Crisis of doctors’ dropout in Egypt
The dropout of doctors in Egypt is one of the most important phenomena worthy of study and observation because of its great threats to the health of patients. This phenomenon also reflects failure of the health policies that have been adopted by successive governments and manifests imbalance in the priorities of the ruling regime. In fact, doctors are a top priority for both developed and developing countries, on the grounds that they perform a precise and complicated profession that requires extensive preparation and intensive training, in addition to sustainable education and substantial expenses. Therefore, public health policy makers should always keep in mind that doctors represent an important national resource and a cornerstone in achieving one of the most important functions of the State, namely the elimination of diseases.
This paper discusses the phenomenon of doctors’ dropout from work in the hospitals of the Ministry of Health, through four main axes:
The first axis deals with the problem of occupational discrimination practiced by the government against doctors within the framework of the concept of social justice and the idea of the relative structure of wages. In fact, doctors in Egypt suffer from several forms of occupational discrimination, including:
– Classification as a service sector versus production sectors, according to the Egyptian government policy.
– Classification as civil servants in general versus those working in the sovereign and military sectors.
– Internal discrimination within the health sector between doctors working in a university hospital and doctors working in the Ministry of Health.
The problem of discrimination is one of the biggest problems faced by doctors in Egypt, making them suffer from alienation and lack of appreciation, which has emerged in many of their demands, especially in the so-called “inconvenience allowances” or “doctors’ cadre”.
The second axis discusses the most important forms of doctors’ dropout from work in government hospitals, dividing them into three main types:
1- Dropout because of emigration: Doctors’ dropout is divided into two types: the first one is emigration for academic study in European countries, the United States, Canada, or Australia; and the second type is emigration to the Gulf countries for obtaining a higher financial return.
2- Dropout for working in the private sector, whether in private hospitals, medical centers or private clinics.
3- Administrative dropout through seeking an administrative occupation within the Ministry of Health’s general secretariat or its affiliated bodies and departments; or seeking a fictitious job with fake attendance, which is a phenomenon in Egyptian society that was discussed in Parliament and the media extensively during the last period.
The third axis addresses the most important reasons for the doctors’ dropout from work in the Ministry of Health, including: the problem of low wages, the problem of doctors’ mandate and its effects on the doctor’s proper professional development, the problem of training and continuing medical education, failure of Egyptian fellowship and board schemes, the deterioration of the health system, the lack of medical supplies and equipment, the poor working environment in government hospitals which affects doctors’ performance, the pressures and attacks against doctors from families of patients, as well as other problems related to the economic conditions experienced by Egypt after the floating of the pound, which pushed doctors to seek work abroad for obtaining higher wages.
The fourth axis addresses evaluation of the Egyptian government’s health policy towards one of the most important elements of the health system, namely doctors, seeking correction of this policy through shedding light on areas of imbalance in the management of the doctors file. This is likely to contributes to repairing the imbalance caused by the phenomenon of doctors’ dropout in the case of existence of a political will and a democratic regime that favors interests of the people to its own interest of remaining in power and seeks to achieve the popular slogan of the January Revolution: “Bread, freedom, social justice, and human dignity”.
The doctors file is not a priority for the current government. The phenomenon of doctors’ dropout in Egypt poses a great danger to the future of hospitals. There are more than 450 hospitals and health units that have already closed in Upper Egypt and remote areas because of absence of doctors. It is expected that this crisis will exacerbate due to the current government’s ineffective policies and its inability to implement the comprehensive health insurance project, amid Egypt’s declining economic situation.
*Read the complete text of this study in Arabic here.