Remuneration, ageing infrastructure and general and financial management continue to hamper the public health system, the Health Department acknowledged on Sunday.

"Minister of Health Aaron Motsoaledi has expressed his commitment to addressing many of these problems which largely have to do with financial and human resources management, amongst others," spokesperson Fidel Hadebe said in a statement.

He was reacting to a Sunday Times report according to which South Africa had one doctor per 3 800 people without medical aid, three times lower than the World Health Organisation recommendation of eight per 10 000 people. The public health system was at "risk of collapse" if hundreds of underpaid and overworked doctors left, it read.

"The Department of Health has on numerous occasions acknowledged the many challenges facing the country's public health system and its plans to address them."

Hadebe said more nurses were rejoining the public sector because of the occupation specific dispensation (OSD), a revised salary structure for nurses, in 2007, which intended to attract more nurses into the sector.

Negotiations were currently underway to agree on a similar OSD for doctors, dentists, pharmacists and emergency medical personnel.

It would also address career progression and performance management, amongst others, so that good performers were recognised and rewarded.

Hadebe said a hospital revitalisation programme was geared at building new infrastructure and rehabilitating existing facilities, with approximately R3-billion being spent in the current financial year, increasing to R4,1-billion in the 2011/2012 financial year.

The Democratic Alliance (DA) on Sunday called for the National Health Insurance (NHI) system to be placed on hold and the current system be made to work more efficiently. This would liberate funds needed to pay health professionals better wages.

Spokesperson Mike Waters said the DA hoped the continuing strike by public sector health professionals would compel the government to tackle the inefficiencies that had created the present crisis.

The NHI was "expensive and complex" and there was no agreement with the Treasury over how the government would afford it, he said in a statement.

The government "continues to neglect the basic principles of good health management and fails to take seriously the problems faced by the doctors and nurses who run the system".

Waters called on Motsoaledi to conduct a survey of all provincial health departments to determine how many new positions had been created over the past 15 years, and how many of these posts were necessary to the effective running of the health system.

He also called for a survey of the qualifications and experience of all hospital executives and other managers, saying that many hospital managers had not been employed for their technical abilities.

Gauteng Health and Social Development MEC Qedani Mahlangu would outline a detailed plan, in the next month, with clear timelines on how Gauteng's public health-care sector would be improved.

In a statement she said elements of the plan would respond in detail to the plight of health workers and patients.

She also admitted there was a "dire need" to change working conditions within the sector.

The provincial government was meeting with clinicians, unions, staff and other role players to appeal for their cooperation in changing things.

"We have been consistent with the message that greater accountability and responsibility is now the order of the day," she said.