Retention of public sector doctors in the Gauteng metropolitan area : implications for health strategy.
The South African public health sector is currently unable to effectively deliver an acceptable level of service to the population it serves. This is due, in part, to the continued attrition of medical doctors from the public service. The aim of this study was to identify the extent to which the national strategy employed by the health ministry has contributed to doctor attrition in addition to assessing the relative importance of factors that public sector employed doctors deemed vital to addressing this problem. In this way, retention strategies could be identified to deal with the migration of these knowledge workers in a cost-effective manner. A review of the available literature indicated that whilst governmental policy was largely well constructed, the failure to effectively implement these strategic objectives has negatively affected service delivery and resulted in doctor attrition. The thrust of this study involved surveying of public sector doctors to assess the relative weights of attrition factors identified. This quantitative assessment highlighted the urgent need to revitalize hospitals and improve infection control within these institutions. Another vital issue identified involved implementing innovative remuneration schemes such as lower tax thresholds and preferential loans from the state. Whilst family opportunities, career development and new learning experiences was considered less important than the abovementioned factors, respondents still attributed fair importance to these addressing these latter dimensions as part of a comprehensive model for retention. This study clarified the strategic initiatives that need to be implemented by the health ministry in order to stem the exodus of medical professionals from the public sector. Such intervention will go some way to realizing the strategic goals of this organization and leave it better placed to effectively deliver critical services that are required by the South African population.