sector skills plan for the health sector in south africa

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4.6 CONCLUSIONS The growing demand for healthcare and the introduction of changes in the way health services are delivered to the public, drive the demand for skills. The information reported in this chapter confirms that the demand for skills in the health sector continues to outstrip supply. In 2010 there were approximately 281 000 filled positions in the Public Service Health Departments. At the time the total number of funded vacancies was not known, and the total number of positions available in the Public Service could not be calculated. However, the scarce skills information obtained through the Public Service Departments’ WSPs indicate that vacancy rates are quite high and that the Public Service total establishment is considerably larger than what is reflected in the current employment figures. The number of filled posts is only slightly higher than to those of 1997/98 and did not increase to allow for population growth or the impact of AIDS. Calculations by health economists using the 1997/98 staffing levels as baseline showed that the public sector required a staff complement of 315 087 by 2008, just to keep up with population growth and the expanding disease burden. Clearly, current post levels are inadequate to meet the demand for healthcare services. A conservative estimate for the number of employees in the private sector was 178 921 during June 2010. The vacancy rate in the private sector is estimated at 2.3%. By contrast, the public sector experiences high vacancy rates and although estimates from PERSAL are not entirely accurate it does imply that there are significant staff shortages. In both the public and private sectors vacancies in professional positions for doctors, medical specialists, professional nurses and pharmacists are the most difficult to fill. Other scarce and critical skills needs in the public sector are for managers in finance and information technology, and in the healthcare fields of dietetics and physiotherapy. In public health, shortages are mostly related to growth in demand, difficulties to retain or replace qualified staff, geographic location, new technology and migration of employees. Skills development targets for the health sector set by the DoH in 2006 indicate the scope of demand for skills, but fail to acknowledge supply-side constraints to a sufficient degree. Some of these constraints are considered in the next chapter. The rollout of key public health programmes to fight HIV and AIDS and TB and to improve the health of mothers, children and women needs to be supported by both developing the clinical skills of existing health workers and the employment of more doctors, medical specialists and nurses. More lower-level workers and community health workers are needed to support and monitor adherence to treatment regimes. Skills interventions should also target nurses involved in integrated management of childhood illnesses and health monitoring programmes for children. Specialised training on a large-scale is required in TB management and infection control, and staff nurses need targeted training in midwifery and antenatal-, obstetric- and post-natal care. Extensive, intensive and purposive skills development is required to address the considerable gaps in the management of public health operations, its employees and technology, as well as its capital and financial resources. 53
Lastly, the introduction of an NHI system will drive demand for higher levels of care offered by doctors and medical specialists and is expected to turn utilisation of health services away from nurse-based primary care. 54
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SECTOR SKILLS PLAN FOR THE HEALTH S
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2.4.6 LABOUR UNIONS ...............
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5.2 THE SOUTH AFRICAN SECONDARY SCH
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LIST OF TABLES Table 2-1 Total empl
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ABBREVIATIONS AND ACRONYMS ABET Agr
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EXECUTIVE SUMMARY INTRODUCTION The
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Health professionals and practition
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Implementation of these policies dr
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statistics are for 2008 when the Ne
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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 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 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
Page 106 and 107: http://www.hwseta.org.za/upload/sec
Page 108 and 109: National Treasury. 2009. “Health
Page 110 and 111: assistants”. Published at http://
Page 112 and 113: APPENDIX A SCARCE SKILLS LIST - PRI
Page 114: OFO Code OFO description Private he
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sector skills plan for the health sector in south africa

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