sector skills plan for the health sector in south africa

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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). 5
2.3 EMPLOYERS IN THE SECTOR The health and social development sector is a heterogeneous sector falling mainly under the Sector Industrial Classification (SIC) category 93. Schedule 2 of Regulation No. R. 316, published on 31 March 2005 in terms of section 9(1) of the Skills Development Act, 1998 (Act No. 97 of 1998) gives the HWSETA jurisdiction over 60 SIC codes. The employers belonging to the 60 SIC sectors are grouped into five groups: Community services Complementary health services Doctors and specialists Hospitals and clinics Research and development institutions. In the 2009/2010 financial year a total of 4 321 organisations paid SDLs to the HWSETA. These are organisations with payrolls in excess of R500 000 per year. Small practices may be excluded from this number. 2.4 ORGANISATIONS IN THE SECTOR 2.4.1 REGULATORS AND PROFESSIONAL BODIES A large portion of the workers in the health sector are registered with statutory councils that control and regulate the various professions. In the health sector these councils are the Health Professions Council of South Africa 6 (HPCSA), the South African Nursing Council 7 (SANC), the South African Pharmacy Council 8 (SAPC), the Allied Health Professions Council of South Africa 9 (AHPCSA), and the South African Dental Technicians Council 10 (SADTC). Members of the veterinary and para-veterinary professions are registered with the South African Veterinary Council (SAVC) 11 and practitioners using indigenous African healthcare techniques and medicines will soon be required to register with the Interim Traditional Health Practitioners Council of South Africa 12 (ITHPCSA). These councils regulate the various health and allied health professions and practices. Statutory provisions authorise the professional councils to demarcate the scope of practice of each category of health profession (i.e. stipulate the type of services permitted and not permitted). Among 6 Established in terms of the Health Professions Act 56 of 1974. 7 Established by the Nursing Act 33 of 2005, and previously by the Nursing Act 50 of 1978. 8 Established in terms of the Pharmacy Act 53 of 1974. 9 Established by the Allied Health Professions Act 63 of 1982. 10 Established by the Dental Technicians Act 19 of 1979. 11 Established by the Veterinary and Para-Veterinary Professions Act , 19 of 1982. 12 Established by the Traditional Health Practitioners Act 22 of 2007. 6
Page 1 and 2: SECTOR SKILLS PLAN FOR THE HEALTH S
Page 3 and 4: 2.4.6 LABOUR UNIONS ...............
Page 5 and 6: 5.2 THE SOUTH AFRICAN SECONDARY SCH
Page 7 and 8: LIST OF TABLES Table 2-1 Total empl
Page 9 and 10: ABBREVIATIONS AND ACRONYMS ABET Agr
Page 11 and 12: EXECUTIVE SUMMARY INTRODUCTION The
Page 13 and 14: Health professionals and practition
Page 15 and 16: Implementation of these policies dr
Page 17 and 18: statistics are for 2008 when the Ne
Page 19 and 20: In collaboration with the professio
Page 21 and 22: Information submitted by the depart
Page 23: 2 PROFILE OF THE SECTOR 2.1 INTRODU
Page 27 and 28: ) The South African Nursing Council
Page 29 and 30: several institutions are specifical
Page 31 and 32: development and care in areas such
Page 33 and 34: PERSAL database The PERSAL system k
Page 35 and 36: African Coloured Indian White Total
Page 38 and 39: In 2010, 460 000 people are employe
Page 40 and 41: Table 3-1 Health expenditure in pub
Page 42 and 43: According to the Development Bank o
Page 44 and 45: Table 3-3 Primary healthcare visits
Page 46 and 47: 3.4 THE MOBILITY OF LABOUR In 2006
Page 48 and 49: Arguably, many of the driving facto
Page 50 and 51: 3.8 MANAGEMENT OF THE HEALTH SYSTEM
Page 52 and 53: 3.9.2 REGULATION OF QUALITY Strict
Page 54 and 55: service are not well defined. 113 S
Page 56 and 57: ) Challenges These proposals aim to
Page 58 and 59: 3.10.5 STRATEGY TO FIGHT TUBERCULOS
Page 60 and 61: Veterinary skills are in demand glo
Page 62 and 63: 4 THE DEMAND FOR SKILLS 4.1 INTRODU
Page 64 and 65: Table 4-2 Total professional positi
Page 66 and 67: Organisations are also required to
Page 68 and 69: 4.4 FUTURE DEMAND 4.4.1 SKILLS DEVE
Page 70 and 71: 4.5.3 MATERNAL, CHILD AND WOMEN’S
Page 72 and 73: 4.6 CONCLUSIONS The growing demand
Page 74 and 75:
5 THE SUPPLY OF SKILLS 5.1 INTRODUC
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Table 5-3 shows that the total numb
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5.3 INSTITUTIONAL ARRANGEMENTS AND
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5.3.4 PRIVATE HOSPITALS Private hos
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Table 5-5 shows the registration fi
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5.4.3 REGISTRATIONS WITH THE SOUTH
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Table 5-10 Number of health-related
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The HWSETA has also registered seve
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5.7.3 INTERNSHIPS The HWSETA has su
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5.8 FACTORS INFLUENCING THE SUPPLY
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d) The introduction of mid-level sk
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of legally enforceable nurse/patien
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annual growth rate in professional
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Therefore, the HWSETA’s skills de
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In Chapter 5 it was mentioned that
Page 104 and 105:
Cape Peninsula University of Techno
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http://www.hwseta.org.za/upload/sec
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National Treasury. 2009. “Health
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assistants”. Published at http://
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APPENDIX A SCARCE SKILLS LIST - PRI
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OFO Code OFO description Private he
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