Employee retention strategies for medical staff in public hospitals : the case of Potchefstroom hospital

Abstract

Citizens‟ democratic right to health care services is enshrined in the Constitution of South Africa, 1996. In addition, the National Development Plan (NDP), Vision 2030 (2011), as the primary developmental policy of South Africa, states the accessibility and quality of health care services as one of the primary challenges of the democratic developmental state and includes it as a developmental objective (SA, 2013:15). To deliver on the mandate set by the Constitution and the NDP, the availability of skilled, adequate and committed medical doctors and professional nurses is essential to the attainment of the national health outcomes. Eighty four percent (84%) of the total population of South Africa depend on the under-resourced public health sector that is capacitated with few medical doctors (Rispel, 2016:18). However, the public service continues to struggle with the retention of medical employees (Labonte, Sanders, Mathole, Crush, Chikanda, Dambisya, Runnels, Packer, Mackenzie, Murphy & Bourgeault, 2015:2; Bergstrom, McPake & Pereira, 2015:307; Rural Health Advocacy Programme, 2015:1). Thus, this study focuses on the retention of medical doctors and professional nurses (scarce skills) in the North West Department of Health (NW DoH), specifically, the Potchefstroom Hospital. The study researched the following problem: the retention strategies used by the NW DoH do not adequately retain employees with scarce skills, especially medical doctors and professional nurses, which consequently, leads to the public health sector not being able to adequately provide health services to the citizens who are reliant on public health care services in the North West Province. Both a literature study and empirical research were conducted. The literature study was conducted to establish the theoretical framework and statutory and regulatory guidelines to employee retention; current employee retention practices at the Potchefstroom Hospital; the understanding of medical doctors and professional nurses as employees with scarce skills; the context of the public health sector in the North West Province; and the typical challenges experienced in the retention of medical employees in the Province, and more specifically, the Potchefstroom Hospital. The empirical research was conducted to determine the factors that are most likely to retain medical doctors and professional nurses at the Potchefstroom Hospital and to establish managers‟ and medical employees‟ views and experiences on employee retention at the Hospital. The review of the theoretical and legislative frameworks for employee retention, as well as the establishment of the current context of the public health sector in the North West Province (including current retention strategies and challenges experienced), informed the drafting of the research instruments for the empirical research. A self-administered, semi-structured questionnaire was distributed to 102 participants (42 medical doctors and 60 professional nurses). In addition, personal interviews were held with four managers at the Hospital: the HRM Manager; the Training Manager; the Clinical Manager; and the Nursing Manager. The Potchefstroom Hospital does have certain retention practices for medical employees in place. However, irrespective of these practices, a high turnover of medical employees is still experienced. The primary findings of the study, obtained from the questionnaire revealed great dissatisfaction pertaining to the implementation and choice of some of these retention practices, as well as a discrepancy in the results obtained from the medical doctors and professional nurses (questionnaire) and the managers (interviews). Based on these findings, recommendations were made to the Potchefstroom Hospital pertaining to the improvement of its employee retention strategy for medical doctors and professional nurses