Posted on: Wed 02-08-2023

South African healthcare workers are weighing their options amid anxiety and uncertainty surrounding the National Health Insurance (NHI) Bill – with many considering moving to Canada, which has put healthcare at the top of its critical skills lists.

Speaking to ENCA, Canadian immigration consultant Nicholas Avramis said there has been a notable surge in South African professionals applying to move abroad, especially healthcare workers like doctors and nurses.

Avramis noted that since January 2023, his offices had received around 17,000 enquiries from South Africans looking to move, and a large portion of these has stemmed from the uncertainty surrounding the proposed changes under the recently passed NHI bill.

Canada has recently classified healthcare workers as an essential service, which means they now operate under the Express Entry system.

“Previously, one would have to get a job offer first and then go the work permit route, but now with the critical skills list, one could apply and get selected straight out of the pool,” he said.

To qualify as a Federal Skilled Worker, a candidate must have suitable education, work experience, age and English language proficiency. Qualified candidates are selected under the Express Entry Immigration system to apply for permanent residency.

A stand-out benefit for South Africans – which many healthcare professionals may not know – is that local doctors and nurses are exempt from having to get re-certified for practice when they make the move.

Avramis said that the Royal College of Physicians and Surgeons of Canada recognises South Africa’s healthcare education – meaning they don’t need to get re-certified.

This change, in combination with healthcare professionals’ uncertainty and anxiety about the future of healthcare in South Africa, has resulted in many South Africans looking to migrate to Canada, he said.

NHI is one of the main reasons why South African healthcare workers are leaving

The NHI Bill was rubber-stamped through the portfolio committee on health in May and passed by an ANC majority in the National Assembly in June.

The controversial new laws are now going through the National Council of Provinces (NCOP) for concurrence and will then head to President Cyril Ramaphosa to be signed into law.

The issues with the bill are plentiful and legal experts, industry stakeholders, consumer groups, business groups, and even parliament’s own legal advisors have warned of the many pitfalls it faces – on constitutional and other grounds.

According to Webber Wentzel, two of the most significant pitfalls are how the scheme will be funded and the destruction of private healthcare that it will likely leave in its wake.

The NHI aims to make the state the sole purchaser of healthcare in South Africa, allowing all citizens to access healthcare at the provider of their choice at no cost.

However, all private healthcare providers – including doctors and hospitals – must register with the scheme to deliver services and get compensation. The scheme will set prices, and providers must operate within its framework.

Avramis said that this prospect had scared a lot of professionals in the country who want assurance that they will be paid, as well as ensure they receive the best compensation they can get for their intricate and often tiresome work.

“There’s a lot of anxiety and mistrust among healthcare workers regarding the NHI – and doctors, who are the tip of the spear in medicine, and nurses, who are the backbone, are professionals who work hard and want to get paid well for their services,” said Avramis.

“And in this competitive global market, if there’s the ability for them to migrate to a better-paying market, they will do that,” he said.

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