Date: 16/09/2004
Source: Ministry of Health
Title: M Tshabalala-Msimang: Launch of Public Hospitals CEO Forum
SPEECH BY THE MINISTER OF HEALTH, DR TSHABALAL-MSIMANG, AT THE LAUNCH OF THE PUBLIC HOSPITALS CEO FORUM, 16 September 2004
Greetings
It is my pleasure to join all of you this evening to witness yet another important milestone in a quest for transformation of the health system in our country, South Africa.
It is important that we remember what we sought to achieve when we started the transformation of our hospitals. You will recall that numerous studies revealed significantly high levels of inefficiencies in our hospitals. The main contributing factor was the archaic management structures and systems. As part addressing these challenges, we agreed that we needed to decentralise management and introduce "General Management" into hospitals.
Some of the elements of decentralisation included:
* Delegation of powers over human resources, finance and other management functions to the hospital management
* A shift in the role of provincial health authorities from an executive or administrative management role to supporting hospital management, setting guidelines and provincial policy approach
* We also resolved to establish representative and accountable hospital boards
Decentralisation means that we delegate authority and decision-making to the lowest sustainable management level. Decentralisation allows hospital management some flexibility to spend the allocated budget to achieve the required outputs.
There have been challenges in implementing this programme. We had to appoint a Ministerial Task Team in 1999 to review progress and make recommendation to speed up implementation. The task team made a number of recommendations, which were later adopted by Minmec. These recommendations included the review of the role and responsibility of national, provincial and district health authorities within a decentralised system. The team also recommended that chief executive officers and general managers needed to be appointed in all hospitals and the appointment should be based on assessed competencies of potential candidates and should not be limited to those within the medical profession.
General management structures have been introduced to ensure proper management of hospitals along business principles. We have moved away from the concept of Medical Superintendents managing hospitals, to appointing appropriately qualified and competent managers to run our hospitals. With the change in our management structures, we are beginning to see a more integrated management approach that seeks to address the overall challenges of a health facility in a holistic manner.
One of the programmes that are making a major contribution in transforming our health services, improving the infrastructure and management capacity in our hospitals is the Hospital Revitalisation programme. We embarked on this programme to improve the condition and accessibility of our facilities, which have been one of the major challenges.
The programme improves not only the infrastructure, but also provides necessary equipment and boosts management capacity. Since 1998, R1.6 billion has been spent on rehabilitating 249 hospitals. The current annual budget of R717 million is expected to increase to R1 billion in 2005/2006 financial year.
We should, in near future, be opening the Nelson Mandela Hospital in Umtata, which is one of the three state of the art hospitals commissioned for tertiary health services. The others are Inkosi Albert Luthuli, which is already operating in Durban, and the soon-to-be completed Pretoria Academic Hospital.
Revitalisation of hospitals includes:
* Improving the condition and quality of hospital buildings and design;
* Rationalising and improving the condition of hospital equipment;
* Decentralisation of hospital management;
* Organisational development and strengthening management capacity;
* Continuous quality improvement and improving the status of Emergency Medical Services.
One of the initiatives that contributed in improving the implementation of the decentralisation programme was the twining of some of our hospitals with UK health facilities. The initiative funded by the European Union and DFID allowed for the sharing of expertise and experiences in undertaking major management functions at a hospital level. There was an exchange of ideas in how to identify the health needs and planning to meet these needs through the negotiation of performance agreements.
While decentralisation increases autonomy and decision making powers of hospital managers, it also requires clearer lines of accountability to the authorities who fund the hospitals and the communities served by the hospitals. In developing an efficient and accountable hospital management, our overall goal is to promote innovation and accountability to clients and funders.
The past five years were characterised by more vibrant and participative efforts in improving the National Planning Framework for the provision of hospital services in the whole country. There is a great deal of creativity and provinces are developing innovative strategic plans to address the health needs of the populations they serve within broad national guidelines. Seven of the nine Provinces have written delegations devolved to hospital level and the remaining 2 provinces are at advanced stages of finalising these delegations.
