HEALTH SECTOR REPORT A Quantitative Research on the Labour Market Demands in the Health Sector

HEALTH SECTOR REPORT A Quantitative Research on the Labour Market Demands in the Health Sector June, 2016 Research, Planning and Development Department

Acknowledgements The Research, Planning and Development Department of the National Training Agency (NTA) would like to express sincere gratitude to all participating organisations for their contribution to this quantitative research. Through their cooperation and candour, a better understanding of the labour market in the Health sector was established. Ultimately, this provided a basis through which targeted and strategic policy improvements could be formulated to help bridge employment gaps. 2

Contents Acknowledgements... 2 Executive Summary... 5 Introduction... 7 International Perspective... 7 The Health Sector... 7 Healthcare Professionals... 8 Contribution to Gross Domestic Product... 9 Labour Force and Employment... 9 Demand for Skilled Persons and Training... 10 Purpose of Study... 11 Objectives... 11 Methodology... 12 Scope... 12 Survey Population... 12 Data Collection... 12 Data Entry... 12 Limitations of the study... 13 Findings... 14 Primary Services... 14 Type of Business... 14 Years in Operation... 14 Present Employment... 15 Work Permits... 15 Vacancies... 15 New and Emerging Skills Sets/Competencies... 16 Demand for Labour... 16 Training Providers/ Institutions... 16 Apprenticeship, Internship Or A Mentorship Programmes... 16 Development Of The Sector... 16 Analysis... 17 Conclusion... 20 Appendix... 21 Appendix 1: Present Employment... 21 Appendix 2: Vacancies... 24 3

References... 27 Bibliography... 28 Tables Table 1: Medical Healthcare Professions... 8 Table 2: Allied Healthcare Professions... 9 Table 3: Auxiliary Healthcare Professions... 9 Table 4: Primary Services Provided By Respondents... 14 Table 5: Job Titles In Which Work Permits Were Applied For Within The Last 12 Months... 15 4

Executive Summary The National Training Agency (NTA) is the coordinating body for all technical, vocational education and training (TVET) in Trinidad and Tobago. One of its mandate is to continually assess and provide relevant information on TVET and workforce development, which includes the demand for and supply of human resources. In keeping with this mandate the NTA conducts labour market studies in the form of sector surveys to evaluate the labour needs of the country. The main focus of this study was to ascertain the nature and scope of the demand side factors affecting the labour market of the Health sector in Trinidad. This research was designed as a census of all employers in the Health sector excluding Pharmacology and Scientific, Diagnostic Labs and Testing Services since these areas were evaluated during other NTA evaluations. The category of Veterinary Medicine was also excluded from this study. The study employed both a qualitative and quantitative approach to data collection. A major constraint to data collection was the unwillingness of some employers to participate in survey due to their busy work schedules. The employers comprised of both private and public sector organisations. The public sector organisations consisted of public hospitals and community health centres. These institutions are under the direction or authority of the Regional Health Authorities (RHA) within the country. On the other hand, the private organisations encompassed private hospitals, nursing homes and the private practices of healthcare services. Based on the findings of the survey, there are 12,563 persons currently employed within the surveyed Health institutions. Many of these persons were allied healthcare workers (972). The results also revealed a large number of vacancies (i.e. 4,324) within both the public and private healthcare organizations. The employers indicated a high demand for Registered Nurses (i.e. 1,300). The employers expressed a great degree of difficulty in sourcing Registered Nurses, Optometrists, Speech Pathologists, Physiotherapist, Dieticians and Occupational Therapists. In the face of stated labour shortages, thirty eight percent (38%) of the employers stated they applied for work permits. Additionally, several of the organisations indicated that while they did not apply for work permits they hired persons already holding work permits. 5

A small number of participants (38%) believed that there will be new and emerging skills/competencies in the Health sector within the next 12 months. Changing technology and advances in research and development in the respective field/profession were expected to contribute to new methods of treatment and the use of equipment or machinery. Ninety-six (96%) of employers anticipated an increase in the demand for jobs. Thirty-seven percent (37%) of surveyed employers stated they have apprenticeship, internship or a mentorship programmes. Sixty-three percent (63%) of the employers indicated that current training providers were not meeting their needs. Respondents complained about the absence or inadequate numbers of training programmes available locally for healthcare professionals. Stakeholders indicated a need for the introduction of new training programmes. Furthermore, respondents believed that private training providers offering health programmes should be monitored and regulated on a frequent basis. In order for the Health sector to develop, all stakeholders recommended the provision of new training programmes; policy implementation, the construction and modernisation of public healthcare facilities. 6

