KHOPOTSO: At the request of the Department of Health’€™s communications office I had a 40 minute conversation with the Chief Director for Human Resources in the Department, Dr Percy Mahlati, the man leading the development of the Plan.

Dr PERCY MAHLATI: One of the challenges is that I have a document. We give it to the Minister who’€™s got a very busy schedule’€¦ not only in the country, but also outside the country’€¦

KHOPOTSO: At the time of the interview the Minister of Health Dr Manto

Tshabalala-Msimang, was in Geneva for the World Health Assembly meeting. Dr Mahlati explained that a document was complete and was sitting on the desks of the Minister and the nine provincial Health MECs. He said he hopes that the National Health Council, formerly the MINMEC, will discuss and approve it at their next meeting at the end of June. He cautioned that this document as it currently stands is not the final Human Resources Plan for the Health Sector.    

Dr PERCY MAHLATI: What we started with is to develop a strategic frame-work for the HR Plan. That strategic frame-work identifies certain guiding principles that say for us to develop a robust HR Plan for health that will be able to withstand, in future, all the stresses and the challenges that our health system will face, these are the things that we need to look at. I’€™ll mention a few: Making sure that there are very good, clear policy and planning measures in place; that we’€™ve got good research into human resources; that we’€™ve got good management of the people that actually work for the health system.

KHOPOTSO: In summary, the Plan that would transform the health sector is yet to be produced and put out for comment. If the Plan is not complete then, what do we have?

Dr PERCY MAHLATI: I’€™ll make a comparison: Before you can have an Act of Parliament you have a Bill. A Bill actually addresses all the issues that intend going into an Act before the President signs them into an Act. If I were to use that analogy, what we have now is a very detailed concise document that analyses the problems that we are experiencing in health care that says this is how these have arisen. We’€™ve got a document that is saying these are the experiences in other countries. We’€™ve got a document that is saying in terms of the development of our own health care system these are the trends that are influencing. For instance, quite a number of years ago before 1994 we did not have nurses leaving the country, but migration now is a fact of life, which means then, in our planning for the future we need to actually have that in. So, we have a document that crystallises all that and it starts saying:

If we are to be able to cater sufficiently for the South African people in terms of human resources in health care these are the areas that we need to look at. Do we need to increase the production of doctors or not? Do we need to increase the production of pharmacists or not? So that then when we sit down with institutions we can be able to look and say: Do we have capacity to increase the numbers? Because that needs not only the physical infrastructure, it also needs money. You need lecturers and all that’€¦ So, we are actually at that stage now where we’€™ve got a document that clearly informs and actually says for us to have a robust Plan of Human Resources for Health in this country these are the areas that need to be looked at’€¦

KHOPOTSO: So, we’€™re still months away from having the final Plan put together?

Dr PERCY MAHLATI: Well, it’€™s a few months because the way that we have structured this strategic frame-work is such that it would only be about less than a third of the work that would have to be done to complete it to be a fully-fledged Plan’€¦ The way we’€™ve done it is to make sure that we don’€™t have a discussion document and then you’€™ve got to start from scratch again. No. It’€™s to make sure that once we’€™ve gone through the consultation period it would actually be a matter of a very few months before we can be able to say: Okay, now we’€™ve put in the last elements so that we’€™ve got a fully-fledged Plan.

KHOPOTSO: What are those elements that would need to be added to the document to make it a final Plan?

Dr MAHLATI: For instance, we’€™ve got a challenge of the shortage of pharmacists. Now we need to increase the number of pharmacists that we train in this country. In what numbers should we produce them? Over what period of time? And what are the resources that are needed for that – do we have enough people teaching in the pharmacy schools who would be able to handle the load, will we need to subsidise students that are going through pharmacy? If so, how much subsidies? Where do we get the money so that Treasury can be able to budget appropriately to be able to support those students?

KHOPOTSO: It sounds as though you are trying to draw up the ‘€œRolls Royce’€ of human resources plans, but in the meantime the health system is buckling. What about things that can be done on a general wider scale in the interim to improve the conditions of public health workers, for instance addressing their remuneration? That is something that has been agreed on a long time ago’€¦

Dr MAHLATI: Well, I’€™m not sure whether that can be done almost immediately because you are dealing with public finances and budgeting is very, very important because you don’€™t have pots of money waiting there to be used without proper plans’€¦ You must remember that most health professionals keep on saying it’€™s not only the question of money. It’€™s about the conditions of service. It’€™s about making sure that there is adequate medicine in our hospitals and clinics. It’€™s about making sure that there is a good transport system for referring patients in emergencies and all that. So, it’€™s not only the question of salaries.

KHOPOTSO: What exactly is being proposed remains to be seen. Dr Mahlati would not say what is in the strategic frame-work document. .

Dr MAHLATI: We do understand the eagerness of people to actually have a plan for number crunching: How many are we going to produce here? How much is it going to cost and all that’€¦? I cannot discuss the specifics of the document because there is a process’€¦ Those are basic governance principles.          

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