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HR ISSUES
Introduction
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Strategies drawn from:
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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
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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
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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
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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
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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
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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
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Production of Health Workers
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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
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Key Purpose
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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
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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
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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
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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 maldistribution.
Findings – Pick Report
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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
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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
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Admission criteria to be reviewed
Representavity should be improved
Skills audit
Multi-skilling
Key recommendation: Creation of midlevel workers
Progress: Sufficient Staff with the
right skills in the right place
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Planning Norms for Staffing Requirement
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Pick report
Provincial Strategic Position Statements
Modernisation of tertiary services
Production of Health Workers
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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
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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
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Strategies for Recruitment and Retention
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Scarce skills and rural allowance
Code of Conduct for Ethical recruitment
Overseas training opportunities
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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
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Representavity
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Agreements reached on second year admissions
within five years
Admission criteria being reviewed
Skills Competency Framework
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Done for District Health Managers
Skills competency gap study done for districts
Using similar framework for hospital managers
Progress: Transformation of
training and education
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Health Management Institute established
Training Centres for Health Managers
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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
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Agreed will have minimum five year curriculum for
medical students with two year internship.
Progress: Transformation of
professional regulation
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Structural reform of professional statutory
councils
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Task Team tabled report with major achievements
Legislation to enact recommendations
Forum of Statutory Councils
Define scopes of practice of health
professionals
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Scopes have been defined for most councils
Progress: Transformation of pay
and human resource
management
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Joint Task Team reviewing salary
structures and scarce skills retention
strategy
Incentive for rural and underserved
areas
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Framework document on monetary and
non monetary incentives approved by
MinMec
Task Team looking at monetary incentives
Transformation of pay and human
resource management
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Non-monetary Incentives
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Bursaries, including dependents
Improved accommodation
Better leave packages
Sabbaticals
Training opportunities
Conclusions
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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