Introduction International Perspective There were more than 59 million health workers worldwide in 2006 with a global shortage of 4.3 million workers 1. According to the Bureau of Labor Statistics (BLS) in the United States, there is expected to be a 19% job growth in healthcare occupations with an addition of 2.3 million new jobs from 2014 to 2024. Job growth is expected in professions such as registered nurses (16%), physicians and surgeons (14%), occupational therapists (27%), dental hygienists (19%), audiologists (29%) and physical therapists (34%). 2 Whereas in Australia, the health sector is estimated to have the largest employment growth of 16% or 229,400 in employment growth over the next five years. 3 Despite the noteworthy growth, the world faces significant labour shortages in healthcare professions. There are several factors that contribute to this labour shortage and these include an aging population, limited or no funding for training and research in these professions, limited or no training provided by local institutions to suit local needs, brain drain to developed countries, government s failure to recognise the importance of non-life threathening illnesses and healthcare reform such as in the United States. The Health Sector The Trinidad and Tobago Health sector consists of both private and public health organizations with the public sector employing the largest amount of workers. The private sector consists of private hospitals and private practices while the public sector consists of public hospitals and community health centres. The public sector offers healthcare services to the majority of the general public at primary (community health centres), secondary (public hospitals) and tertiary level (specialised hospitals). In Trinidad and Tobago, the Ministry of Health oversees the healthcare system and does not provide healthcare services. The provision of healthcare services is done by the Regional Health Authorities (RHAs) as a result of the passing of the Regional Health Authorities Act No. 5 in 1994. There are four Regional Health 1 World Health Report 2006, Working Together for Health page 15 2 Occupational Outlook Handbook, Bureau of Labor Statistics 3 Employment Outlook to November 2018, page 3 7

Authorities located in Trinidad and one in Tobago. The RHAs oversees all public hospitals and health centres for their respective district or region. Within the health sector, there are several legal bodies responsible for registering and regulating health workers. For instance, the Medical Board, Nursing Council, Pharmacy Board and the Council for the Professions Related to Medicine are responsible for ensuring that the respective health worker is legally able to practice in the country. In terms of funding for the sector, the Government of Trinidad and Tobago, allocated $644.1 million in the fiscal 2016 for the procurement of medical equipment and construction as well as the modernisation of public health facilities. 4 This suggests an increased demand for healthcare workers in the future. Additionally, in the 2015/2016 Budget presentation the Minister of Finance stated that the Government of Trinidad and Tobago would expend substantial resources on training opportunities in all areas of healthcare, including support staff in professionals allied to medicine. 5 Healthcare Professionals According to the Ministry of Health, Trinidad and Tobago, healthcare professions can be broken down into three categories, namely, medical health, allied health and auxiliary health (see www.health.gov.tt). Tables 1 to 3 below list various healthcare professions. Table 1: Medical Healthcare Professions Medical Health Careers Professions that deal with the diagnosis, treatment and prevention of physical and mental disorders caused by disease or injury: Medical Doctor Nurse Dentist Veterinarian 4 Public Sector Investment Programme (PSIP) 2016, page 96 5 Budget Statement 2016, page 21, October 5 th, 2015 8

