HR ISSUES

1
HR ISSUES
2
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

3
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

4
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

5
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

6
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

7
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

8
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

9
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

10
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

11
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 21.
  Training of enrolled nurses to increase. Scopes
  of practice should be revised

12
Findings Pick Report

• Dentists Supply exceeding population growth.
  Ratio will improve from 19,400 to 17,800.
  Distribution between public and private sector
  problematic. Reduction in annual intake could be
  considered.
• Pharmacists 13920 to 13840. Increasing numbers
  not justified. Problem of mal-distribution.

13
Findings Pick Report

• Physiotherapists 110,000. Will improve to
  16000. Creation of extra posts and community
  service
• Radiographers 18,700 to 19,800. Increasing
  rate of production or mid-level worker
• Dieticians, psychologists, speech therapist Will
  all have worsening population ratios. Increase
  production

14
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

15
Other Findings

• Admission criteria to be reviewed
• Representavity should be improved
• Skills audit
• Multi-skilling
• Key recommendation Creation of mid-level workers

16
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

17
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

18
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

19
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

20
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.

21
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

22
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

23
Transformation of pay and human resource
management

• Non-monetary Incentives
• Bursaries, including dependents
• Improved accommodation
• Better leave packages
• Sabbaticals
• Training opportunities

24
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