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

The impact of human resource management on health

systems    

[email protected]

Page 2: The impact of human resource management on health systems jbuchan@qmu.ac.uk

HRH Management

• HRH Challenges

• HRH Dynamics

• Impact of recession

• HR Interventions

Page 3: The impact of human resource management on health systems jbuchan@qmu.ac.uk

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 motivating doctors, 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?

Page 4: The impact of human resource management on health systems jbuchan@qmu.ac.uk

Common HRH Challenges

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

Page 5: The impact of human resource management on health systems jbuchan@qmu.ac.uk

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

Page 6: The impact of human resource management on health systems jbuchan@qmu.ac.uk

“Stocks and flows”

Workforce (“ Stock”)

Leavers (“flows”) retirement international non health

sector etc

Joiners (“Flows”) From training international returners etc

Page 7: The impact of human resource management on health systems jbuchan@qmu.ac.uk

“Flows” (Maldistribution)

• FROM:• rural• “poor” districts• public sector• health sector• “poorer” countries

• TO• urban• “richer” districts• private sector• other sectors• “richer” countries

Page 8: The impact of human resource management on health systems jbuchan@qmu.ac.uk

P

Distribution of physicians in the European RegionDistribution of physicians in the European Region

<= 700

<= 580

<= 460

<= 340

<= 220

No data

Min = 100

Physicians per 100000

Lastavailable

European Region352.92

Source: WHO HFA database, 2007

Page 9: The impact of human resource management on health systems jbuchan@qmu.ac.uk

Diversity in the European regionDiversity in the European regionHealth professionals / 100.000 population, 2002Health professionals / 100.000 population, 2002

Physicians Nurses Midwives Pharmacists

European Region

351.22 669.02 45.07 50.93

EU 343.56 708.26 35.95 77.54Central Asian Republics and Kazakhstan

293.14 767.68 66.9 16.38

CIS 373.55 794.18 54.15 18.44

Lowest 118.54 (Albania)

245.15(Turkey)

11.30 (Germany)

3.03 (Uzbekistan)

Highest 618.52(Italy)

1856.91 (Ireland)

122.77 (Azerbaijan)

204.31 (Malta)

Source: WHO HFA database, 2007

Page 10: The impact of human resource management on health systems jbuchan@qmu.ac.uk

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 $

Page 11: The impact of human resource management on health systems jbuchan@qmu.ac.uk

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

0

5

10

15

20

25

Albania Belgium Czech Germany Ireland Latvia Poland Romania Serbia Spain UK

2008

2009

Page 12: The impact of human resource management on health systems jbuchan@qmu.ac.uk

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

Page 13: The impact of human resource management on health systems jbuchan@qmu.ac.uk

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

Page 14: The impact of human resource management on health systems jbuchan@qmu.ac.uk

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)

Page 15: The impact of human resource management on health systems jbuchan@qmu.ac.uk

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 2004:6http://www.human-resources-health.com/content/pdf/1478-4491-2-6.pdf


Top Related