Staffing for effective care

  • Letters
  • Thursday, 05 Dec 2019

THE government’s decision to approve the Health Ministry’s request for additional staff to fill the shortage at its hospitals and clinics is welcomed indeed. The Public Service Department has agreed for 10,675 posts, which include doctors, dentists, pharmacists, nurses and other medical officers, to be added to the current 280,000 civil servants in the health sector.

While there is no denying that an increasing workload in public health facilities is becoming a burden to healthcare staff, we also need to admit that there is a serious structural problem. An increase in the number would not solve the issue.

More often than not, healthcare staff are over-burdened with clerical work. Instead of providing the nursing care they are trained for, nurses become clinic staff manning counters and sorting appointments for patients.

Similarly, in wards, many non-clinical duties and chores for nurses may compromise patient care. If we seriously want to achieve a minimum nurse-to-patient optimum ratio, nurses should not be dealing with administrative work.

We have to choose if we want our staff to multitask or be further specialised and become experts at their job. Staff who are trained in a certain speciality and have gained experience in the field should not be transferred out. Perhaps more clerical staff should be employed or the Health director-general could redeploy administrative officers to clinics and wards to handle non-clinical work.

In fact, we are seeing many doctors, especially the juniors, saddled with paperwork. Do they have time to juggle various tasks during their working shift hours? How can they learn and hone their clinical skills of listening and deducing? What about learning procedures that need different skill sets and competence?

Apart from doctors, nurses and pharmacists who form the backbone of healthcare services, we also need to look beyond to other important professionals. Currently, there is only a handful of social workers in public hospitals. Their presence is important because many times when patients are admitted in our local setting, they often have numerous social issues. The elderly, poor, neglected or marginalised needs welfare help which can range from financial assistance to home or institutional placement. This involves a lot of interviews, home visits, paperwork and coordination which can overwhelm the current staff.

We also need more counsellors. We often see busy social workers performing the duties of counsellors as well. When faced with illness, many experience stress and depression. Some are life-changing events. Very often, this aspect is overlooked by the attending doctor. A trained counsellor would be able to recognise these problems and offer the necessary counselling and help, thus enabling holistic care.

One aspect that receives little attention is informatics. If healthcare is to modernise and keep pace with big data, we need to invest in information technology (IT). And to do this, we need IT officers, programmers and engineers to solve and troubleshoot programming problems.

Administrators have to know why, despite the adoption of IT, clinical staff are still performing loads of paper work. We are also in a situation where data and statistics of our patients need to be collected and analysed. How can we project and plan when there is poor data or none at all? To perform this role, dedicated scientific officers with good IT skills are needed to collect and analyse data.

The real deal is knowing and understanding our patients rather than focusing on performance. If we want to practise lean management and increase productivity, we must eliminate overlapping duties and unnecessary and redundant tasks. Human resources require planning, effective training and efficient deployment to the areas in need, and calibrated to respond to the changing landscape of modern healthcare.

Workforce restructuring should be one of the healthcare reform agendas. Perhaps it is too academic for us to argue if Keynesian macroeconomics, which promotes the idea that governments should try to stimulate the economy by increasing employment, be applied in these current times. But on a personal level, a job does provide decency to the living. If we do not give opportunity to our own people, who will?



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