Table 2: Allied Healthcare Professions Allied Health Careers Professions that provide direct patient care and support, through technical, diagnostic and therapeutic services that compliment other health care professions and do not include medical, nursing and dental professionals: Audiologist Dental Nurse Epidemiologist Nutritionist Phlebotomist Respiratory Therapist Biochemist Dietetician Health Education Officer Occupational Therapist Physiotherapist Speech Therapist Biomedical Engineer Emergency Medical Technician Medical Laboratory Technician Optometrist Psychologist Biomedical Technician Entomologist Social Worker Pharmacist Radiation Therapist Table 3: Auxiliary Healthcare Professions Auxillary Health Careers Professions that assist in promoting the health and welfare of persons through non-direct or non-medical techniques and methods: Public Health Inspector Field Interviewer Source: Dictionary of Careers in the Health Sector Medical Records Mortuary Attendant Contribution to Gross Domestic Product According to the CSO National Accounts Classification, the Health sector is positioned under the Personal Services economic sector. There is little to no economic data available specifically for the Health sector. However, as outlined in the Review of the Economy 2014, the Personal Services sector recorded a 6.3 percent growth in GDP for the year 2015 as compared to 4.7 percent in 2014. Increased employment levels were recorded in Community, Social and Personal Services Sector (7,900 persons). Labour Force and Employment According to the Ministry of Health in 2013, a total of 4,270 vacancies existed in the public health sector across four regional health authorities. They included vacancies for 2,691 nurses, 282 pharmacology staff, 190 laboratory staff, and 109 medical imaging staff 6. In 2014, there were 244,000 persons employed within the Personal Services sector. However, no data were recorded for the health sector as a separate industry. 6 Newsday, Healthcare needs 2691 nurses, October 26, 2013 9

Demand for Skilled Persons and Training One of the requirements for the provision of quality healthcare services and hospitals as stated by the Government of Trinidad and Tobago in the Medium Term Policy Framework 2011 2014 is Developing Professional and Quality Human Resources to reduce the labour shortages within the health sector 7. Consequently, the Ministry of Health sought ways to increase the labour pool of medical and allied healthcare workers by offering scholarships and bursaries. Additionally, the Ministry also advertised vacancies to locals and foreign based nationals. In an effort to meet the demand for over 4000 certified public health workers, the Government embarked on an initiative which entailed paying trainees of the Academy of Nursing and Allied Health a stipend to ensure they completed their respective medical programmes. Additionally there was the introduction of the Student Volunteer Programme in 2012 with participants from various schools in Port of Spain and environs. The purpose of this programme is to create awareness of the wide range of health careers available in Trinidad and Tobago. For the period 2004 to 2010, three thousand, two hundred and eighty-nine (3,289) healthcare professionals comprising of two hundred and ninety (290) allied healthcare workers, nine hundred and thirty-three (933) doctors and two thousand and sixty-six (2,066) nurses had accessed training opportunities offered by the Ministry of Health and the respective Regional Health Authorities in various disciplines. There are several other training institutions that provide healthcare programmes such as University of the West Indies (UWI), College of Science, Technology and Applied Arts of Trinidad and Tobago (COSTAATT) and the University of the Southern Caribbean (USC). 7 Medium-Term Policy Framework 2011 2014, Ministry of Planning and the Economy, October 2011 page 53 10

Purpose of Study The National Training Agency selected the Health sector to be evaluated during the period November 2015 February 2016. This selection was guided by the Government s goal to establish universal health coverage for the national community. In the 2015/2016 Budget presentation, the Minister of Finance indicated that the Government would expend substantial resources on training opportunities in all areas of healthcare. The main focus of the project therefore, was to ascertain the nature and scope of the industry demand for labour in the local Health sector. Objectives The broad objective of this survey was to assess the current state of the labour market of the Health sector, so as to provide information useful to the development of the country s human resource capacity. The specific objectives of this survey were as follows: to provide the National Training Agency with the required quantitative data and research on the demand side of this sector; to lay the groundwork, through data collection, for the establishment of an updated training needs analysis; to ensure a comprehensive understanding of the labour market conditions and labour market signalling of this sector; 11

Methodology Scope The study adopted a census approach to data collection given the small population size of 124 organisations. The study employed both a quantitative and qualitative approach. Both the public and private sector organisations were surveyed. Pharmacology and Scientific and Diagnostic Labs and Testing Services were the only two categories not focused on in this study as these two were covered in other NTA evaluations. The category of Veterinary Medicine was also excluded from this study. Survey Population The list of employers for the public sector was taken from the Ministry of Health s website. While the list of employers for the private sector was sourced from key health registries, the Central Statistical Office (CSO) Business Establishments Listing (2011) and the Telephone Directory. The sample frame amounted to 120 private companies and 4 Regional Health Authorities in the public sector. Data Collection All 124 companies were contacted via emails requesting participation in the study. Emails sent included an official letter and the survey instrument. However, at initial contact, several employers declared that they were not interested in participating as they were too busy and did not see any benefit in completing the questionnaire. Questionnaires were disseminated to willing participants via email and fax. Follow-up calls were made to remind employers to submit the completed questionnaires within the stipulated deadline. Respondents either emailed or faxed the completed questionnaire. Data Entry Data entry was done simultaneouly with data collection. This was done using the Microsoft Access software. 12

