the ICN International Nursing Conference
28 June 2006
Programme director
Delegates
Ladies and gentlemen
The nursing profession finds itself at the cutting edge of health care
delivery in South Africa. Indeed, you are the public face of the medical
profession. Most often you are the first person a patient comes into contact
with when he or she enters the system and almost certainly the last before they
depart. Public perceptions about health services therefore, depend to a
significant degree on your attitudes and professionalism.
Programme director,
It is therefore heartening to see so many of you present at this
International Congress of Nutrition (ICN) conference and to observe the quality
and the depth of your programme over the next two days. For me it speaks of a
profession that is dedicated to the principles of quality, excellence in
service delivery and ambition to continuously increase your knowledge and
skills levels. Florence Nightingale once remarked that �nursing is a noble
profession but it takes nurses to make it so.� This has been my experience as
well in the slightly more than 100 days that I have filled this position in the
province of Gauteng. If there is one thing that I have come to realise it is
that effective health service delivery can not only be achieved through big
budgets and modern management systems. Health care is much more than high
technology and sophisticated machines that keep patients alive and healthy.
Health service delivery is a profoundly human experience where the
interaction between patient and health care provider is the irreplaceable
factor. We in Gauteng have set ourselves clear objectives to develop healthy,
skilled and productive people that can take our province into the future and
ensure a better life for all our people. We are quite aware of the fact that
these goals can not be achieved without quality people working in our system.
The availability of human resources is one of the biggest challenges facing
health care delivery in South Africa. But it is far more than a mere local
issue. It is prevalent across the world as health care professionals migrate
from rural settings to the urban environments; from the public sector to
private health care and from developing countries towards the more
sophisticated markets attracted by short term offers of substantially higher
wages.
Ladies and gentlemen,
You are, no doubt, aware of the fact that South Africa has been at the
forefront of the efforts to place this issue at the top of the global health
care agenda. At the World Health Assembly in Geneva last year African Ministers
of Health gave their unanimous support to a resolution drafted by South Africa
to treat this as a priority issue. As a result the World Health Organisation
has declared 2006 as the year where special attention will be given to the
global crisis in the health workforce. According to the most recent WHO survey
there is an estimated world-wide shortage of 4,3 million doctors, nurses,
midwives and other health support workers.
In his introduction to the report, the former Director General of the World
Health Organisation (WHO), Dr Lee Jong-wook notes that �people are a vital
ingredient in the strengthening of health systems. But it takes a considerable
investment of time and money to train health workers. Countries need their
skilled workforce to stay so that their professional expertise can benefit the
population. When health workers leave to work elsewhere, there is a loss of
hope and a loss of years of investment.�
A recent global survey has shown that most health care professionals migrate
because they want to gain international exposure in environments that are
different from the ones in which they are currently working. This finding is
important because it also implies that many professionals move on a temporary
basis to enable them to gain new experiences and raise their levels of
skills.
It is against this background that the Minister of Health, Dr Manto
Tshabalala-Msimang has reached a bilateral agreement with Britain on the
recruitment of health professionals. This arrangement allows South African
health professionals to work in the United Kingdom for a specified period and
then return back to this country. At the same time we are providing
opportunities for British professionals to gain new skills and experience in
the South African setting. This agreement is already yielding positive results
and we expect that similar agreements will in future be signed with other
countries such as Canada, that recruit local health professionals on a
significant scale.
However, ladies and gentlemen, I have to state it clearly that we cannot
continue to see how the migration of health care professionals especially
nurses undercuts our ability to provide quality health services to our own
people. This is a complex problem that requires a multi-pronged approach. We in
Gauteng have not escaped this global trend. In this province we have to
implement a human resource strategy against the backdrop of a sharp rise in
demands for our services. The number of people visiting our primary healthcare
facilities has risen from a mere one million in 1994 to the current figure of
12 million. This rise can directly be attributed to the success of this
government and this administration to make health care facilities accessible to
the entire population.
I want to call on you who are leading the nursing profession in South Africa
today to work with government to find mutually acceptable solutions. We have to
be very realistic about this because we are operating within an environment of
competing demands for limited budgets. Clearly, health service delivery is a
top priority for government but we are not operating in a vacuum. Education,
job creation, economic growth and development, social services and safety and
security all have to be accommodated in government budgets on an equitable
basis.
