THE DNA OF Charisma! IN THE LABOUR RECRUITMENT HEALTHCARE SECTOR

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1 THE DNA OF Charisma! IN THE LABOUR RECRUITMENT HEALTHCARE SECTOR THE BUSINESS SECTOR TEMPORARY EMPLOYMENT SERVICE (TES) 1. The core business is nursing TEMPORARY AND PERMANENT PLACEMENTS 2. Key to the Temporary Employment Service (TES) industry in the healthcare sector is the supply and vetting of suitable candidates this aspect has undergone radical change where the focus is to attract and retain critical skills and to afford South African nurses the opportunity to earn additional income in their home country. 3. We consider the supply and demand of competent staff through an evaluation process and the scarcity of highly specialised skills, such as ICU trained nurses. 4. There are a lot of challenges and opportunities, for example the availability of competent staff for specific areas in healthcare. 5. We strive to ensure that the health sector does not suffer serious consequences because of critical staffing shortages. 6. We try to stay ahead of changes in curriculums and scopes of practice and then cater for skills development and training or up skilling courses. 7. TES address the need for additional income because the South African salary structure is not competitive with developed foreign countries such as the United Kingdom, Saudi Arabia, Australia and the USA. Temporary employment provides an option to prevent migration of nurses to developed countries to earn much higher income. 8. Temporary employment addresses the need of individuals not seeking permanent employment, but merely additional income and flexible hours of work, e.g. one or two days or nights per week. 9. The choice to work through TES is voluntary - most assignees do have primary employment or, they choose to work through TES by choice it provides them with more flexibility; they can determine their own working hours, and choices about working night duty, weekends and Public Holidays. 10. This service contributes to job creation through constant placement of temporary employees in one area and with a specific client and potential permanent employment.

2 11. Temporary employment contributes to economic growth. 12. Charisma! complies with legal requirements, e.g. labour and other relevant legislation affecting healthcare and employment relations. 13. The approach undertaken by Charisma! sets standards and promote ethical healthcare by ensuring quality and not quantity. 14. Contributions are made to skills levies and learnerships through courses offered and accredited by the SETA s. 15. Seeking self-regulation of temporary employment services in the healthcare sector to ensure legal compliance and protect the nurse as an assignee. 16. TES in healthcare cannot be categorised as casual labour because it is professional individuals, registered with the SANC, rendering the health service. 17. Maintain a Code of professional conduct for employer and employees. 18. Continuous health research and international networking. THE SOUTH AFRICAN NURSING COUNCIL ( 1. Acts old Nursing Act has been repealed in whole in 2008 and very limited number of clients and employees know the Act. 2. Nursing Act Regulations affecting advertising, general provisions and specific scopes of practice which is in the process of changing and affects nursing as a whole are not known by many employees or employers. 3. We promote constant engagement, ongoing training and development and RPL according to SANC Guide SANC also has a CPD system which will in future be regulated by the Nursing Act. 4. Foreign nurses we abide by specific procedures and exams for foreign nurses 5. Scope of practice there are three categories of nurses, each with a specific scope of practice and they may not practice outside such a scope. 6. Level of practice specific post basic courses are recognised by the SANC and therefore it influences the hourly rate of pay of the employee. 7. Please note that to practise without registration with SANC is illegal according to the Nursing Act 33 of All categories of nurses have to pay an annual certification fee to continue practising. 8. The SANC regulates the nursing profession as prescribed in the Nursing Act and professional misconduct hearings are held throughout the year awarding different sanctions which might influence the ability to place such an employee.

3 PROFESSIONAL MALPRACTICE INSURANCE / INDEMNITY 1. Case management should assist in monitoring misconduct and possible litigation cases. 2. No nursing employee may work unless they have provided proof of indemnity there is the option of top-up cover for high risk areas such as maternity and obstetric care available through certain underwriters at an additional cost for the employee. 3. This is an industry requirement without Professional Malpractice Insurance a nurse may not be placed with a client. 4. Indemnity can be obtained either through a private insurer or through union membership that has been verified. TRAINING AND EDUCATION 1. Induction and orientation of staff will set a standard and ensure quality care to the patients of a client. 2. Workshops prior to placements of staff a requirement for certain current TES s in Healthcare also to ensure competent staff. 3. Continued clinical accompaniment of temporary employees in the work place is a requirement for certain current TES s in healthcare to ensure competency and ongoing training and development. SETA 1. Relevant SETA s in this sector includes the HWSETA and SSETA, but HWSETA does not cater for the training needs of TES within the health sector. THE CLIENT AND RATES 1. Public tenders currently rates are dictated by the state in their tenders. 2. Private currently rates are dictated by the private client. UNION INVOLVEMENT 1) Nurses belong to DENOSA, HOSPERSA, PSA, Solidarity, Nehawu and SADNU. 2) Membership are recognized because it includes malpractice insurance. NURSING 1. Clinical facilitation has now become a requirement from the client to ensure competency in the workplace and to address incompetency on an urgent basis to eliminate clinical errors and adverse incidents. 2. Working hours are determined by the fact that nurses work 12 hour shifts and 99% of the time the employee will only be available to work during their off time. These working times are very