Limitations of the study This study faced a number of challenges and every effort was made to minimise these challenges to ensure its validity. The challenges were as follows: the unwillingness of employers to participate in the survey, the heavy or tight work schedules preventing the employer sparing the time to complete the form, the lack of updated company listings and the absence of contact information for some stakeholders. 13

Findings Primary Services A total of thirty-two (32) stakeholders completed the survey. The respondents consisted of twenty-nine (29) private health organizations and three (3) public health organizations. A breakdown of the type of services provided by these organizations is provided in Table 4. In some institutions, some of the services provided are contracted outside the institution. Table 4: Primary Services Provided By Respondents Primary Services Of Respondents Eye Testing Eye Examination Dispensation of Contact Lenses Diagnostic Testing Accident and Emergency Care Dispensation of Drugs Inpatient Care Obstetric, Medical and Surgical Procedures Occupational Therapy Music Therapy Patient Assessment Children Camps (such asalert Camp, Therapy Camps, Motor Camps, Sib Camps) Group Therapy Programs Professional Teacher Development & Support Psychology Physical Therapy Cardiac Rehab and Massage Dental Care Type of Business Of the total employers surveyed, eighty-eight percent (88%) were private and nine percent (9%) were public. The remaining organisations (3%) were Non-Governmental Organisations (NGO). Years in Operation The participating organizations had been in operation between one (1) to just under one hundred (100) years. The majority of respondents (41%) indicated that they had been in operation between 11 to 20 years. 14

Present Employment Based on the data collected from both the private and public health organizations, there were approximately twelve thousand, five hundred and sixty-three (12,563) employees (permanent and contract positions). The majority of respondents (78%) employed one to fifty persons. Appendix 1 shows a snapshot of present job titles within both the public and private health organizations. Work Permits Sixty-two percent (62%) of the participants did not apply for any work permits within the last twelve (12) months while thirty-eight percent (38%) did apply. Respondents were asked to indicate the job titles for which work permits were applied for within the last twelve (12) months. Table 5 lists these job titles. Table 5: Job Titles In Which Work Permits Were Applied For Within The Last 12 Months Job Titles Which Work Permits Were Applied For Within The Last 12 Months Accounting Personnel Occupational Therapist Allied Healthcare Professionals Optometrist Biomedical Technician Pharmacist Cardiac Catheterization Lab Technician Physicist (Medical) Dosimetrist Radiation Therapist House Officer Radiographer Medical Doctor Registered Nurse Medical Officer I Registrar Nurse Theatre Technician (Medical) Vacancies The data collected showed a significant number of vacancies within both the public and private health organizations. Based on the results, a total of four thousand, three hundred and twenty-four (4,324) vacancies existed within the health sector at the time of the study (see Appendix 2). Many respondents reported high vacancies numbers for registered nurses (1,300), enrolled nursing assistants (884), clerical assistants (162), and patient care assistants (135). Employers also indicated the vacant positions which were most difficult to source. These included registered nurses, enrolled nursing assistants, radiographers and registrars. 15

New and Emerging Skills Sets/Competencies Respondents were asked if they thought there would be new and emerging skill sets/ competencies in the sector within the next twelve (12) months. Only thirty-eight percent (38%) of participants indicated Yes. The respondents believed there will be an emerging need for new skills in new technology for areas such as dentistry, optometry, radiology and mammography. Demand for Labour Ninety-six percent (96%) of respondents anticipated an increase in the demand for jobs within the next twelve (12) months while four percent (4%) anticipated a reduction in the demand. The reason given for the increase in the demand for jobs was the expansion of new health facilities and the creation of new departments within existing facilities. The reason given for a decrease was that persons lacked the requisite skills and competencies required for the job. Training Providers/ Institutions When asked whether current training providers/ institutions were meeting their needs, sixty-three percent (63%) of the respondents stated that current training providers/ institutions were meeting their needs. Thirtyseven percent (37%) of the employers indicated the opposite. Apprenticeship, Internship Or A Mentorship Programmes Only forty percent (40%) of the participants stated they did have an apprenticeship, internship or a mentorship programme established in their organization. Development Of The Sector When respondents were asked what more could be done to develop the sector, the majority of respondents (60%) requested the introduction of new training programmes within the health sector. Respondents also expressed a need for policy implementation and healthcare infrastructure. Other recommendations included a greater focus on health, labour importation and the effective marketing of healthcare services. 16

