Nurses have become the latest group of health-care professionals to complain about their community service obligations, with their opposition sparking suggestions that the concept be extended to a range of professions outside the medical arena.
Community service is currently required of new graduates in medical fields only, including psychology, dentistry and pharmacy.
Now experts from the health and education fields are proposing that practitioners in all professions, including law, engineering, accounting and journalism, should do a stint.
”Lawyers could make huge contributions in terms of helping to improve the running of the legal system, and accountants can contribute to building the capacity of small and medium industries, which could lead to employment,” said Loveday Penn-Kekana of the Centre for Health Policy.
Trevor Ngwane, leader of the Anti-Privatisation Forum, said he understands negative attitudes towards community service. ”The government has implemented it in a contradictory fashion,” he said. ”We expect the students to serve the community in a society that is profit-driven.”
He said young doctors and nurses are trained to make money but are then expected to work for nothing after their studies, while other professionals leave university and earn a good salary. ”Students should be made to believe in the country and be patriotic. This can only happen if the government pays for their education.”
Nurses represented by the Democratic Nurses Organisation of South Africa (Denosa) said they were tired of being exploited and demanded clarity before the process is put into place. ”Denosa does not have a problem with the concept of community service because the practice will afford our rural communities with health services that they need. It’s just the ambiguities in the proposed Nursing Bill that have been out for comment,” said Denosa deputy director Thembi Mngomezulu.
The union’s concern is that the state has failed to provide details about how the Nursing Bill will be implemented, even though nurses were aware that they would eventually be expected to do community service.
Major objections have arisen in relation to the issue of training, as many nurses’ studies are subsidised by private institutions, while some students cover the full costs of their own education.
”Netcare itself is currently training around 1 200 of these students without any subsidy from the government,” said Eileen Brannigan, director of group nursing of the Network Healthcare Holdings Limited (Netcare). And for students who pay for their own training, ”it’s hard to understand why they should have to work in a public institution afterwards”.
Penn-Kekana disagrees that students who have to pay for their education should be exempt from contributing to society. She says research in rural hospitals indicates that if doctors and nurses do not do community service, lives will be lost. ”I have also observed situations where, without support, community doctors have made mistakes.
”My perception is that community service could be run better and more supervisory structures are needed — but at the same time, it means people have access to health-care services and lives are being saved.”
Additional reporting by Nawaal Deane