sector skills plan for the health sector in south africa

5.3 INSTITUTIONAL ARRANGEMENTS AND CAPACITY FOR THE TRAINING OF HEALTH
WORKERS
5.3.1 ACADEMIC COMPLEXES
Prospective health professionals are trained in academic health complexes established under the
National Health Act that aim at providing comprehensive training in primary-, district- and tertiary-level
care. Each of these academic health complexes consists of health facilities at all levels of the national
health system, including peripheral facilities and one or more educational institutions. 185 Although there
are many calls for increased output from the academic health complexes, training capacity is limited as a
result of constraints related to infrastructure, bed-count, laboratories, and other resources. Despite the
high demand for placement in healthcare educational programmes the annual intake remains restricted.
Leading health academics, in a presentation to the Parliamentary Portfolio Committee on Health,
warned that the academic health complexes are in a state of crisis due to the lack of a national
governance structure and an appropriate funding framework. According to these academics, although
provincial health departments are responsible for funding the complexes, very little money is allocated
to them. These complexes compete with other priorities in the provincial budgets, such as primary and
district health care. 186 As a result, fewer healthcare workers are produced and the quality of tertiarylevel
healthcare and training is reduced. There are fears that some academic hospitals may lose their
accreditation as teaching institutions unless funding is made available to maintain infrastructure,
provide adequate standards of service and supply medication. There is a real risk that the numbers of
undergraduate medical students may be cut and intern training posts be reduced. 187 Owing to budget
constraints the bed-count in several tertiary hospitals has dropped, and this has resulted in a diminished
capacity to train health professionals.
In addition, the HWSETA baseline study reported that the brain drain of academic and experienced
personnel leads to deficiencies within training institutions, impacting in this way on the professional
attachment and supervision of new graduates and the production of future health personnel.
5.3.2 PRIVATE HIGHER EDUCATION AND TRAINING INSTITUTIONS
Although South Africa has dynamic and well established private higher education institutions (HEIs) they
may be challenged in meeting the extensive accreditation requirements for the training of health
professionals set by the professional councils and the HEQC of the Council for Higher Education.
185 Section 51 of the National Health Act, 61 of 2003.
186 Bateman, C. 2010. “Academic health complexes bleeding in ‘no man’s land’”. South African Medical Journal. January 2010.
100 (1). Published at http://www.scielo.org.za/pdf/samj/V100n1; Development Bank of South Africa. 2008. A Roadmap for the
Reform of the South African Health System.
(Accessed August 2010).
187 Bateman, C. 2010. “Academic health complexes bleeding in ‘no man’s land’”. South African Medical Journal. January 2010.
100 (1). Published at http://www.scielo.org.za/pdf/samj/V100n1.
(Accessed August 2010).
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