sector skills plan for the health sector in south africa

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3.9.2 REGULATION OF QUALITY Strict regulatory controls are in place to control standards for entry into the healthcare professions. Statutory provisions require health professionals to be registered as such in their respective fields. As discussed in Chapter 2, the HPCSA, AHPCSA, SANC, SAPC, SADTC and SAVC control the respective registers entrusted to them by statute. Registration as a healthcare professional or technician only takes place once the applicant has obtained the required qualifications and has served an internship or has completed practical training. Several categories of healthcare professionals are required to serve one year of community service in the public health services before they are allowed to register for independent practice. The professional bodies also determine the scope of practice for the various categories of healthcare professionals, which amounts to controlling the services and treatment that are permitted and those that are not. Although the professional councils do not control or influence the supply of skills, they do control the quality of skills available in the health sector. As such, the councils set standards for practice, education and training and ensure that the training programmes offered meet the specifications of registered qualifications. The councils also assess and accredit training providers entrusted with delivering accredited programmes and perform quality assurance functions required in terms of the skills development legislation. The councils furthermore determine the standards for the CPD that professionals require in order to retain their registration. Generally healthcare professionals may engage in a range of activities to update their skills, including organisational activities, self-study and groupstudy, usage of information from latest research publications, teaching, and the acquisition of additional qualifications. 107 The NHA establishes academic health complexes 108 where health workers are trained in primary, secondary and tertiary healthcare facilities and are exposed to peripheral facilities serving communities. The intention is to better prepare staff to work in a range of facilities, including primary healthcare. 3.10 NATIONAL HEALTH POLICIES South Africa endorsed three health-related Millennium Development Goals (MDGs), which are to: reduce child mortality; improve maternal health; and combat HIV and AIDS, malaria and other diseases. 109 Several national health policies are focused on achieving those goals and to improve the health profile of all South Africans. A number of the key priorities in the “Health Sector Strategic Framework: The 10 Point Plan” 110 of the DoH have a direct bearing on the actions and skills required to achieve national policy objectives. Among these are: 107 Macheke, C. 2010. HWSETA Health Sector Baseline Study. 108 Section 51 of the National Health Act 61 of 2003. 109 Day, C. and Gray, A. 2008. “Health and Related Indicators”. South African Health Review. Health Systems Trust. Published at http://www.hst.org.za/uploads/files/chap16_08.pdf. (Accessed August 2010); 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). 110 DoH. 2010. “Health Sector Strategic Framework: The 10 Point Plan” in the Strategic Plan 2010/11-2012/13 . Published at www.doh.gov.za (Accessed August 2010). 33
a. An overhaul of the healthcare system by re-focusing on primary healthcare and communitybased health services; b. Implementation of National Health Insurance (NHI); c. Accelerated implementation of tuberculosis controls and HIV and AIDS policies (including expanded prevention strategies and access to ART); d. Greater focus on improving maternal, perinatal and child health; e. Promoting the prevention of lifestyle diseases and better nutrition; f. Strategic leadership, improved management and governance of the health system; and g. Improvements in human resources planning and development, including the recruitment and retention of professionals and the training of nurses, primary healthcare personnel and mid-level health workers. 3.10.1 PRIMARY HEALTHCARE Over the last decade the delivery mode for public health services has moved from a hospital-centred approach to a primary healthcare (PHC)approach. Such services are rendered by nurses and community care workers in clinics and community health centres. 111 Government plans to strengthen and develop primary healthcare and community-based services even further. With the increasing burden of disease the demand for primary care is increasing at a rapid rate. It is anticipated that the concomitant demand for nurses across all categories will also increase. Through the National School Health Policy government plans to deploy PHC nurses to schools to provide health education, impart life skills, and screen children for diseases, disabilities, immunisation status and other healthcare needs. 112 The development and support to nurses will be required for them to manage a large proportion of health problems at a PHC level. The national DoH Strategic Plan for 2010/11-2012/13 also identifies the incorporation of and utilisation of community health workers (CHWs) in the delivery of PHC services. This implies that the development of the skills of existing CHWs will be required as well as training of new CHWs. 3.10.2 COMMUNITY HEALTH WORKERS Due to the rapid spread in the HIV and AIDS pandemic and TB epidemic, the health sector has experienced a sharp growth of a range of community carers who are mostly affiliated to NGOs and community-based organisations (CBOs). Community health workers (CHWs) or community care workers (CCWs) are generalist health workers who provide primary care, but their mandates and conditions of 111 Lehmann, U. 2008. “Strengthening Human Resources for Primary Health Care”. South African Health Review. Health Systems Trust. Published at www.hst.org.za/publications/841. (Accessed August 2010). 112 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). 34
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 48 and 49: Arguably, many of the driving facto
Page 50 and 51: 3.8 MANAGEMENT OF THE HEALTH SYSTEM
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
Page 100 and 101: Therefore, the HWSETA’s skills de
Page 102 and 103:
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
Page 110 and 111:
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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