Health-e (Cape Town)

7 November 2012

South Africa: Academy to Improve the Health Service

From now on, new hospital CEOs and other high-level managers responsible for health care delivery in South Africa will undergo specialised training in health care management. Yesterday (Tue,06/11/12), the national Health Department launched the Academy for Leadership and Management in Health Care, whose aim is to equip health managers with the know-how of navigating through situations that can compromise health care delivery.

Many of the appalling conditions of South Africa’s public health care service, such as hospitals running out of drugs or crucial equipment not working, are directly linked to the quality of managers that lead our public health institutions. The Academy for Leadership and Management particularly aims to empower hospital CEOs with practical knowledge about the day-to-day running of hospitals. Health Director-General, Precious Matsoso, says the Academy seeks to fill the gap between current health education and practice, thus giving health care workers class-based as well as on-the-job training on crucial aspects of health care delivery, particularly towards the implementation of the National Health Insurance scheme.

“Most of them would be trained as mainly post-graduates. There are quite a number of training programmes within the country, some at Masters level, others at post-graduate diploma level. But these have not been specifically designed to prepare CEOs of hospitals and neither have they been specifically designed to prepare district managers, as you know, the thrust of service delivery for NHI is at district level. We’ve done an analysis of all the training programmes in the country that are provided by various institutions. The academy is actually supposed to pull all of those together to ensure that we can produce a certain cadre of health managers as well as CEOs of hospitals, which will be a combination of not only class-room training, but also on the job training on-site”, says Matsoso.

The Academy will start operating in January and the first learners will be the new CEOs of the 97 hospitals located in eight provinces, with the exception of the Western Cape, that the national Health Department has decided need competent CEOs. Health Minister, Dr Aaron Motsoaledi, says the interviewing process for the appointment of the CEOs will be finalised before the end of the year. Motsoaledi said two of the eight provinces have already completed the interviews, but he declined to name them. He said no new hospital CEO will start work before they are taken through the necessary paces at the Academy for Leadership and Management in Health Care.

“In my thinking, nobody should ever be interviewed, win an interview and enter a hospital as a CEO without having gone through some form of training through this academy… even if (it is) just for induction, and they will continue doing in-service training over a long period of time”, he says.

The Academy is modelled on the College of Medicine in South Africa. It will train health care workers who have an interest in health care management in practical skills needed for the smooth functioning of health services at hospital, district, provincial and national level.

“Those who know how the College of Medicine in South Africa functions, whereby people do their different degrees in different medical universities, but when they do a senior a degree - a particular qualification - they must be accredited or write their exams through the College of Medicine, which encompasses all medical universities (in) South Africa. We are doing more or less the same thing. We need a central Academy of Health Leadership and Management which will standardise and accredit people who must manage health care institutions, and we’d like to start with CEOs. They will do custom-made courses. In other words, if you must be a CEO of a hospital, what do you do every day when you arrive? What do you do before you knock off? What do you do on a weekly basis? What do you do on a monthly basis? The various sectors of the hospital… what do you do for them? Many people don’t necessarily know that. That’s what the institution will do.

But, further than that, what about people who must manage health districts? What must they know? But, lastly, at head office… to be a DG for Health or a DDG or a chief director, what form of skill must you have acquired apart from your first degree or your primary qualification?”, Motsoaledi explains.

He says the Academy has been in the pipeline for the last two years and has described it as a gigantic step towards the implementation of the National Health Insurance scheme.

“It has to develop education, training and professional standards to drive towards scientific practice and evidence-based, patient-orientated services suitable for NHI. We, in the Department of Health, see this Academy as a gigantic step towards the implementation of NHI”.

An advisory committee comprising 12 senior local and international experts in health care delivery will lead and provide guidance to the Academy. Professor Noddy Jinabhai, a retired professor from the University of KwaZulu-Natal and a member of the advisory committee says the launch of the Academy seeks to address problems in the public health care sector over time.

“The aim of this academy is to improve service delivery, and the Minister hopes, through the launch of this unique innovative academy, to address and overcome those deficiencies of the past 18 years”, says Professor Jinabhai.

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