1. 1 Human Resources Work Group National Health Consultative Forum Hilton Hotel SANDTON 19 - 20 July 2007

2. 2 Approach Premise: Attainment of MDGs based on sound programmes with an adequate competent health workforce to implement such programmes Discussion areas Policy dissemination Ethical issues Management issues Workforce issues

3. 3 Policy Dissemination

4. 4 Policy Dissemination Observations Policies available but access may be a limitation if only the Internet is used as method of dissemination Implementability proven a challenge in certain respects � need knowdgeable implementers Once policies are adopted, no mechanisms is developed for marketing same for greater buy-in and active implementation

5. 5 Policy Dissemination Observations Policies are generally received well by stakeholders and disseminated to all levels Limitations with electronic dissemination of new policies particularly the gaps created with lower levels who cannot access these policies electronically

6. 6 Policy Dissemination Policy flexibility vs uniformity to address perculiar challenges � customisation brings in certain challenges Challenge of extended consultative processes without reaching finality: decisiveness and leadership required

7. 7 Policy Dissemination Proposals Need manual of operating procedures (e.g. manual circulars) for buy-in at all levels of the organisation Consistency across the provinces in terms of policies must be maintained with flexibility allowed within certain limits Encourage more in-house policy debates to arm managers

8. 8 Summary of Key Issues:Policy Dissemination Ensure appropriate and broad access Market the policies Co-ordination between various policy units to ensure harmonisation of the various pieces of policy frameworks Avoid utilisation of one mode of dissemination Customisation within the national context

9. 9 Summary of Key Issues:Policy Dissemination Customisation must mean simplification without deviating from the national standards Creating multiple platforms for dissemination of policies In HRH field implementation responsibility beyond HR Managers Encouraging more in-house policy dialogue

10. 10 Ethical Issues

11. 11 Observations: Ethical Issues Notable increase in the complaints on ethical transgressions Could there be a moral leadership crisis in the professions and lack of role-modelling for younger professionals? Possible gaps in training on ethics Strengthen penalty regimes for deterrence purposes

12. 12 Proposals:Ethical Issues Need ongoing training for all health professionals [CPD] Mentorship and induction programs for younger professionals Leadership development at institutional level Review Curriculum and training modalities [HPCSA HR/Ethics curriculum]

13. 13 Proposals:Ethical Issues Integrated quality management processes/systems and inter-liaison between government and statutory health councils Decisiveness in terms of removing �bad apples� Consider general review selection process for health professionals across professions � careful not to block access

14. 14 Management Issues

15. 15 Observations:Management Issues Concerns about lack of quality leadership across many levels Concern about lack of professionalism eg. appearance and uniforms Some leaders not understanding the environment Soft issues not addressed promptly or adequately leading to resignations or instability Problem: delegations but not wanting to take responsibility

16. 16 Proposals:Management Issues Push professionals to project a professional image Health Managers should as far as possible have a good understanding of the health environment Put in place intensive induction process for promoted managers Effective guidance of the younger professionals by the older ones Establish management accountability structures and TQM systems

17. 17 Workforce Issues

18. 18 Workforce Issues Broad issues relate to: Planning Development Management Encompass all sub-sectors of health system Must be addressed & where possible certain aspects funded jointly with private health sector

19. 19 Proposal:Workforce Issues Market health sciences at an early stage in schools Structure partnerships with the private sector and communities Enhance specialist training intakes particularly from HDI (leadership issue) Reduce recycling of health professionals Create better career paths and succession planning

20. 20 Proposals:Workforce Issues Flexible remuneration structures for professionals to favour services in rural areas Consistently review and ensure adherence to scopes of practice by the professions