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The impact of human resource management on health systems    

The impact of human resource management on health systems    . jbuchan@qmu.ac.uk. HRH Management. HRH Challenges HRH Dynamics Impact of recession HR Interventions. Common challenges: Policy maker priorities.

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The impact of human resource management on health systems    

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  1. The impact of human resource management on health systems     jbuchan@qmu.ac.uk

  2. HRH Management • HRH Challenges • HRH Dynamics • Impact of recession • HR Interventions

  3. Common challenges: Policy maker priorities • How do we plan how many doctors, nurses, and other health workers to educate, and employ? • How can we improve recruitment, retention and return? • Which incentives are effective in motivatingdoctors, nurses etc • How can we determine and deploy the most effective skill mix of doctors, nurses and other staff? • How can we improve productivity of health workers? • How do we maintain workload with reasonable limits, for individuals and for teams of health workers?

  4. Common HRH Challenges • Skills shortages • Geographic maldistribution • Fragmented planning • Education- employer linkages • Managing Staff Performance • Effective Skill mix • Migration • (Data; research/evaluation; informing policy)

  5. Dynamics in Europe • European health care labour markets are dynamic- will change in response to demographic change (ageing populations) ; general economic conditions; -health sector reform • Accession- countries with relatively low paid health professionals – outflow to established “richer” EU countries? (Knock on effect to East/ CIS?) • Patient safety/ country level regulatory issues • “Stocks and Flows” : Different data sets- different pictures

  6. “Stocks and flows”

  7. FROM: rural “poor” districts public sector health sector “poorer” countries TO urban “richer” districts private sector other sectors “richer” countries “Flows” (Maldistribution)

  8. Distribution of physicians in the European Region P Source: WHO HFA database, 2007

  9. Diversity in the European regionHealth professionals / 100.000 population, 2002 Source: WHO HFA database, 2007

  10. Impact of recession/crisis • “multidimensional and severe”(WHO,2009) • Many European countries will be in economic recession this year; employment decline most evident in [export oriented] manufacturing, finance, construction • Countries with financial resources are funding “stimulus” packages- those with limited resources have less scope for fiscal interventions • Depreciation of national currencies in Central/ East / South East Europe (and UK) in comparison to euro and $

  11. Unemployment (%) 2008/2009, selected countries [Source: WHO, 2009;EIU]

  12. Recession: Impact on HRH • Reduced demand for “new” HRH because of funding constraints, and increased retention of workers already working in health sector • Labour cost reductions/ improved productivity= skill mix changes, increased workload/ stress • Pay “freezes” or pay reductions in health sector • Increased pressure to migrate, but reduced job opportunities in many countries • Increase in unemployment/ underemployment of health workers as supply increases and demand reduces or stagnates

  13. Policy options • Establish “anti-crisis unit” in Ministry of Health: monitor situation, explore strategic options, link to other Ministries (particularly Ministry of Finance) • Maintain/develop communication links with other stakeholders (donors, professions, civil society, NGOs etc)- “we are all in this together” • Develop advocacy/ influence to protect health budgets • Review HRH cost containment/ productivity options to identify action with potential for positive impacts (assess HRH impact) • Review workforce planning and projections to assess if oversupply of ”new “ staff

  14. HRM Evidence Base • about 30 studies examining links between HRM and organisational performance: • “Fit” : HRM must be aligned with organisational context and objectives • “Bundles” : co-ordinated HRM interventions are more effective than single interventions • HRM can make a positive difference to performance(Buchan, 2004)

  15. References • WHO (2009) Health in times of global economic crisis: implications for the WHO European region • Buchan J (2004) What Difference Does (Good) HRM make? Human Resources for Health 2004:6 http://www.human-resources-health.com/content/pdf/1478-4491-2-6.pdf

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