Analysis The health sector employs a significant number of persons. This is evidenced by over 12,563 persons being employed within the private and public healthcare organizations. This number is only a snapshot of the entire sector. Despite, this large workforce, the sector still requires a tremendous amount of qualified, skilled individuals. With the introduction of new healthcare facilities such as the Couva Children s Hospital, the need for more skilled persons continues to increase. Thus emphasizing the need for qualified, experienced healthcare personnel within the health sector. The study found a large number of vacancies existing within the health sector, generally in the public healthcare organizations. Based on the results, over 4,324 persons are needed for various areas of the healthcare system. Registered nurses proved to be in highest demanded and most difficult to source. Other positions such as optometrists, speech pathologists, physiotherapists, dieticians, speech therapists, art therapists, child developmental psychologists, occupational therapists and social workers were also difficult to source. The findings revealed that this difficulty was attributed to the poor working conditions and compensation packages offered. More specifically, the unavailability of relevant training programmes as well. Despite this critical labour shortage, national loyalty still seems to prevail within the health sector. This is evidenced by only thirty-eight percent (38%) of employers applying for work permits. Notwithstanding this, several organizations did indicate that while they didn t apply for work permits, they hired persons already holding work permits. This avenue helped employers avoid the lengthy application process. Conversely, the Government still continues to address labour shortage by seeking foreign labour to address the vacancy challenges occurring within the health sector. More so, in the case of the Children s Hospital staff shortage, the Government sought to enter into a public-private partnership so that the public can have access to the hospital initially designed to cater mainly to the medical needs for children. Furthermore, there is an anticipation of an increase in demand for jobs within the next twelve (12) months. Ninety-six percent (96%) of respondents anticipates this increase will be due to the expansion of new health facilities and the creation of new departments within existing facilities. 17

With changing technology, new medical equipment and advances in research and development in the healthcare field, 40% of the respondents thought there will be new and emerging skills sets/ competencies. With respect to new technology, these stakeholders believed that skills would be required to operate new equipment in areas such as radiology, mammography and lab testing. Respondents claimed that technological diagnostic instruments were becoming cheaper and easier to operate and implement in more offices. However, In order for these skills to be acquired, training would be necessary. Over sixty percent (60%) of employers training needs are being met by training providers. Yet still, there is a clear gap between the employer s needs and the training programmes being provided or not provided locally. Many employers highlighted the need for specific training programmes which are not being provided by local medical institutions. Many persons have to migrate to receive post-graduate training in various areas of medicine. As a result of the gaps, the sector continues to face a significant shortage in medical personnel. The employers expressed a need for new training programmes for various health professions such as occupational therapy, physiotherapy, optometry and dentistry. The employers also suggested that Government provide scholarships to assist locals where training is only available in foreign countries. Clearly, there is need to review the demand and supply of labour against current training programmes being offered. There is an apparent mismatch between what employers demand from what programmes training providers are offering or supplying. As a consequence, some employers have resorted to in-house training of new hires. Respondents pleaded for the introduction of more internship or mentorship opportunities in the private sector. Based on the findings, only forty percent (40%) of respondents have apprenticeship, internship or a mentorship programmes at their organizations. Such programmes allow for more practical training. Respondents suggested that priority be given to the regulation and monitoring of private training providers curriculum in the health sector to ensure greater output of competent graduates. As the sector develops, it is essential that an efficient and quality healthcare system be provided to the population. The aim should be to provide incentives to encourage nationals to enter the health sector and 18

ultimately provide them with the relevant training necessary in areas lacking specialty in order to meet the demands of the population. The trained nationals will then be given placements within the national health system. This will in turn reduce the shortage of labour in speciality area that are in great demand. Similarly, legal bodies such as the Medical Board, the Nursing Council, the Pharmacy Board and the Council for the Professions Related to Medicine all have an important role to play in the staffing and advancement of the health sector. 19

