HR ISSUES

Introduction Strategies drawn from:

Pick Report on Human Resource Strategy for Health

Task Team Report on Transformation of Statutory Councils

Joint personnel task team report Various reports on migration, midlevel

workers, foreign health professionals

Five Key Goals Ensure that there is sufficient staff with

the right skills in the right places Transformation of training and

education Transformation of professional

regulation Transformation of pay and human

resource management, including improving staff morale

Goal: Sufficient staff with the right skills in the right places Planning norms for staffing

requirements Training of new categories of health

workers, including mid-level workers Appropriate production of health

professional Strategies for recruitment and

retention Strategies to fill posts in areas of need

Goal: Transformation of training and education Improve representativity in undergraduate

and post graduate student demography Review of training length of certain

categories of health professionals Exit competencies for undergraduate

students Establish Institute of Health Management Establish training centre for health managers Skills competency frameworks for hospital

and DHS managers

Goal: Transformation of professional regulation Structural reform of professional

statutory councils Improved coordination between

councils Review of disciplinary processes

within councils Extension of regulation for health

workers not currently regulated

Goal: Transformation of pay and human resource management Implementation of pay progression

system Job evaluations and upgrading of certain

categories of health professionals Monetary and non-monetary incentives

for rural and underserved areas Retention strategy to recruit and retain

scarce skills

Key Recommendations from the Pick report Production of Health Workers

No increase in the intake of medical students An increase in the intake of enrolled nursing

students 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 Resources for Health – The Pick Report

Key Purpose Ensure an adequate supply of people

with the requisite knowledge and skills for the health system guided by PHC approach

Main findings: Shortages do exist, but main problem 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 a thirty year period Average annual population growth

rate of 2% Variable net loss rates

Findings – Pick Report Doctors: 1 doctor: 1,290. Will decline

to 1doctor: 1,320. Current production sufficient, but poor distribution

Nurses: Staffing ratio of enrolled nurse: professional nurse should be revised to 2:1. Training of enrolled nurses to increase. Scopes of practice should be revised

Findings – Pick Report Dentists: Supply exceeding population

growth. Ratio will improve from 1:9,400 to 1:7,800. Distribution between public and private sector problematic. Reduction in annual intake could be considered.

Pharmacists: 1:3920 to 1:3840. Increasing numbers not justified. Problem of mal-distribution.

Findings – Pick Report Physiotherapists: 1:10,000. Will improve

to 1:6000. Creation of extra posts and community service

Radiographers: 1:8,700 to 1:9,800. Increasing rate of production or mid-level worker

Dieticians, psychologists, speech therapist: Will all have worsening population ratios. Increase production

Other Findings Any increase in staffing unaffordable,

unless financial allocation increased in real terms

Key issue is shortages in underserved areas. Need to look at increasing financial allocations to recruit and retain staff.

Health professionals should acquire specifically 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 the right 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 the right skills in the right place

Midlevel workers cont Occupational therapy assistant Phlebotomist Medical assistant

Will drive as major learnership initiative with HWSETA and DoL

Integrate from Level 1 to Level 6. Therefore will include CHWs

Progress: Sufficient Staff with the right 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 of training and education Representavity

Agreements reached on second year admissions within 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 of training and education Health Management Institute established Training Centres for Health Managers

French Programme Harvard School of Public Health MESOL

Exit competencies for undergraduate students have been worked on by councils. Will be negotiated to ensure it reflects skills required

Training length Agreed will have minimum five year curriculum for

medical students with two year internship.

Progress: Transformation of professional regulation Structural reform of professional

statutory councils Task Team tabled report with major

achievements Legislation to enact recommendations Forum of Statutory Councils

Define scopes of practice of health professionals Scopes have been defined for most councils

Progress: Transformation of pay and human resource management Joint Task Team reviewing salary

structures and scarce skills retention strategy

Incentive for rural and underserved areas Framework document on monetary and

non monetary incentives approved by MinMec

Task Team looking at monetary incentives

Transformation of pay and human 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

major initiatives Will have major public sector

learnership drive. Recruitment and retention will be a

focus