Q&A with SA Nursing Council CEO and registrar Prof Ntombifikile Mtshali

Do you see the nursing shortage as a national crisis?

We acknowledge the shortage of nurses, though we don't have the exact statistics.

The department of health projects that by 2025 there will be a shortage of 34,000 registered nurses in primary health care alone. That's a crisis, isn't it?

It's something that needs to be considered, but it's not easy to say there is a real shortage. Some nurses are in the council register but working in other countries.

Any idea how bad the shortage is in clinical specialities such as surgery and intensive care?

The best department to respond to that is the national department of health because they are the employers of the nurses.

Certainly the shortage is bad enough to put them on the critical skills list, isn’t it?

In terms of the critical skills list, it's not because of the shortage, it's because of the need.

Which is not being met because there's a shortage?

Yes. But it's not all specialisations that are included.

Only the most vital, such as surgery and intensive care?

And midwifery.

Indeed. And the shortages are getting worse as nurses with these skills take them abroad, aren't they?

It's because they're sitting at home and the system is not affording them.

On top of that, hasn't it been estimated that half the current contingent of skilled nurses will retire over the next 10 years?

Yes, it's a significant number but not half.

So given the growing shortage of skilled nurses, are you going to remove the caps on private sector training?

There is no cap.

Why do private hospital groups and the Hospital Association of South Africa say there is?

We must train according to the needs of the country. We want nurses to be exposed to training in remote and rural areas so they can serve the population. What type of a nurse do you want to produce if their learning experience is limited to the private sector?

Aren't they saying let them train more nurses for the public sector as well, at their own expense, because they have the capacity?

If they're saying they want to train for the public sector, what do they mean? Are they saying they're going to use their facilities for training and then let them go and work in the public sector? They need to clarify that.

Are you in effect saying that caps on how many nurses private hospital groups can train will remain?

There is no capping anywhere. They give us the numbers they would prefer, then we assess if they'd be able to cope with the number of students they want to train.

To what extent are these restrictions politically or ideologically motivated?

It's about standards not politics. We try to be a neutral body that is there to protect the public. Political interference does not exist

Even though nursing council CEOs and registrars are appointed by the minister?

When you look at the composition of the nursing council or the board there is no way we can have such influences.