A staggering exodus of medical professionals is crippling South Africa’s public health sector. Official figures reveal that nearly 6,000 doctors and nurses are resigning from state facilities every year. This devastating brain drain is placing the nation's healthcare system under immense pressure. As a result, hospitals are critically understaffed and vulnerable communities are left without care.
Recent data presented in Parliament paints a grim picture of the crisis. The statistics, from the government's Persal system, reveal the alarming scale of resignations. These took place between 2013 and early 2025. This poses a threat to the very foundation of public healthcare in the country, especially among doctors and nurses.
The Shocking Scale of the Exodus of Doctors and Nurses
The official figures highlight a sustained and damaging trend over the last twelve years. From 2013 to 2024, South Africa’s public sector lost:
- 12,745 doctors
- 58,897 nurses
Combined, this averages out to approximately 5,900 essential medical professionals leaving their posts annually.
Since 2013, 124,123 practitioners, including pharmacists and administrative staff, have resigned from the health service.
The crisis peaked in 2021 and 2022, during which the system lost 2,690 doctors and 11,763 nurses in just two years.
Although the authorities have not fully updated the Persal data since January 2025, the trend continues. In that month alone, 53 doctors and 113 nurses resigned. This highlights the ongoing struggle.
Gauteng and KZN Hit Hardest
The brain drain has not been felt equally across the country. Gauteng province is the epicentre of the crisis, losing 3,351 doctors since 2013. KwaZulu-Natal is second, with 2,609 doctor and nurse resignations.
In terms of nursing staff, Gauteng again leads with 4,697 resignations since the 2021-2022 peak. It is closely followed by KwaZulu-Natal, with 4,353, and the Eastern Cape, with 2,631.
A System Under Strain
The reasons behind the mass resignations are complex. They stem from a combination of poor working conditions, career path frustrations, and global competition for skills.
The Department of Health has highlighted a reluctance among junior doctors and nurses to accept community service placements in remote rural areas. These areas often lack basic amenities such as reliable mobile networks. This reluctance exacerbates the problem of staffing shortages.
However, medical professionals and associations point to more systemic failures:
Poor Working Conditions: Research by the South African Family Practice (SAFP) highlights that state health facilities are often characterised by "poor working conditions, inadequate infrastructure and below-market salaries."
Unsustainable Workloads: The South African Medical Association (SAMA) has described a system where many departments in public hospitals are dangerously understaffed. This forces existing health care workers to shoulder unsustainable workloads. It is particularly challenging for doctors and nurses who are striving to maintain high-quality care.
The Junior Doctor Dilemma: In a cruel paradox, over 1,800 junior doctors who have completed their community service remained unemployed as of January this year. This is despite the severe shortages. SAMA warned that a lack of funding for posts forces many to volunteer without pay or emigrate. This fuels the brain drain.
The International Exodus
The crisis extends beyond internal challenges. Skilled South African professionals are being lured overseas by better pay and conditions. According to SAFP research, over 23,400 South African health professionals are currently working in the UK, New Zealand, the US, and Australia. This international brain drain strips the local system of its most experienced and highly educated talent. The drain affects both doctors and nurses.
Former SAMA board chair Dr Angelique Coetzee warned that policy missteps, such as heavily restricting the ability of public sector doctors to perform remunerative work in private practice, could backfire and "worsen the exodus."
With only 0.3 doctors per 1,000 people in the public sector - far below the WHO's recommendation of 1 per 1,000 - the continued loss of staff poses an existential threat. This jeopardises the provision of quality healthcare for millions of South Africans.