US funding halted, futures at stake - finding a path forward for SA's healthcare workers

The Star

13-05-2025

Donald McMillan | Published 3 hours ago
As public hospitals struggle with fewer staff and shrinking resources, the country is at risk of losing not only jobs but skills, infrastructure, and hope. But there are still ways to keep services running and people employed, says the writer.
Image: Picture: Oupa Mokoena Independent Newspapers
South Africa's healthcare system is under serious pressure. The sudden suspension of critical US funding has resulted in the loss of around 15 000 healthcare jobs - many of them linked to HIV/AIDS programmes that served as lifelines for vulnerable communities.
Combined with broader public sector budget cuts and a national hiring freeze, the situation threatens to undo decades of progress in healthcare delivery.
As public hospitals struggle with fewer staff and shrinking resources, the country is at risk of losing not only jobs but skills, infrastructure, and hope.
But in the face of these challenges, there are still ways to keep services running and people employed. One of them is through Temporary Employment Services (TES), which provides a flexible staffing approach that can help stabilise the system while longer-term solutions are explored. A healthcare system under pressure
The US aid cut has had an immediate and devastating impact. Programmes focused on HIV, tuberculosis, and reproductive health, many of which were propped up by international donor funding, have been forced to scale back or shut down entirely. Thousands of community healthcare workers, nurses, counsellors, and administrators have found themselves jobless, while patients are left facing longer wait times and reduced access to care.
At the same time, cost-cutting across the public sector has put a freeze on new hires, even in essential departments like health and the impact is already being felt. With public hospitals and clinics stretched thin, they're unable to take on newly trained doctors and nurses. And while the private sector plays a role, it simply cannot absorb the overflow. This isn't just a staffing issue; it's a setback for the entire healthcare system, affecting everything from medical training to frontline care.
Every year, South Africa produces thousands of highly trained doctors and healthcare workers, many of whom move into the public health system after completing their compulsory community service. These roles used to be a given, but with hiring freezes and shrinking budgets, many young professionals are now finishing their training with nowhere to go. Despite their skills and frontline experience, these workers are left in limbo.
This is a double blow as South Africa loses out on the return from its investment in their education, while the risk of a growing skills drain looms large. With countries like the UK, Australia, and Canada actively recruiting healthcare workers, there's a real chance they may leave and not come back.
In response to this crisis, temporary employment solutions have become a practical and effective solution. TES providers offer qualified healthcare professionals short- to medium-term flexible contracts, enabling them to continue working in their field while delivering essential support to overburdened healthcare facilities.
This approach offers a lifeline not just for displaced workers but for clinics and hospitals struggling with limited resources. TES employees can be rapidly deployed where they are needed most, whether to cover staff shortages, serve remote communities, or support seasonal fluctuations in demand. Unlike permanent hires, they don't carry long-term costs such as medical aid or pension contributions, making them a more budget-conscious option in uncertain times.
The benefits of the TES model have already been proven. During the COVID-19 pandemic, temporary staff played a key role in scaling up testing, vaccination, and treatment efforts across the sector. That same adaptability is needed now to respond to the healthcare funding crisis.
While temporary employment solutions cannot solve the problem alone, they can provide an important stopgap and potentially a new way of thinking about workforce planning in the healthcare sector. Rather than relying solely on permanent positions, South Africa may need to adopt a more fluid, demand-based deployment model that allows professionals to move between roles, regions, and areas of urgent need.
Shifting to this model calls for a change in mindset. Permanent posts have traditionally been seen as the gold standard in healthcare, valued for their stability and benefits. But in a time of uncertainty, contract and locum roles - especially when managed by trusted TES providers - can offer a practical alternative, combining income, ongoing experience, and flexibility. Retaining talent, restoring hope
Avoiding long-term damage to South Africa's healthcare system will require urgent, coordinated action. Government departments must urgently reprioritise spending toward essential services like health and education.
At the same time, private healthcare providers and staffing agencies must step up and work together to ensure that skilled professionals are not lost to the system or the country.
Despite the current turbulence, South Africa's healthcare workers remain among the best trained and most resilient in the world and with the right support structures, including flexible employment options like TES, we can preserve our healthcare capacity and continue to serve those who need it most.
Donald McMillan, Managing Director at Allmed Healthcare Professionals