World Bank: Health care crisis looms

A NEW World Bank report says Papua New Guinea faces a major health care crisis because of a rapidly ageing workforce.
The report, highlighted in a recent Radio Australia interview, claimed that in less than 10 years 50% of the health sector workforce would have retired or moved elsewhere.
Inadequate funding and lack of policies controlling human resources were cited as the main reasons for the dilemma.
Speaking on the radio network’s Pacific service, Aparnaa Somanathan, who was introduced as World Bank task manager, said if PNG did not make changes in human resource capacity in the next 20 years it would face a major crisis in the ability to deliver health services.
A consultant for the World Bank, Ian Morris, supported Somanathan, saying staffing in the health workforce was at crisis point and he called for a whole of government approach to tackle issues such as training.
PNG Institute of National Affairs director Paul Barker agreed, saying that successive governments in the past 20 years had not given the health sector the priority it deserved.
PNG Nurses Association president Eimi Kaptigau said on a separate occasion that nursing staff nationwide were leaving for better paid jobs outside the profession, causing a severe shortage in public health facilities.
Somanathan told Radio Australia the Health Department had acknowledged that the health sector was facing a workforce crisis because there was an ageing work force, there was limited pre-service training capacity to replenish that work force, there was weakness in the curriculum of training programmes and there was an almost total lack of in-service training capacity.
“I think training capacity in PNG has weakened considerably over the past 10-15 years.
“There has been less and less resources being put into training, so PNG’s ability to train more and more doctors and nurses has declined.
“So what came out in the report was not so much that nobody wanted to be in those professions, but rather that the country’s ability or capacity to train workers had declined.”
Somanathan said that the current health budget outlay had fallen 9.4% in real terms between 1996 and 2004.
So what needed to be done, he was asked.
“Basically, training capacity needs to be ranked up very, very quickly, with additional resources in order to produce more doctors, more nurses, to put them into the system.
“We produced a couple of scenarios of what might happen and those scenarios were based on the resources that will be coming into PNG for the health sector over the next couple of years and the feasibility and the speed with which training capacity can be ramped up.
“We see a reasonable expansion of the number of doctors, most of them to be targeted for the rural facilities and expansion of the general nursing graduates as well.
“But underlay, it’s not just about increasing the number of doctors and so on.
“It’s the expansion of pre-service and in-service capacity, providing additional staff to support services, and more quality enhancing non-salary budgets which are also important.
“You can increase the health workers, but you also need to provide non-salary inputs at health facilities.”
Somanathan said the health sector did not have a human resource policy so it needed the whole of government institutions, personnel management, Department of Planning and Office of Higher Education to work together to develop and implement the policy.
In Port Moresby, Kaptigau called on the government to do something about the brain drain caused by low pay and housing allowance and poor working environment conditions.
“There is no recognition from the government while they are overworked, stressed out and underpaid.
“There are less than 10 nursing colleges and schools turning out no more than 20 trainees every year. Most of them have merged with the major universities in the country.
“There are less than 13,000 nursing personnel in PNG – 8,000 of them in the public health service.
“The experienced of the latter group have left for greener pastures, leaving behind ageing nurses and raw trainees.”
Kaptigau said the ageing offices have reached retirement age but could not be retrenched because there was no good retrenchment package to retire on.
Early last month Health and Personnel Management departments signed respective memorandum of agreement with health extension office and medical laboratory staff associations to increase their pay and allowances.
Personnel Management secretary John Kali said the government was keen to retain their services.
INA’s Barker told Radio New Zealand International that “with inadequate support for human resource capacity we have been going backwards.”
He said there had been a brain drain of PNG medical staff heading to Australia and elsewhere.
“So, that’s an added challenge,” he said, adding that in rural areas medical staff numbers were low and many nurses and midwives were in their late 1950s or early 1960s.”