Public Health - Recruitment of Doctors: The Gap Between Announcements and Reality

Title: Public Health - Recruitment of Doctors: The Gap Between Announcements and Reality

On November 18, the Mauritian Health Minister, Anil Bachoo, celebrated the integration of new doctors into the public service, praising the perseverance, courage, and dedication of those who have chosen this noble yet demanding profession. He claimed that the arrival of these officers would strengthen the system and improve the quality of care.

On paper, the numbers are impressive: 111 general practitioners recruited. However, public health unions are denouncing a significant gap between the ministerial announcement and the reality on the ground. Far from solving the chronic shortage of personnel that has persisted for years and has worsened with retirements, this recruitment is described as "an exercise in futility."

Dr. Vinesh Sewsurn, president of the Medical Health Officers Association (MHOA), and Dr. Meetheelesh Abeeluck, president of the Government Medical and Dental Health Officers Association (GMDOA), agree: there should be no "intellectual dishonesty" in presenting these figures. Their analysis converges on a stark reality: the recruitment conducted has not made a significant impact on the public health service.

Dr. Sewsurn reveals the underlying facts of these flattering statistics. In the public service, two types of contracts coexist: temporary contracts, renewed monthly or annually, and permanent contracts under the Public Service Commission (PSC).

“If the ‘recruited’ doctors were already employed under a temporary contract and are now being hired under a permanent contract, there is no increase in staff because it’s the same doctor’s contract that is changing,” he explains. Thus, the actual number of personnel does not increase.

About forty of the 111 doctors recruited on a permanent basis were already working under temporary contracts. The others were in private practice, either in clinics or independently. “If they are independent, they can join the public service immediately, but if they are in a private clinic, they need to give a notice period first,” Dr. Sewsurn clarifies.

This explains why some have not yet started their positions. “We must not conflate recruitment by the PSC with the absorption of doctors who are already in the public health system,” he insists.

Official figures clash with the reality in health facilities. On average, only 2 to 5 doctors per regional hospital actually showed up, according to Dr. Sewsurn. A department head, who requested anonymity, illustrates this contradiction: out of a list of about twenty doctors who were supposed to join his facility, only four turned up. This number is insufficient to fill the acute shortage of personnel.

Dr. Abeeluck confirms: “Not many have reported in.” Among those who received their letter from the PSC, some never showed up. “It’s only when they come for reporting that we can concretely say they have joined the public service by accepting the working conditions,” he emphasizes. He mentions that a similar scenario has occurred twice in the past. Ultimately, the number of newcomers is therefore less than 100. “The situation remains critical and chronic despite the announced recruitments,” warns Dr. Abeeluck.

Limited Impact on the Ground

This shortage has concrete consequences: according to a hospital department head, some clinics can no longer operate in the afternoon due to lack of personnel, while some doctors refuse to work overtime, as payments for those already worked have not been honored for months. The public health service, with its chronic staff shortage, is said to be "on the verge of asphyxiation."

Working conditions remain a core concern. According to Dr. Sewsurn, salaries are meager for those just starting in the public service: Rs 41,000, compared to double that in the private sector, along with various allowances.

“For me, there is a mismatch,” he asserts. The poorly planned rotation system leaves many practitioners “exhausted by the end of their shifts.”

Despite these criticisms, Dr. Sewsurn appreciates that the ministry continues its recruitment efforts. The union has always advocated for this and pushes for regular, not sporadic, hiring. “There should be annual recruitments to address staff shortages, to replace general practitioners who are studying for specialization, but also those who are retiring,” he explains.

These recruitments should also help staff the new units and services being offered, both nationally and regionally. The demand for general practitioners remains constant.

The MHOA president commends those who have indeed joined the public service. “It’s not easy to work in the public health service given the pressure in regional hospitals and the various health centers attached to them. We are very happy that they have joined the public service to lend us a hand.”

Many doctors are now waiting for the publication of the Pay Research Bureau (PRB) to decide on their future in the public service, reports a department head. Others have already decided to leave the public sector. The PRB does not help improve working conditions, according to the union representative. “But everything is done to keep the system running nevertheless,” asserts Dr. Sewsurn.