Conclusion In conclusion, there is an apparent shortage of labour within the health sector. Many vacancies exist within the sector. In addition, training providers are not meeting the demands of the employers. As a consequence, the Government has vowed to expend substantial resources on training opportunities in all areas of healthcare, including support staff in professional allied care medicine. Despite these challenges, the health sector continues to operate at a satisfactory level. 20

Appendix Appendix 1: Present Employment Academic Manager Accident and Emergency Administrator Accounting Staff Administration Manager Administrative Assistant Administrator Admission Clerk Ambulance Driver Anaesthetics Assistant Area Administrative Officer Art Therapist Assistant Manager - Information Systems/Information Technology Audio Visual Technician Audiologist Auditor Auxillaries Billing Administrator Billing Clerk Billings Supervisor Biochemist Biomedical Engineer Biomedical Technician Branch Manager Car Park Attendant Cardiac Cath Lab Technician Cardiac Sonographer Cardio Lab Assistant Cashier Chief Executive Officer Cleaner Clerical Staff Clinical Coordinator Clinical Exercise Physiologist Clinical PACS Administrator CLU Manager College Secretary College Consultant Job Titles College Counsellor College Physician Commercial Manager Communications Officer Cook Corporate Secretary Counter Attendants County Medical Officer of Health Courier CPSD Technician Customer Relations Officer Customer Sales Representative Customer Service Representative Cytoscreener Darkroom Technician Data Communication System Administrator Database Administrator Dental Administrative Assistant Dental Assistant Dental Assistant Nurse Dental Nurse Dental Surgery Assistant Dental Trainee Dentist Department Managers Desk Side Support Technician Developmental Fellow Dialysis Technician Dietetic Technician Dietician (Registered) Director Dispensing Assistant Dispensing Manager Dispensing Optician Dispensing Optician Trainee Dispensing Technician Domestic Supervisor Driver EAP Coordinator Electrical Technician Electro Cardiographer Operator Emergency Medical Technician Engineering Assistant Enrolled Nursing Assistant Equipment Manager Examination Evaluators Executive Assistant Executive Driver Executive Secretary Exercise Specialist Facility Coordinator Filing Clerk / Driver Finance Manager Financial Controller Fleet Coordinator Food Demonstrator Food Service Supervisor Food Service Worker Frame Stylist Front Desk Clerk General Assistant General Manager General Manager - Finance General Manager - Hospital Services General Manager - Human Resources General Manager - Legal and Corporate Affairs General Manager - Operations General Manager - Primary Health Care Services Groundsman Handyman Head Nurse Head of Emergency Head of Operating Theatre Health and Safety Officer 21

Health Education Aide Health Education Officer Histology Technician Hospital Administrator Hospital Nursing Manager Hospitality Clerk Hostess House Officer Housekeeping and Maintenance Staff Human Resource Assistant Human Resource Clerk Human Resource Manager Human Resource Officer Imaging Coordinator Infection Control Nurse Information Technology Administrator Information Technology Staff Information Technology Technician Internal Auditor Inventory Clerk IS/IT Business Systems Analyst Kitchen Assistant Kitchen Supervisor Lab Assistant Lab Technician Laboratory Director Laboratory Staff Labourer Laundress Lecturers Legal Officer Liaison Officer Maintenance Staff Maintenance Technician Manager Manager - Corporate Communications Manager - Cost and Management Accounting Job Titles Manager - Employment and Employee Services Manager - Financial Accounting Manager - Hospital Administration Manager - Industrial Relations, Compensation and Benefits Administration Manager - Information Systems/Information Technology Manager - Occupational Safety and Health Manager - Organisational and Employee Development Manager - Para-Clinical Services Manager - Projects Manager - Purchasing and Logistics Manager - Quality Manager - Security Services Managing Director Marketing Officer Massage Therapist Materials Officer Medical Assistant Medical Attendant Medical Director Medical Doctor Medical Dosimetrist Medical Laboratory Analyst Medical Officer Medical Physicist Medical Records Assistant Medical Records Clerk Medical Records Officer Medical Transcriptionist Mental Health Officer Messenger Mortuary Attendant Nurse Nurse Manager Nurses Aide Nursing Administrator Nursing Staff Nursing Supervisor Nutrition & Dietetic Technician Nutritionist Occupational Safety and Health Officer Occupational Therapist Office Hospitality Assistant Office Manager Oncologist Operating Assistant - PCA Operating Theatre - Auxillaries Operating Theatre - Nurse Operating Theatre Assistant Operating Theatre Attendant Operating Theatre Utility Staff Operations Manager Operations Officer Ophthalmologist Ophthalmic Assistant Ophthalmic Technicians Optical Assistant Optician Optometrist Optometry Trainee Orthodontist Patient Care Assistant Patient Coordinator Pharmacist Pharmacy Assistant Pharmacy Attendant Pharmacy Clerk Pharmacy Technician Phlebotomist Physical Therapist Physio Therapy Aide Physiotherapist Plaster Technicians 22