The role of Hospital Boards is crucial in this transformation process. Training Programme for Hospital Boards that is coordinated at national level is being provided in Provinces to build skills and capacity. The training focuses on understanding issues of governance and accountability in support of management and ensuring responsiveness to community needs.
The National Health Act makes provision for establishment of various governance structures within the health sector including hospital boards and clinic committees. The regulations, under the National Health Act, on Hospital Boards are at an advanced drafting stage.
The launch of the Public Hospitals CEO Forum (PHCF) is therefore a formal recognition of these executive positions in the Public Health System. Your mandate as CEO's of our hospitals is to restore and uphold the dignity and respect of people who use our public health facilities. You can achieve this by rigorously driving quality assurance and improvement strategies in accordance with the National Health Act. You have to adopt a humane approach and culture of caring that should characterise our hospitals.
You should manage resources at your disposal skilfully and competently to achieve these goals. You should be accountable and responsive to the needs of the communities you serve.
The CEO Forum we are launching today will provide a management development platform where Hospital Managers and CEO's can share operational information and experiences. The Forum will seek to achieve the following objectives:
* A dynamic responsive hospital management;
* Delivery of high quality services to communities and stakeholders;
* Accountability for the operational management of public hospitals;
* And quality improvement and efficiencies.
We should use this Forum to achieve a paradigm shift in the management of public hospitals. We should usher in a model of "best-practice" management approach that is characterised by:
* A culture of efficient service delivery;
* Accountable cadre of executive managers and;
* An uncompromising quality of care
The decentralisation of our management functions and the establishment of the CEO Forum cover at least five of the ten priorities we have set for the next five years. We resolved to improve the governance and management of the National Health System; improving quality of care; strengthening hospital service delivery systems; human resource management; as well as planning, budgeting and monitoring and evaluation.
This initiative is therefore a major step in our efforts to achieve our vision of an accessible, caring and high quality health system.
I wish all the best in ensuring that this Forum achieves its objectives.
Thank you
Issued by: Ministry of Health
16 September 2004
Source: Department of Health (http://www.doh.gov.za)
Source: Ministry of Health
Title: M Tshabalala-Msimang: Launch of Public Hospitals CEO Forum
SPEECH BY THE MINISTER OF HEALTH, DR TSHABALAL-MSIMANG, AT THE LAUNCH OF THE PUBLIC HOSPITALS CEO FORUM, 16 September 2004
Greetings
It is my pleasure to join all of you this evening to witness yet another important milestone in a quest for transformation of the health system in our country, South Africa.
It is important that we remember what we sought to achieve when we started the transformation of our hospitals. You will recall that numerous studies revealed significantly high levels of inefficiencies in our hospitals. The main contributing factor was the archaic management structures and systems. As part addressing these challenges, we agreed that we needed to decentralise management and introduce "General Management" into hospitals.
Some of the elements of decentralisation included:
* Delegation of powers over human resources, finance and other management functions to the hospital management
* A shift in the role of provincial health authorities from an executive or administrative management role to supporting hospital management, setting guidelines and provincial policy approach
* We also resolved to establish representative and accountable hospital boards
Decentralisation means that we delegate authority and decision-making to the lowest sustainable management level. Decentralisation allows hospital management some flexibility to spend the allocated budget to achieve the required outputs.
There have been challenges in implementing this programme. We had to appoint a Ministerial Task Team in 1999 to review progress and make recommendation to speed up implementation. The task team made a number of recommendations, which were later adopted by Minmec. These recommendations included the review of the role and responsibility of national, provincial and district health authorities within a decentralised system. The team also recommended that chief executive officers and general managers needed to be appointed in all hospitals and the appointment should be based on assessed competencies of potential candidates and should not be limited to those within the medical profession.
General management structures have been introduced to ensure proper management of hospitals along business principles. We have moved away from the concept of Medical Superintendents managing hospitals, to appointing appropriately qualified and competent managers to run our hospitals. With the change in our management structures, we are beginning to see a more integrated management approach that seeks to address the overall challenges of a health facility in a holistic manner.
