Frustrated Eastern Cape health MEC Ntandokazi Capa has called for the scrapping of compulsory community service and commuted overtime for doctors and nurses, saying the policies have become a financial burden on the province’s already strained health budget.
Capa was addressing a group of about 50 unemployed medical graduates who had camped outside the Bhisho State House since Monday, demanding answers after completing their 12-month community service without being offered employment.
“The health department does not have money,” she told the group on Tuesday.
“For you to get employment, there must be another budget.
“I would love for you to be employed now, but the economy is not growing.”
Capa said the provincial department had been hoping to fund new posts by cutting back on commuted overtime, but had been instructed to stop the process as the matter was being dealt with nationally.
“The minister has established a committee to review the issue of community service and commuted overtime to see if they are still relevant,” she said.
“We had a case where 17 doctors went on leave at the same time and still wanted commuted overtime.
“Even with community service, there are complaints about being placed in other areas and needing accommodation.
“Let’s rather not have both.”
The provincial department had about 3,000 vacancies, but had overspent by more than R400m, making new appointments impossible, she said.
In 2024, the department clashed with provincial doctors after it moved to limit commuted overtime — a system which pays doctors a fixed amount for being available after hours, regardless of the number of hours worked.
The department said it wanted doctors to claim for actual overtime worked, but doctors warned that hospitals could be left without emergency cover.
Health minister Aaron Motsoaledi in April announced a national review of the compulsory community service programme, saying it had served its purpose and suggesting it could be replaced by new medical officer and registrar posts.
Cosatu representative Andisile Pampila proposed that the province adopt a system similar to Gauteng’s, where graduates are employed on six-month contracts to plug temporary gaps.
“There are nurses and doctors who leave the department every year.
“The department could employ these graduates on short contracts while waiting for a permanent budget,” he said.
One unemployed nurse suggested volunteering at hospitals in exchange for preferential access to vacancies, but Capa said that would raise legal issues.
“Volunteering does not guarantee employment.
“If something happens to you at the hospital, someone will be in trouble.
“We must look at the legal implications,” she said.
Somelele Situta, an unemployed nurse who completed his community service at Dora Nginza Hospital in Gqeberha, broke down in tears as he addressed Capa.
He said he had been unemployed for seven months and had been promised first preference for permanent posts.
In response, Capa said: “There are nurses who were employed in Dora, but they were specialists.
“We had to prioritise due to crises in our hospitals.”
She stressed that the department’s limited budget had to be shared across all staff categories, not just by doctors and nurses.
Capa was joined by provincial health head Rolene Wagner and other senior officials.
She promised to return on Wednesday morning to provide further feedback.
The protesters were allowed to spend the night in the Bhisho Hospital hall.
Pampila said they would not leave until they received clear answers.
Eastern Cape health spokesperson Sizwe Kupelo said 115 doctors had been permanently employed in the current financial year and recruitment for nursing posts was ongoing.
However, Capa said those appointments were not part of the R1.78bn national allocation announced in April by Motsoaledi, which is intended to fund 1,200 doctor, 200 nurse and 250 allied health posts nationally.
“We are still waiting for that money. When it comes, we will fight for a bigger share based on our crisis,” Capa said.
Daily Dispatch
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