HR ISSUES
Introduction
Strategies drawn from:
Pick Report on Human Resource Strategyfor Health
Task Team Report on Transformation ofStatutory Councils
Joint personnel task team report
Various reports on migration, midlevelworkers, foreign health professionals
Five Key Goals
Ensure that there is sufficient staff with theright skills in the right places
Transformation of training and education
Transformation of professional regulation
Transformation of pay and human resourcemanagement, including improving staffmorale
Goal: Sufficient staff with theright skills in the right places
Planning norms for staffingrequirements
Training of new categories of healthworkers, including mid-level workers
Appropriate production of healthprofessional
Strategies for recruitment and retention
Strategies to fill posts in areas of need
Goal: Transformation oftraining and education
Improve representativity in undergraduateand post graduate student demography
Review of training length of certain categoriesof health professionals
Exit competencies for undergraduate students
Establish Institute of Health Management
Establish training centre for health managers
Skills competency frameworks for hospitaland DHS managers
Goal: Transformation ofprofessional regulation
Structural reform of professionalstatutory councils
Improved coordination betweencouncils
Review of disciplinary processes withincouncils
Extension of regulation for healthworkers not currently regulated
Goal: Transformation of pay andhuman resource management
Implementation of pay progression system
Job evaluations and upgrading of certaincategories of health professionals
Monetary and non-monetary incentives forrural and underserved areas
Retention strategy to recruit and retain scarceskills
Key Recommendations fromthe Pick report
Production of Health Workers
No increase in the intake of medical students
An increase in the intake of enrolled nursingstudents
Revision of the nursing curriculum
Modest reduction in the intake of dental students
An increased intake of clinical psychology students
Mid level workers
National Strategy on Human Resourcesfor Health – The Pick Report
Key Purpose
Ensure an adequate supply of people withthe requisite knowledge and skills for thehealth system guided by PHC approach
Main findings: Shortages do exist, but mainproblem is mal-distribution
Scopes of practice must be revised
Creation of midlevel worker posts
Findings – Pick Report
Computer simulation models
Different scenarios and projected over athirty year period
Average annual population growth rateof 2%
Variable net loss rates
Findings – Pick Report
Doctors: 1 doctor: 1,290. Will decline to1doctor: 1,320. Current productionsufficient, but poor distribution
Nurses: Staffing ratio of enrolled nurse:professional nurse should be revised to2:1. Training of enrolled nurses toincrease. Scopes of practice should berevised
Findings – Pick Report
Dentists: Supply exceeding populationgrowth. Ratio will improve from 1:9,400 to1:7,800. Distribution between public andprivate sector problematic. Reduction inannual intake could be considered.
Pharmacists: 1:3920 to 1:3840. Increasingnumbers not justified. Problem of mal-distribution.
Findings – Pick Report
Physiotherapists: 1:10,000. Will improve to1:6000. Creation of extra posts andcommunity service
Radiographers: 1:8,700 to 1:9,800.Increasing rate of production or mid-levelworker
Dieticians, psychologists, speech therapist:Will all have worsening population ratios.Increase production
Other Findings
Any increase in staffing unaffordable, unlessfinancial allocation increased in real terms
Key issue is shortages in underserved areas.Need to look at increasing financialallocations to recruit and retain staff.
Health professionals should acquirespecifically defined skills
Other Findings
Admission criteria to be reviewed
Representavity should be improved
Skills audit
Multi-skilling
Key recommendation: Creation of mid-level workers
Progress: Sufficient Staff with theright skills in the right place
Planning Norms for Staffing Requirement
Pick report
Provincial Strategic Position Statements
Modernisation of tertiary services
Production of Health Workers
Most councils have worked on or revising scopes of practice
Enrolled nursing courses
Midlevel workers
Pharmacy assistants
Enrolled nurses
Radiography assistants
Physiotherapy technologist
Speech, Language and Hearing Assistant
Progress: Sufficient Staff with theright skills in the right place
Midlevel workers cont
Occupational therapy assistant
Phlebotomist
Medical assistant
Will drive as major learnership initiativewith HWSETA and DoL
Integrate from Level 1 to Level 6.Therefore will include CHWs
Progress: Sufficient Staff with theright skills in the right place
Strategies for Recruitment and Retention
Scarce skills and rural allowance
Code of Conduct for Ethical recruitment
Overseas training opportunities
Cuba
India
Japan
USA
Italy
Belguim
Work opportunities
Government to government agreements for recruitment
Fast tracking of registration for underserved areas
Progress: Transformation oftraining and education
Representavity
Agreements reached on second year admissionswithin five years
Admission criteria being reviewed
Skills Competency Framework
Done for District Health Managers
Skills competency gap study done for districts
Using similar framework for hospital managers
Progress: Transformation oftraining and education
Health Management Institute established
Training Centres for Health Managers
French Programme
Harvard School of Public Health
MESOL
Exit competencies for undergraduate studentshave been worked on by councils. Will benegotiated to ensure it reflects skills required
Training length
Agreed will have minimum five year curriculum formedical students with two year internship.
Progress: Transformation ofprofessional regulation
Structural reform of professional statutorycouncils
Task Team tabled report with major achievements
Legislation to enact recommendations
Forum of Statutory Councils
Define scopes of practice of healthprofessionals
Scopes have been defined for most councils
Progress: Transformation of payand human resourcemanagement
Joint Task Team reviewing salarystructures and scarce skills retentionstrategy
Incentive for rural and underservedareas
Framework document on monetary andnon monetary incentives approved byMinMec
Task Team looking at monetary incentives
Transformation of pay andhuman resource management
Non-monetary Incentives
Bursaries, including dependents
Improved accommodation
Better leave packages
Sabbaticals
Training opportunities
Conclusions
Progress has been made
This year will see unfolding of majorinitiatives
Will have major public sectorlearnership drive.
Recruitment and retention will be afocus