Cash to keep doctors

The South African government is investigating ways of financially rewarding medical schools that produce doctors who stay in the country, according to Olive Shisana, director general of the National Department of Health.

Dr Shisana announced recently that future funding would favour universities with high numbers of Afrikaner and black students because English-speaking doctors were more likely to emigrate. Institutions that could prove their graduates remained in South Africa would receive a higher allocation.

However, the national financial newspaper Business Day reported this week that equal numbers of English and Afrikaans medical graduates had gone to the United Kingdom in the past 18 months.

A Cape Town agency reported processing applications from 333 graduates from English and 328 from Afrikaans medical schools in the past 18 months. A Johannesburg agency, which will be sending 150 graduates in the UK, at the end of January said the largest group was from the University of Stellenbosch followed by the Universities of the Wi****ersrand, Cape Town and Pretoria.

The agency said it had also received many queries from graduates of the "black" Medical University of South Africa, but since its qualifications were not recognised in the UK its graduates were not eligible to work there.

The brain drain of doctors from South Africa has long been a cause of concern. Emigration of doctors doubled in 1994.

At the time, advisers to the Ministry of Health suggested national service for recently qualified doctors to ensure that they worked off at least some of the public money spent on their education. Now it appears the emphasis has shifted.

Medical schools have urged that decisions over funding be based on correctly calculated demographic profiles of medical emigrants, and whether doctors are leaving South Africa permanently or working temporarily overseas to gain experience or earn foreign currency to pay off large study loans.

James van Dellen, dean of the mostly black University of Natal, said: "We need incentives to keep doctors in the country rather than coercions."