It is thus patently clear that we in South Africa must have the strategies
and the programmes that will not only enable us to recruit and train health
professionals to meet our growing needs but also to retain their services in a
global environment where the skills and knowledge of our professionals are in
great demand. In line with the WHO focus for 2006 we had already in our
province set a strategic objective to be a leader in human resource management
and development for health.
The Bill of Rights puts the right to access to basic health care and
emergency services as a primary mandate. To deliver on this mandate, we have
set ourselves a target of increasing the number of nurses produced by our
colleges by 20% annually. In the last financial year we admitted 3651 student
nurses of all categories into the education programme, which exceeds our target
by 600. In addition 1249 new graduates were employed in different hospitals and
clinics. This year we will reopen one nursing college and our objective is to
double the number of nurses we are producing by 2009. This will necessitate
that we appoint 50 more tutors and clinical facilitators to meet the teaching
needs of the increased production of nurses.
Programme Director, You are aware that the new Nursing Bill brings nursing
education into the mainstream of the further education sector and the National
Qualification Framework. One of the key results will be that nurses can now
gain recognisable credits for work completed and retain them for future
studies. We are working with our partners, organised labour and professional
associations to retain our existing nursing staff and improve the quality of
their work environment. This takes place through projects such as the �Caring
for the Carers� programme, led by Democratic Nurses Organisation of South
Africa (DENOSA) and other partnership programmes with the International Labour
Organisation, the International Council of Nurses, the World Health
Organisation and Public Service International.
The department�s drive to recruit and retain health professionals is
yielding positive results in that 2 900 professionals joined the Department in
the previous year. This drive will continue in the coming months with the
target to recruit 2 300 health professionals by the end of the financial year.
I am pleased to report that we have been able to retain critical staff through
a number of important interventions. This includes the revision of remuneration
structures, through notch and level increments, that were implemented for
targeted health professionals. We are also improving the quality of the work
environment for professionals through the increase in the number of trained
nurses, procurement of state of the art equipment, the payment of recognition
awards to deserving employees and the improved positive profile of the
department as a preferred employer.
At national level the issue of the remuneration of public health care
workers is receiving priority attention. I think there is now broad agreement
that the salaries of health care officials have lagged behind other public
sector officials. The Department of Health has engaged both the National
Treasury and the Department of Public Service of administration on this issue
and I am quite confident that a new remuneration structure will be in place in
the next financial year.
Programme director, I have no doubt that an important element of the
solution to our human resources concerns is to raise the status of the nursing
profession and to improve the quality and the skills base of the nurses that we
produce. However, I want to state clearly that the status of a profession is
not conferred or trusted upon from the outside. Status is something you have to
earn. From our side we must look at remuneration and working conditions of
health professionals but there has to be an equal response in terms of
professionalism, commitment to service, ethics and innovation. I believe that
the new Nursing Bill and the newly constituted Nursing Council will go a long
way in addressing many of the concerns we share about the future of the
profession. I am also aware that there are concerns within the profession about
certain aspects of the Bill. I want to urge you to use the channels that are
available to you through the Council and organisations such as DENOSA to raise
these issues with government. I am sure you will find an open door and a
sympathetic ear.
As we make inroads in our recruitment and retention strategies we also have
to pay attention to changing the attitudes of our staff. It is our fervent hope
that, the efforts that we are putting in improving the working environment of
our staff will have a direct positive influence on the relationship between
health professionals and our patients. While our patients have become more
informed about their rights they are still vulnerable because of the burden of
disease. It is upon us to give them a new experience, show them care, and treat
them with compassion and dignity which will prove to them that we are indeed
living in the Age of Hope.
Programme director, I want to pay tribute to the role played by the
organised nursing profession and especially DENOSA in raising the standards of
health care delivery in South Africa. Your efforts have not only been
recognised here but also in the global environment as evidenced by the decision
that the 2009 ICN World Conference will be hosted by South Africa. I trust that
you will have an extremely productive two days of deliberations and that the
decisions you take will support our efforts to raise the quality of care that
we provide to the people of our country.
I thank you
Issued by: Department of Health, Gauteng Provincial Government
28 June 2006
Source: http://www.gpg.gov.za/
