Slaves of the state – medical internship and community service in South Africa

by Nicolette Erasmus

Take a look at this study in order to understand the shocking conditions interns endure in the health sector. PaySlipBanSA is committed to mainstreaming conversations about unfair labour market practices.

PaySlipBanSA and our sister site Keep Climbing, draw attention to youth labour market injustices.

We’re publishing about this research because we believe it’s possible for the public to make a difference once informed. Labour market conditions are worsening for everyone, it’s time we stood up to unfair power.


Owing to a chronic shortage of medical staff in South Africa, sleep-deprived medical interns and community service doctors work up to 200 hours of overtime per month under the state’s commuted overtime policy.

Nurses moonlight in circumvention of the Basic Conditions of Employment Act.

For trainee doctors, overtime over 80 hours is unpaid, and rendered involuntarily under threat of not qualifying to practise medicine in South Africa. As forced labour, and sleep deprivation amounting to cruel and degrading treatment, it is outlawed in international law.

No other professional group in the country is subjected to such levels of exploitation and discrimination by the state.

These abuses should be challenged under the Constitution. Solutions include the installation of electronic time recording in state hospitals, cessation of unpaid overtime, limits on medical intern shifts to a maximum of 16 hours, and an investigation by the Human Rights Commission of South Africa

The failings of our public health care system are evident,1 but few realise just how far the government is prepared to go to prop up a severely under-resourced public health care system as hospitals and teaching institutions teeter on the brink of collapse.2,3

This article focuses on the unfair labour practices and human rights abuses perpetrated on the most vulnerable public health care employees, trainee doctors, who work inhuman amounts of unpaid overtime under the guise of training and a misguided commuted overtime policy.

Off-duty state nurses are selling their rest-time back to state hospitals through third-party agencies with the full knowledge of the state, in complete disregard for statutory limits on working hours.4

A road accident case reported that a nurse employed by the Western Cape Department of Health sued for lost ‘moonlighting’ hours worked at Groote Schuur Hospital in her spare time via the Albrecht Nursing Agency with the permission of her employer.5

Those opposing such abuses find themselves in such an undemocratic and combative discourse with government that the issues require investigation by the Human Rights Commission.

Read the full article here!

Hey! Did you know job adverts without a pay range are banned in New York City?

We believe pay secrecy during recruitment disadvantages job applicants, this is unconstitutional.



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