RHD Prelude Chapter - Health Systems Trust

HRM in the public sector remains centralised to the national and provincial levels, although
some functions within hiring, in-service training, leave and placement of staff within
facilities have been decentralised to health regions (districts) and health districts.
North West Province
NW Province, as with all other provinces, has a shortage of health personnel. The total number
of posts has been reduced as part of the process of rationalising the services. There remains,
however, a shortage of professional staff such as doctors, nurses and para-medicals. Posts
especially in rural areas remain vacant and are difficult to fill. Some personnel functions have
been decentralised, such as appointments of nurses and some other categories of staff, but this
does not appear to assist at a local level. The Provincial Chief Director, as with many other
managers, believes one of the main problems in the health sector is lack of staff. He said:
“To me decentralisation is not negatively impacting; to me it is about human resources
availability. That’s the main problem and we've lost the staff. … I do think we are making
progress at the moment … on obstetric services in the province …. I think the biggest
problem is staff shortage and having the available professional nurses. I have clinics where
I only have staff nurses and that staff nurse catches the baby, she does everything –
specifically in the rural areas.”
Table 8.2: North West Province, Department of Health - Total funded and vacant
posts- November 2003
Posts
Total
Posts
Funded
Posts
Unfunded
Posts
Total Vacant
Posts
Vacancy
Rate
% Unfunded
219
Medical Officers
391
369
22
80
22
6
Specialists
77
67
10
22
33
13
Professional Nurses
3 793
3 595
198
736
20
5
TOTAL
4 261
4 031
230
838
21
5
Source: Chief Director: Health Service Delivery - North West Department of Health
(Provincial Chief Director, Health Services)
Table 8.2 shows the total number of posts, posts funded and unfunded and number of vacancies
in November 2003. There was an overall vacancy rate of 21% and 5% of posts were unfunded.
Figure 8.2 shows the percentage vacant and unfunded posts in November 2003.
Figure 8.3 shows total number of posts, funded, unfunded and vacant for doctors, specialists,
and professional nurses and total for the province as at November 2003.