sector skills plan for the health sector in south africa

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Arguably, many of the driving factors in the disease burden are linked to social and economic inequalities and are not primarily caused by poor health services. 90 The scope and complexity of these health threats are creating increased demands on the health services and its workforce. 91 It is evident that the sector requires well-skilled health professionals who are prepared, willing and able to tackle the demands of treating and alleviating the burden of disease. 3.7 HUMAN RESOURCES CHALLENGES Market forces, working conditions and career advancement opportunities are all factors that determine where and for how long people work in a particular workplace. This is also true of the health sector labour market. While this SSP looks at the availability of skills and the demand and supply of the skills in more detail in the following chapters, it is useful to sketch key issues at this stage. Decisionmakers, operational managers and analysts of the sector have expressed concerns about the quantity and quality of healthcare professionals available in the country. It is widely recognised that care levels, outcomes and management of the public health system are under strain, partly because of significant staff shortages and an inadequate skills base. 92 The DBSA work groups found that South Africa lacked an effective human resources strategy to ensure that the public sector is resourced and that the country has an adequate supply of health professionals. 93 It is not only the numbers of health workers that is of concern, but also their distribution between the public and private sectors. Estimates on the distribution of resources across the sectors vary, depending on the approach adopted and the interpretation of available (and often uncertain) data. Nevertheless, Table 3-5 compares the allocation of general medical practitioners, medical specialists and nurses per 100000 population in the public and private sectors. Table 3-5 Key resources per 100 000 population in public and private sectors: 2009 GPs per 100 000 population Specialists per 100 000 population Nurses per 100 000 population Public sector 26 9 255 Private sector 86 65 500 Total 37 19 300 Source: Econex in Van der Berg, S., Burger, R., Theron, N. et al. 2010. Financial Implications of a National Health Insurance Plan for South Africa. 90 Harrison, D. 2009. An Overview of Health and Health care in South Africa 1994-2010: Priorities, Progress and Prospects for New Gains. Published at www.doh.gov.za (Accessed February 2010). 91 Lehmann, U. 2008. “Strengthening Human Resources for Primary Health Care”. South African Health Review 2008. Health Systems Trust. Published at www.hst.org.za/publications/841 (Accessed August 2010). 92 Harrison, D. 2009. An Overview of Health and Health care in South Africa 1994-2010: Priorities, Progress and Prospects for New Gains. Published at www.doh.gov.za (Accessed February 2010); 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); 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) 93 Development Bank of South Africa. 2008. A Roadmap for the Reform of the South African Health System. 29
More than three times the number of GPs are available to private sector users as are available in the public sector. The difference for specialists is higher, with seven times more specialists available to private sector patients than to users of public healthcare. The ratio of nurses per private sector population is almost double that of the public sector. Human resources are also unevenly distributed between provinces in the public sector as staff favour working near urban-based medical schools, and doctors prefer working in hospitals rather than in primary healthcare facilities. 94 Table 3-6 shows the skewed distribution of different categories of health professionals as a ratio of the population in each province. Table 3-6 Distribution of health professionals per 100000 population in public sector: 2008 EC FS GP KZN LP MP NC NW WC SA Professionals per 100 000 population Dental practitioners 1.10 2.30 3.10 0.8 1.50 2.70 3.40 1.20 3.20 1.90 Enrolled nurses 31.8 16.2 52.2 110.5 53.8 38.3 27.0 21.9 54.4 55.4 Medical practitioners 17.9 23.2 32.0 34.7 17.4 18.3 35.7 14.1 37.9 26.0 Medical specialists 2.5 14.7 22.3 6.2 1.7 1.6 2.9 1.3 31.9 9.8 Occupational therapists 1.0 3.0 2.4 1.5 2.1 2.2 2.6 1.2 2.8 1.9 Pharmacists 2.9 3.7 4.2 5.0 4.5 4.0 5.7 3.1 8.7 4.5 Physiotherapists 1.00 2.20 2.60 2.90 1.60 2.00 5.10 1.10 3.30 2.20 Professional nurses 114.2 94.5 111.7 136.3 127.5 102.9 155.0 81.1 123.4 116.6 Radiographers 4.5 6.2 7.0 5.5 2.9 2.4 5.3 1.5 10.7 5.2 Source: Day, C. and Gray, A. 2008. “Health and Related Indicators”. South African Health Review 2008. 94 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 2010). 30
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 44 and 45: Table 3-3 Primary healthcare visits
Page 46 and 47: 3.4 THE MOBILITY OF LABOUR In 2006
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
Page 94 and 95: d) The introduction of mid-level sk
Page 96 and 97: of legally enforceable nurse/patien
Page 98 and 99:
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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