I was horrified to hear that certain parts of the National Health Act have recently been signed into law and that the government is currently consulting on regulations in that regard.  Horrified, because what these sections provide is that Doctors, before opening a practice in an area, from 2016, will have to get a certificate from the government that there is a need for a healthcare practice in that area.  In other words, if they apply in an area where there is no need, which would presumably be much of the northern suburbs of Johannesburg and Sandton, where there are a number of Doctors, they will be told that they cannot practice there. They will have to look and see whether or not there is a shortage of doctors in Ventersdorp or perhaps somewhere in a township in Mpumalanga.  I fully understand the good thoughts and the idea that goes into legislation like that. Would it not be a wonderful world if we could have doctors where we need them, and everybody has the right to having a Doctor?  

Unfortunately, that is a utopian idea that probably has its roots in communism.  There are very few people who study at University, for 7 years, who then go through the hardships of being a locum that are going to be interested in being told that they cannot practice in a lucrative area, but in fact have to go to a small town and start practicing there or worse, a poor township.  That is an economic reality and that is why governments often fail spectacularly when they try to control the market, because the market has to be left to itself to a large extent, although some regulation is always needed, to control itself.  The government can make all the laws they want, but all that will happen is that the people who will apply for a certificate to practice in an area where they want, and be rejected, will by and large simply decide to emigrate. So, they will not go to Mpumalanga or Limpopo, but they will go to London or Miami or possibly Perth.  

Our country will lose more qualified and educated people, our tax base will lose yet another productive and highly skilled worker who pays a decent amount of taxes and the poor will not be any better off.  There must be other ways to achieve those goals and normally those other ways would perhaps involve a government hospital paying higher salaries to be in less attractive areas.  That after all is how oil rigs or mines in the outback of Australia work.  They know it is not a desirable place to work and they pay far higher salaries to those types of workers who will agree to go and work there than the salaries that would be available in the middle of a beautiful city where everybody would like to live and work.  If you want people to go to a less attractive location with less wealthy people, and less of the attractions of a major metropolitan area, you need to pay them more money. Focus on getting the economy right, reducing the unemployment rate and getting everyone working and many of these other problems will be resolved – without you having to try and legislate and force professionals to go and work in areas where you say you need them.