| Summary: | Background: In 2007, occupational specific dispensation (OSD) was introduced
for public sector employees in South Africa which is unique to each identified
occupation in the public service. The OSD for doctors was later introduced in
2009. The purpose of the OSD was to improve government's ability to attract and
retain skilled employees, through increased remuneration. Previously, employees
in the public service were remunerated by a single salary structure which did not
adequately address the diverse needs of occupational categories in the public
service (DPSA, 2009). Although the South African government has been
investing a significant amount of resources to attract and retain medical doctors
in public service, no formal study has been done to evaluate its impact in
reducing the vacancy rate and retention of medical doctors in public hospitals in
South Africa. This study aimed to assess the vacancy rate and the profile of
doctors working at the Dr George Mukhari Hospital (DGMH) a public sector
tertiary academic hospital for last three years (2007-2010) to determine the
impact of OSD.
Aim: To determine the impact of OSD on the vacancy rate and the profile of
doctors working at the DGMH during a three year period (2007 to 2010)
Methodology: A cross sectional study design was used to extract retrospective
data routinely collected from the Personnel Salaries (PERSAL) system. Variables
for the study included: Number of posts per category (Medical officer/ Registrar/
Specialist) funded/ filled and vacant, Profile (age, gender, ethnicity, nationality).
The data was exported to MS EXCEL for storage and analysis. No primary data
collection was done. The study commenced after obtaining approval from the
University of the Witwatersrand ’Human research Ethics Committee (Medical)
and Gauteng Department of Health and Social development. Results: The vacancy rate for doctors at the DGMH did not show any significant
change after the introduction of ODS. The Hospital employed around 40% female
doctors. The majority of doctors were Black and Coloured doctors, although
certain department were still staffed by White doctors. There were no significant
changes in the mean age of the doctors working in the Hospital. As expected the
specialists were generally older than the registrars and medical officers. More
South African doctors were appointed in 2010 in comparison to 2008.
Conclusion: OSD did not have the intended effect of decreasing the vacancy rate
of doctors at the DGMH. This might be because unfunded posts did not get
additional funding to free them and therefore the status quo would have remained
the same with or without OSD. It suggests that the additional funding should be
considered for vacant unfunded posts. Hopefully, the funding model for NHI will
dramatically increase the funding in the public sector allowing for OSD and an
increase in funded vacant posts simultaneously.
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