sector skills plan for the health sector in south africa

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Table 3-3 Primary healthcare visits per province: 2008/09 PHC total headcount Utilisation rateannualised Utilisation rate for under 5 yr olds annualised Eastern Cape 17814953 2.6 4.3 Free State 6455360 2.2 4.0 Gauteng 19111520 1.9 3.6 KwaZulu-Natal 24495932 2.4 4.3 Limpopo 14772977 2.8 5.9 Mpumalanga 7932495 2.2 4.5 Northern Cape 3484634 3.1 4.9 North West 8329076 2.6 4.5 Western Cape 14944309 3.0 5.2 Total/Average 117341256 2.5 4.6 Source: National Treasury. 2009. “Health”. In Provincial Budgets and Expenditure Review 2005/06 – 2011/12 (from district health information systems). Table 3-4 compares the reported number of patients treated per day by a doctor or a nurse at primary healthcare clinics per province in 2008/09. The clinical workload of doctors and nurses differed between provinces. Doctors in Mpumalanga and the Free State had the highest workload. Nurses in the Free State and Western Cape had a higher workload than their counterparts in other provinces. Table 3-4 Primary healthcare workload per province: 2008/09 Province Doctor clinical workload in PHC Nurse clinical workload in PHC Eastern Cape 21.5 21.7 Free State 28.6 33.9 Gauteng 24.2 28.5 KwaZulu-Natal 24.4 23.4 Limpopo 18.8 17.8 Mpumalanga 29.0 21.5 Northern Cape 17.6 25.5 North West 12.3 20.5 Western Cape 24.3 31.1 Total/Average 22.3 24.9 Source: National Treasury. 2009. “Health”. In Provincial Budgets and Expenditure Review 2005/06 – 2011/12 (from district health information systems). Demand for healthcare services in the public sector continues to rise and exceeds supply. Reports about lack of medicines and equipment, as well as backlogs in payments for goods and services procured, 25
emain fairly common. 63 Not everyone requiring HIV and AIDS medication can be treated due to resource constraints. 64 Recent research has shown that the rise in the child mortality rate in South Africa since 1990 can be attributed to constraints in the availability of healthcare services (the coverage of care) and the quality of care due to staff shortages. It has been shown that the available financial and human resources are insufficient to meet the demands for care of mothers, babies and children. 65 Lowquality care in the neo-natal stage may result in complications such as cerebral palsy and blindness (retinopathy of prematurity) which have a long-term impact on the demand for specialist care. Demand for healthcare among the urban poor population is also increasing due to the growing prominence of non-communicable and chronic diseases such as diabetes, hypertension and kidney disease and certain types of cancer. 66 A comprehensive revitalisation programme for public hospitals and public healthcare facilities is underway. New hospitals are under construction and existing facilities are being upgraded, renovated and repaired. 67 As the number of hospital beds is increased, so will the demand for medical professionals and staff increase. 3.3.3 THE DEMAND FOR PRIVATE HEALTHCARE SERVICES The private sector also experienced an increase in demand for healthcare. This is evidenced by the increase in medical scheme membership, higher hospital occupancy rates, the growth in the percentage of people consulting health workers, as well as considerations about the quality of healthcare. Membership of medical schemes increased from about 6.5 million in 2000 to about 7.9 million people in 2009. The hospital occupancy rate in private hospitals also increased from 62% in 2007 to 65% in 2008. 68 A larger percentage of people with medical aid coverage (87.4%) consulted health workers in 2007 than did in 2002 (85.5%). 69 Several research studies over the last decade found that users of public health facilities remain concerned about the quality of care due to long waiting lines, lack of equipment and medication, disrespect for patients and rude staff. 70 Growing numbers of people from the poorest households prefer to pay for private care, which increases the demand for private providers and GPs in particular. 71 63 National Treasury. 2009. “Health”. In Provincial Budgets and Expenditure Review 2005/06 – 2011/12. 64 Harrison, D. 2009. An Overview of Health and Health care in South Africa 1994-2010: Priorities, Progress and Prospects for New Gains. 65 Chopra, M., Daviaud, E., Pattinson, R. et al. 2009. “Saving the lives of South Africa’s mothers, babies, and children: can the health system deliver?” Lancet. September 2009. Vol. 374. Published at http://thelancet.com. (Accessed August 2010). 66 Chopra, M., Lawn, J.E., Sanders, D. et al. 2009. “Achieving the health Millennium Development Goals for South Africa: challenges and priorities”. Lancet. September 2009. Vol. 374. Published at http://thelancet.com. (Accessed August 2010). 67 National Treasury. 2010. “Vote 15: Health”. Estimates of National Expenditure 2010. 68 Development Bank of South Africa. 2008. A Roadmap for the Reform of the South African Health System. 69 Van der Berg, S., Burger, R., Theron, N. et al. 2010. Financial Implications of a National Health Insurance Plan for South Africa; Hospital Association of South Africa. 2009. Private Hospital Review:2009. Published at http://www.hasa.co.za/media/uploads/news/.../Private_Hospital_Review_2009.pdf. (Accessed August 2010). 70 McIntyre, D., Goudge, J., Harris, B. et al. 2009. “Prerequisites for National Health Insurance in South Africa: Results of a national household survey”. South African Medical Journal. October 2009. 99 (10). Published at http://www.scielo.org.za/pdf/samj/V99n10. (Accessed August 2009). 71 Van der Berg, S., Burger, R., Theron, N. et al. 2010. Financial Implications of a National Health Insurance Plan for South Africa. 26
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 and 24: 2 PROFILE OF THE SECTOR 2.1 INTRODU
Page 25 and 26: 2.3 EMPLOYERS IN THE SECTOR The hea
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 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
Page 76 and 77: Table 5-3 shows that the total numb
Page 78 and 79: 5.3 INSTITUTIONAL ARRANGEMENTS AND
Page 80 and 81: 5.3.4 PRIVATE HOSPITALS Private hos
Page 82 and 83: Table 5-5 shows the registration fi
Page 84 and 85: 5.4.3 REGISTRATIONS WITH THE SOUTH
Page 86 and 87: Table 5-10 Number of health-related
Page 88 and 89: The HWSETA has also registered seve
Page 90 and 91: 5.7.3 INTERNSHIPS The HWSETA has su
Page 92 and 93: 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
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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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sector skills plan for the health sector in south africa

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