KHOPOTSO: So unprecedented is the threat posed by the scarcity of professionals in the public health sector that African Ministers of Health currently meeting at the World Health Assembly have spoken out with one voice in expressing concern over the continued migration and recruitment of health personnel from developing to developed nations. Championing the call at the meeting is South Africa’s Health Minister, Dr Manto Tshabalala-Msimang. A press statement released last week by the Ministry’spokesperson Sibane Mngadi, reports that South Africa has drafted a resolution highlighting the international migration and recruitment, particularly of skilled and experienced health workers, as a major challenge for health systems in developing countries. The resolution calls on the Director-General of the World Health Organisation to urgently implement measures to curb the poaching of skilled and experienced health workers from Africa. The resolution is expected to be tabled for adoption before the full meeting of the World Health Assembly after full endorsement by the African Ministers.
Curiously though, back home the Minister is sitting on a long-awaited plan to address the shortage of health workers that is crippling the provision of care in the public health sector. Tshabalala-Msimang promised that by the end of March a national human resources plan to address the crisis would be released after consultation with stakeholders, including the unions. Enquiries with three nurses’ unions DENOSA, NEHAWU and SADNU have revealed that neither the Minister nor her Department has consulted with them on the plan. They say they have only heard about it through the media. However, consultation has taken place with the South African Medical Association (SAMA) which represents doctors. This selective consultation process could potentially further delay or de-rail the plan. Fikile Majola, Secretary-General of the
National Education Health and Allied Workers’ Union, NEHAWU.
FIKILE MAJOLA: All services have suffered overall, but the one that’s most hit is nursing because of the reasons of flight ‘ nurses leaving the public service for the private sector or leaving the country. In Chris Hani Baragwanath, for example, a study has been done to determine the extent of staff shortage there. Overall there is a staff shortage of 30% when it comes to nurses and doctors. At Natalspruit the organogram makes provision for 1 576 workers. At the moment we have 1 246. There’s a total shortage of 276 workers. Once again, there’s supposed to be 112 medical personnel there. At the moment we only have 75. Of the 748 nurses that we need we only have 624. The same picture that we see at Chris Hani Baragwanath is there at Natalspruit, and we dare say that we’ll find the same in almost all of the public hospitals in Gauteng and the other provinces.
KHOPOTSO: Yet, the development of a plan aimed at addressing this critical shortage of health personnel does not seek to consider the views of nursing bodies, whose members leave the public sector in droves largely because of poor working conditions and little remuneration. Although recruitment and retention measures such as the scarce skills and rural allowances have been put in place, their effectiveness is questionable. For example, there is resentment among those who through long experience are able to perform the scarce skills, such as work in operating theatres, but because they do not have official training for that position, cannot receive the allowance.
Transformation of the health system cannot take place without adequate human resources and so, there is a legal duty on the part of government to develop a reasonable human resources plan which will be balanced and flexible. The plan must take care of short, medium and long-term needs and be responsive to the needs of those in desperate situations. Constitutionally, the plan is essential for the protection of human rights – the rights to dignity, access to health care services and equality. It also needs to be transparent, that is, the government must communicate with all stakeholders in the development and implementation of the plan.
But it would appear that even though there was no broad-based consultation on the plan, it is almost ready for release. The only stumbling block, according to a source close to the process is that the Minister has yet to sign off on it. In an interview with Health-e last month, Chief Director for Human Resources in the Department of Health, Dr Percy Mahlati ‘ the driving force behind the plan ‘ would not be drawn on its contents until it had been seen and signed by the Minister.
E-mail Khopotso Bodibe