4 unpredictable and they might work one or two days per week and, depending on whether it is day or night work, the rate per hour will differ. 3. Nearly all nurses (who work for TES) are either permanently employed (whether in a hospital, clinic or medical aid) or retired or prefer not to have permanent employment. LEGISLATION 1. All relevant acts are adhered to, especially employment related legislation, the Nursing Act and the Constitution. 2. All the Regulations governed by the New Nursing Act have not been passed yet and we can still comment on and influence those regulations. 3. Constant engagement with relevant stakeholders in order to influence national and international policy regarding nursing and healthcare. 4. There are unique health and safety issues, especially with regard to the hospital environment that need to be taken into consideration. 5. We abide by Ministerial determinations which are applied for on an annual basis to vary from the BCEA regarding leave and sick leave. 6. We believe that existing labour laws are not policed properly therefore the need for self-regulation. We agree that illegal and unethical operators should be eliminated from this industry. 7. We are a legitimate industry in terms of the Constitution of RSA section 22: every citizen has the right to choose his or her trade, occupation or profession freely and therefore has a basis in our law. As a TES in healthcare this is also regulated by the Convention 181 of the ILO. ASSOCIATIONS 1. APSO (i) Primary Objectives Sector specialist to represent a specialise group (health) in TES with unique needs. Credibility as an Business and recognition by Healthcare Institutions and the Government. Service to the Nurse and the Public. Assistance with legal compliance to all Nursing Agencies in South Africa. Improvement of Standards via Accreditation of Agencies. Skills Development. 2. Private with societies which represent nurses. 3. Aim for international recognition and liaison with the ICN and related associations to contribute positively to healthcare (nursing) needs.

5 DIFFERENCES BETWEEN HEALTHCARE RECRUITERS AND ORDINARY RECRUITMENT Healthcare Recruitment: 1. Scares skills environment highly competitive 2. Recruitment and selection 3. Orientation, induction and clinical accompaniment complexities 4. Working hours 24/7 5. Rate of pay dictated by client 6. Professional liability 7. Compliance with Act and Regulations applicable to nursing ECONOMIC CONTRIBUTION 1. The population of South Africa increased from approximately million in 1999 to million in 2008 (+13.1% growth over the 9 years). 2. Placing on average 5000 nurses per day in private and public sector this is a rough estimate (no documented research). 3. Compliance with statutory deductions and IRP tax certificates for the temporary employees. 4. A skill does not necessarily have to be bought or imported from foreign countries. We utilize what is trained in our own country. All categories of nurses can work even if they are student nurses. The possibility of permanent employment should always be advocated for. 5. A flexible labour force is critical to SA s economic growth and in the current global economic crisis. 6. Skills development is an essential part of continued professional development and the constant change of the health care environment. 7. Temporary employment creates an opportunity for nurses who do not want or need permanent employment, to function as independent credible citizens who receive a legitimate pay-slip on a regular basis. SKILLS SHORTAGE AND WAR FOR THESE SKILLS IN THE HEALTHCARE SECTOR 1. Skills deficit would take decades to address. 2. There is a continuously growing population. 4. Statistics: (i) SANC registered and enrolled a total of nurses in 2008: Over a 9 year period (1999 to 2008) there has been an overall increase in the total number of nurses on the registers from to (+23.1% growth). Not all the nurses on the registers and rolls of the Council are practicing the profession.

6 (ii) (iii) (iv) (v) Currently registered; (a) Registered Professional Nurse (grown by +16.9% over the 9 years) (b) Registered Enrolled Nurse (grown by +32.7% over last 5 years) (c) Registered Nursing Auxiliary (grown by +28.5% over last 5 years) Students Registration for 2008 per category: (a) Students (4 years) (b) Pupils (2 years) (c) PNA s 5058 (1 year) nurses was removed from the register in 2009 for not renewing their annual license. At the beginning of 2009, there was a *NEW RECORD* number of students/pupils in training in colleges and universities (vi) The population of South Africa increased from approximately million in 1999 to million in 2008 (+13.1% growth over the 9 years). Population per Qualified Nurse Registered Enrolled Auxiliaries Total TOTAL :1 1264:1 858:1 245:1 TOTAL :1 1206:1 824:1 241:1 TOTAL :1 1179:1 803:1 235:1 TOTAL :1 1114:1 796:1 229:1 Verifications (process to leave the country) +/ per year (Reference:

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