Premises Supervisor Primary Care Nurse Manager Primary Care Physician II Primary Health Care Services Administrative Officer Project Officer Psychologist Public Health Inspector I Puppeteers Purchasing Officer Quality Auditor Quality Coordinator Quality Management Systems Officer Radiation Therapist Radiographer Receptionist Registered Nurse (District Health Visitor, Midwife, Mental Nurse, General Nurse) Registrar Research Officer Restaurant Manager Job Titles Sales Associates School Health Screening Assistant Scrub Technician Seamstress Secretary Security Staff Senior Technologist Server Storage Administrator Shift Supervisor Social Worker (Medical, Psychiatric) Sonographer / Ultrasonographer Specialist Medical Officer Speech Pathologist Speech Therapist Statistical Assistant Sterilizer Operator Storekeeper Stores Manager Systems Administrator LAN Technician Help Desk Coordinator Telephone Operator Theatre Administrator Theatre Technician Training Officer Transport Assistant Wards Clerk Wardsmaid Watchman Wellness Centre Coordinator X-Ray Clerk 23

Appendix 2: Vacancies Job Title Total Job Title Total Accounting Assistant 1 Mortuary Attendant 6 Administrative Assistant 7 Mortuary Coordinator 1 Administrator - Clinical Services 1 Motor Vehicle Driver 2 Anaesthetic Department Assistant 1 Music Therapist 1 Assistant Bereavement Counsellor 1 Nurse Educator Counsellor 1 Assistant Head Nurse 38 Nurse Manager 1 Assistant Medical Director, Primary Services 1 Nurse Aide 7 Assistant Nurse Manager 1 Nursing Supervisor 5 Audiologist 2 Nutrition & Dietetic Technician 15 Auxiliaries 1 Nutrition and Dietetic Aide 61 Bereavement Counsellor 1 Nutrition and Dietetic Assistant 1 Billing Clerk 3 Nutrition and Dietetic Attendant 6 Biochemist 1 Nutrition Educator 1 Biomedical Engineer 2 Nutritionist 3 Biomedical Technician (Repair Medical Equipment) 3 Occupational Therapist 13 Cardiac Cath Lab Technician 3 Occupational Therapist - Paediatric 1 Cardiac Sonographer 5 Occupational Therapy Aide 9 Caretaker 2 Oncology Nurse 8 Cashier 3 Optical Assistant 3 Child & Adolescent Psychiatrist 1 Optometrist 1 Chiropodist 4 Orthopaedic Plaster Technician 1 Chiropodist Assistant 1 PACS Assistant (formerly Dark Room Technician) 6 Cleaner 8 Part Time SMO & Sessional Medical Officer 5 Clerical Assistant 163 Patient Care Assistant 135 Clinical Coordinator 1 Patient Care Coordinator 6 Clinical PACS Administrator 4 Peer Educator HIV/AIDS Educational Services 1 Clini-Mobile Programme Coordinator 1 Pharmacist 93 Community Health Administrator (formerly Area Administrator) 3 Pharmacy Assistant 54 Cook I 15 Pharmacy Attendant 18 Coordinator HIV/AIDS Educational Services 1 Pharmacy Clerk 13 Coordinator Staff Development Unit 1 Pharmacy Coordinator 1 CT Technologist 2 Pharmacy Supervisor 1 Customer Service Assistant 20 Phlebotomist 81 Cytoscreener 3 Physicist (Medical) 2 Data Entry Assistant 12 Physical Therapist 1 Dental Assistant 2 Physio Therapy Aide 1 24

