage of healthcare professionals in the country. She noted that this has resulted in nurses employed in the public health sector being burdened with nearly twice the amount of work.

“The country does not have enough nursing personnel, and this started long before the pandemic, and we still struggled terribly during the start of the Covid-19 pandemic,” said Maduma-Gova.

Maduma-Gova also expressed concern regarding the fact that a single nurse is often tasked with completing the workload that would typically require the efforts of six nurses.

“A job that is supposed to be done by six nurses is being done by a single nurse, and a ward of 30 patients is still being managed by one registered nurse with the assistance of lower-category nurses. But to be very honest, we are running a healthcare system that is very unsafe, and that is very low quality,” explained Madumo-Gova.

According to Prof Laetitia Rispel, the South African research chair on the Health Workforce at Wits University, the shortage of nurses that is currently happening and is expected to happen in the future seems to be caused by larger systemic issues and changes within the nursing field.

“It’s an underinvestment in human resources for health in general and a historical neglect of nurses and nursing,” Rispel told the Sunday Times in October 2021.