Human Resources for Health Dr Percy Mahlathi Deputy Director General National Department of Health 24 August 2004

Introduction Major human resource challenges in health Human Resource branch as of April 2004 HR Strategy adopted in 2001 Align service delivery with strategic objectives & priorities Overall objective is to deliver on the constitutional mandate

Vision and Mission Vision Mission: An accessible, caring and high quality health system Mission: To improve health status through prevention and promotion of healthy lifestyles and to consistently improve the health care delivery system by focusing on access, equity, efficiency, quality and sustainability

Strategic objectives Ensure sustainable national health system Ensure appropriate management of human resource Ensure access good quality health care Ensure appropriate skills mix Position health professions as careers of choice Ensure right skills are in right place in conducive working environment

Broad challenges Generic imperatives Legal (adherence to labour laws) Moral (restoring human dignity) Perceptual (leadership image) National imperatives Advancing objectives of freedom (equity) Constitutional imperatives (better life) Global imperatives NEPAD & International Leadership

Some specific HR Challenges Shortage of human resources – clinical & management, supply not matching needs Migration of health workers – (intensive discourse) vacancy rates & increased workloads Improving the working environment, remuneration, morale Insufficient evaluation of impact of human resource policies Planning for the future & ensuring good return on investment

Migration of Health Workers A global problem – rural/urban, public to private Some reasons: better remuneration, gain international experience, heavy workload, poor resource management, lack of facilities & support, declining values, family related matters Excessive workloads on remaining staff Young inexperienced staff remain to carry workload- demotivation and burnout

Strategies to address migration Local: skills & rural allowances, community service, individual initiatives by provinces, service excellence awards International: memoranda of understanding to better manage the flow of skills and encourage exchange of professionals between countries Policy on recruitment & employment of Foreign Health Workers (passed in 2001)

Strategies to address challenges Better equipping of health facilities New categories (mid-level workers) - pharmacist & radiographic assistants etc to take off pressure from highly skilled professionals Management: Leadership & Executive Management Programs – Presidential Leadership Programme, Oliver Tambo Fellowship, Harvard, Gengold/MESOL- to equip managers

Broad Strategic Approach to HR Country HR Plan for Health Position department to support and manage the Country Plan Meaningful needs driven HR Development Corporate identity & relationship building Improve morale & retain internal staff Develop dynamic communication plan

Implementation strategies Country Plan: production, staffing norms and standards Specific projects: e.g. National HR database for reliable statistics Operational: improve skills, multi-skill & re-skill staff where necessary Internal programs: e.g. improve employee assistance programs

Implementation strategies Improve capacity & skills mix at management level Address mal-distribution between private & public, rural & urban Internal: review of macro-organizational structure, address morale issues Attract people with good technical & management skills to public health service

Conclusion National Plan absolute necessity – April 2005 Departmental Plan – align structure to functions, improve conditions Leadership development & mentorship Interaction with Statutory Councils, Higher Education Institutions & Professional Associations – responsibility office of HR DDG

BUDGET 2004/5 R 8,7bn (4.8%) increase compared to 2003/4 R 7,7bn (88%) allocated to provinces for various programs and services e.g. training of professionals and research, improving hospital management capacity National Department for HR Planning, Development & Management R27m