One of the programmes that are making a major contribution in transforming our health services, improving the infrastructure and management capacity in our hospitals is the Hospital Revitalisation programme. We embarked on this programme to improve the condition and accessibility of our facilities, which have been one of the major challenges.
The programme improves not only the infrastructure, but also provides necessary equipment and boosts management capacity. Since 1998, R1.6 billion has been spent on rehabilitating 249 hospitals. The current annual budget of R717 million is expected to increase to R1 billion in 2005/2006 financial year.
We should, in near future, be opening the Nelson Mandela Hospital in Umtata, which is one of the three state of the art hospitals commissioned for tertiary health services. The others are Inkosi Albert Luthuli, which is already operating in Durban, and the soon-to-be completed Pretoria Academic Hospital.
Revitalisation of hospitals includes:
* Improving the condition and quality of hospital buildings and design;
* Rationalising and improving the condition of hospital equipment;
* Decentralisation of hospital management;
* Organisational development and strengthening management capacity;
* Continuous quality improvement and improving the status of Emergency Medical Services.
One of the initiatives that contributed in improving the implementation of the decentralisation programme was the twining of some of our hospitals with UK health facilities. The initiative funded by the European Union and DFID allowed for the sharing of expertise and experiences in undertaking major management functions at a hospital level. There was an exchange of ideas in how to identify the health needs and planning to meet these needs through the negotiation of performance agreements.
While decentralisation increases autonomy and decision making powers of hospital managers, it also requires clearer lines of accountability to the authorities who fund the hospitals and the communities served by the hospitals. In developing an efficient and accountable hospital management, our overall goal is to promote innovation and accountability to clients and funders.
The past five years were characterised by more vibrant and participative efforts in improving the National Planning Framework for the provision of hospital services in the whole country. There is a great deal of creativity and provinces are developing innovative strategic plans to address the health needs of the populations they serve within broad national guidelines. Seven of the nine Provinces have written delegations devolved to hospital level and the remaining 2 provinces are at advanced stages of finalising these delegations.
The role of Hospital Boards is crucial in this transformation process. Training Programme for Hospital Boards that is coordinated at national level is being provided in Provinces to build skills and capacity. The training focuses on understanding issues of governance and accountability in support of management and ensuring responsiveness to community needs.
The National Health Act makes provision for establishment of various governance structures within the health sector including hospital boards and clinic committees. The regulations, under the National Health Act, on Hospital Boards are at an advanced drafting stage.
The launch of the Public Hospitals CEO Forum (PHCF) is therefore a formal recognition of these executive positions in the Public Health System. Your mandate as CEO's of our hospitals is to restore and uphold the dignity and respect of people who use our public health facilities. You can achieve this by rigorously driving quality assurance and improvement strategies in accordance with the National Health Act. You have to adopt a humane approach and culture of caring that should characterise our hospitals.
You should manage resources at your disposal skilfully and competently to achieve these goals. You should be accountable and responsive to the needs of the communities you serve.
The CEO Forum we are launching today will provide a management development platform where Hospital Managers and CEO's can share operational information and experiences. The Forum will seek to achieve the following objectives:
* A dynamic responsive hospital management;
* Delivery of high quality services to communities and stakeholders;
* Accountability for the operational management of public hospitals;
* And quality improvement and efficiencies.
We should use this Forum to achieve a paradigm shift in the management of public hospitals. We should usher in a model of "best-practice" management approach that is characterised by:
* A culture of efficient service delivery;
* Accountable cadre of executive managers and;
* An uncompromising quality of care
The decentralisation of our management functions and the establishment of the CEO Forum cover at least five of the ten priorities we have set for the next five years. We resolved to improve the governance and management of the National Health System; improving quality of care; strengthening hospital service delivery systems; human resource management; as well as planning, budgeting and monitoring and evaluation.
This initiative is therefore a major step in our efforts to achieve our vision of an accessible, caring and high quality health system.
I wish all the best in ensuring that this Forum achieves its objectives.
Thank you
Issued by: Ministry of Health
16 September 2004
Source: Department of Health (http://www.doh.gov.za)
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