sector skills plan for the health sector in south africa

The South African health system spans the economic sectors for human and animal health. The national
Department of Health (DoH) 2 is responsible for the national human health system, which comprises both
public and private health sectors.
Key entities in the public health sector are the nine provincial departments of health, state health and
research institutions, and municipalities. Provincial health departments are responsible for public
service delivery and for planning and managing human resources for health. Academic health
complexes (where health sciences learners are trained) are financed and administered at provincial
level. Provincial hospitals operate at three tiers: tertiary, regional, and district level. The district health
system consists of 52 districts. Ambulance and other emergency services, occupational health and
primary care services are delivered at district level. Municipal health services encompass environmental
issues such as water quality, waste management, pollution control, surveillance and prevention of
communicable diseases and food control. 3 Many local authorities provide primary healthcare services
which may either be financed from municipal revenues or by provincial health authorities. 4
The private health sector is made up of private hospitals, individual health service providers, NGOs and
the medical insurance industry. 5 Extending across the human and animal health sectors are the
pharmaceutical industry, providers of health services and products, and manufacturers of surgical goods
and appliances. On the animal health side the Department of Agriculture (DoA) oversees veterinary
services, which comprise state and private veterinary services and veterinary research.
Not all the entities in the South African health system form part of the HWSETA sector and there is
considerable overlap with several other SETAs. The national and provincial departments of health
submit Workplace Skills Plans (WSPs) and Annual Training Reports (ATRs) to the Public Service Sector
SETA (PSETA), while municipalities are more closely aligned with the Local Government SETA (LGSETA).
The medical insurance industry,which comprises medical schemes and other bodies, forms part of the
Insurance Sector Education and Training Authority (INSETA). Even though pharmacists and pharmacies
are allocated to the HWSETA, many employers pay skills development levies to the Wholesale and Retail
SETA (W&RSETA). Although the HWSETA is responsible for skills development in animal health, many
veterinarians in private practice pay their SDL to the Agricultural Sector Education and Training
Authority (AgriSETA) and are more closely affiliated with this SETA.
2 Established by the National Health Act, 2003 to provide equitable healthcare services.
3 Development Bank of South Africa. 2008. A Roadmap for the Reform of the South African Health System. Report on a process
convened and facilitated by the DBSA.
4 Burger, D. 2009. South Africa Yearbook 2009/10. Government Communication and Information System. Published at
http://www.gcis.gov.za/resource_centre/sa_info/yearbook/2009-10.htm. (Accessed August 2010).
5 Coovadia, H., Jewkes, R., Barron, P. et al. 2009. “The health and health system of South Africa: historical roots of current public
health challenges”. Lancet. September 2009. Vol. 374. Published at http://thelancet.com. (Accessed August 2009); McIntyre,
D., Thiede, M., Nkosi, M. et al. 2007. SHIELD work package 1 report: A critical analysis of the current South African health
system. Health Economics Unit, University of Cape Town. Published at
http://www.web.uct.ac.za/depts/heu/SHIELD/reports/SouthAfrica1.pdf (Accessed August 2010).
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