Job Title Total Job Title Total Dental Nurse 12 Physiotherapist 38 Dental Surgery Assistant 5 Physiotherapist - Paediatric 1 Dentist 15 Physiotherapy Supervisor 1 Diabetes Nurse Educator 1 Placement Monitoring and Evaluation Officer 1 Dietician 15 Placement Officer 1 Disaster Preparedness Coordinator 1 POCT Operator 4 Domestic Supervisor 18 Point of Care Coordinator 1 Dosimetrist 3 Primary Care Coordinator 7 EAP Coordinator 1 Primary Care Nurse Manager 1 ECC Technician 1 Primary Care Physician 70 Echo Cardiograph Technologist 1 Professional Secretary 20 Electrocardiograph Technician 25 Programme Manager Diabetic Retinal Screening Services 1 Electroencephalogram Technician 2 Psychologist 4 Emergency Medical Technician 38 Public Health Inspector 2 Enrolled Nursing Assistant 884 Radiation Therapist 1 Epidemiologist 1 Radiographer 107 Executive Assistant 1 Radiology Assistant 32 Food Demonstrator 1 Radiology Attendant 8 Food Service Supervisor 66 Radiology Coordinator (formerly Senior Radiographer Institution & District) 1 General Office Aide 3 Radiology Supervisor 1 General Supervisor Medical Orderlies 1 Receptionist 10 Handyman 4 Regional Manager Liaison Services 1 Head Nurse 19 Regional Manager Nutrition & Dietetics 1 Head of Departments 13 Regional Manager Pathology Laboratory Services 1 Health Education Aide 1 Regional Manager Pharmacy Services 1 Health Education Officer 1 Regional Manager Physiotherapy Services 1 Health Promotion Specialist I 1 Regional Manager Psychiatric/Mental Health 1 Help Desk Operator 1 Regional Manager Radiology Services 1 Hospital Attendant (Male) 1 Regional Manager, Medical Social Work Services 1 House Officer 105 Registered Nurse (Nurse, Mental Nurse, Midwife, District Health Visitor) 1300 Human Resource Manager 1 Registrar 106 Infection Prevention and Control Nurse 4 Research Officer, Nutrition & Dietetics 1 Infection Prevention and Control Officer 4 Respiratory Therapist 2 Inventory Management Officer 3 Retinal Grader 3 Junior Secretary 12 Retinal Photographer 1 Laboratory Manager 1 School Health Screening Assistant 3 Laboratory Quality Manager 1 School Nurse 20 25

Job Title Total Job Title Total Laboratory Scientist 2 School Nurse Coordinator 3 Labourer 4 Seamstress 9 Laundry Attendant 8 Secretary 14 Laundry Supervisor 1 Senior Technologist 1 Library Assistant 1 Sewing Supervisor 1 Manager - Clinical Services 1 Sleep Laboratory Technician 1 Manager - Employment and Employee Services 1 Social Worker (Medical / Psychiatric) 27 Manager - Health 1 Software Implementation Systems Analyst 1 Manager - Patient Services 1 Sonographer / Ultrasonographer 34 Manager - Purchasing and Logistics 1 Specialist Medical Officer 58 Manager - Regional Nursing 1 Specialist Medical Officer - Gynaecology 1 Manager - Security Services 1 Specialist Medical Officer - Obstetrics 1 Medical Director (Secondary, Primary, AHPF) 1 Specialist Medical Officer - Oncology 2 Medical Education Coordinator 1 Specialist Medical Officer - Ophthalmology 2 Medical Lab Supervisor 1 Specialist Primary Care Physician II 7 Medical Lab Technician III 2 Speech Pathologist 2 Medical Laboratory Assistant 28 Speech Therapist - Paediatric 1 Medical Laboratory Technologist I 47 Statistician 1 Medical Officer 6 Sterilizer Operator 1 Medical Orderly 59 Stores Clerk 1 Medical Photographer 2 Supervisor Medical Orderlies 5 Medical Social Work Assistant 5 Supervisor Orthopaedic Services 1 Medical Transcriptionist 1 Theatre Technician (Medical) 3 Mental Health Aide 5 Unit Manager - Oncology 1 Mental Health Officer 13 Wards-maid 41 Microbiologist 1 X-Ray Attendant 2 Monitoring & Evaluation Officer 1 26

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