Attracting and Retaining Staff in Public Healthcare: Challenges and Strategies

This essay discusses the challenges faced by public healthcare organizations in attracting and retaining staff. It covers issues such as workforce training and development, diversity and work-life balance, employment relationship, performance management, and selection and recruitment of healthcare workforce.

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Essay: Attracting and retaining staff
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Essay: Attracting and retaining staff
Human resource management (HRM) is mainly concerned with development of
organisation’s as well as individuals working for the organisation. It not only engages
developing and securing of workforce talent but also in implementing programs that can
enhance cooperation and communication between individual workers to nurture
organisational development. Responsibilities undertaken by HRM of organisation’s includes
training, appraisal, recruitment, selection, utilisation of workforce, implementation of rewards
and pay systems, etc. When examining public health care system in global context, various
issues regarding human resources management and questions arise. Among them, few issues
will be discussed further in this essay including workforce training and development,
diversity and work-life balance, employment relationship, performance management along
with selection and recruitment of healthcare workforce. While going through the articles in
general, it was found that challenges in attraction and retention of workforce in every country
seemed prominent, however, health care organisations seemed to have additional challenges
as compared to the others.
According to Knies, et al. (2015), composition and size of workforce is of great
concern in public sectors. This study has been further supported by Tarsunbayeva, et al.
(2017) where the authors state that workforce training and development is an important issue
that demands giving critical attention to health care workforce composition in terms of skill
and training programs. Performance management of health care workforce is an issue that
generally arise at the time of global health care examination. In literature, it has been
suggested that movement in human resource workforce closely follows performance
management considering every individual especially in the internal workplaces within every

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country (Cogin, Ng, & Lee, 2016). Moreover, mobility and migration issues further demand
workforce planning and giving attention to those issues that considers rewards and pay to
improve overall performance of workforce. Nowadays, organisations do not hesitate in
providing employees with additional incentives like housing, infrastructure, bonuses, etc. to
retain qualified workforce and for enabling job rotation. However, Manimaran & Kumar
(2016) argues that public healthcare workforce in developing countries remain underpaid and
thus shows poorly motivation and dissatisfaction.
According to Kramar, et al. (2014), “HR recruitment is defined as any practice or
activity carried on by the organisation with the primary purpose of identifying and attracting
potential employee” (p.244). It can also be said that recruitment and selection have many
implications for individuals as well as organisations. According to the authors, even after the
global economic recession recognised during 2008-09, many organisations still faces issues
in upholding skilled labour and find difficulties in retaining and attracting key talent. In
HRM, recruitment activities are implemented to design and mark the number of individuals
who apply for any vacancy, type of individuals who apply for job role and/or likelihood that
applied individuals will be accepted for the applied post according to the vacancy. In other
words, organisational recruitment and selection goal is to make sure that organisation have
reasonable amount of qualified applicant who finds the job acceptable and can be chosen for
any vacant position. HRM, when relating to public healthcare, can be well-defined as
diversified clinical and non-clinical individuals responsible for public and personal health
intervention.
The most significant health care system inputs are based upon performances and
benefits the system can deliver through skilled, knowledgeable and motivated workforce.
HRM is a about cohesive use of policies, system and management practice to develop,
maintain, retain and recruit employees for strengthening organisational capacity in meeting

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desired objectives. HRM also deals with firing and hiring workforce, development and
payroll where it plans and implement effective process and frameworks for people
management in the organisation like recruitment, job placement, planning and engagement.
According to Podger (2017), HRM emphasizes that individuals remain critical in achieving
sustainable competitive advantage and for that they integrate human practices with firm’s
corporate strategies which helps human resource specialists to control workforce and provide
efficiency and equity goals. However, in most of the organisation’s the role of HRM is
misunderstood and utilised inefficiently, especially in today’s public healthcare systems.
Mbemba, et al. (2016) suggests some effective strategies that can retain, recruit and
select workforce for countries who faces issues regarding HRM in their healthcare
organisation. According to the authors, training can support rural as well as developing
countries workforce background and desire to work more effectively. Though, before
commencing training of recruited staff, selecting is a critical stage where the role of HRM
proves very significant as selection involves many critical judgements and taking
responsibilities like selecting workforce that are suitable for the vacant position along with
placing appropriate staff at appropriate place. Kramar, et al. (2014) examined five critical
standards in which employee selection can be made effectively that includes ‘reliability,
validity, generalisability, utility and legality’. The authors also mention about different
selection modes for related five standards that can be utilised by the organisations depending
upon the nature of work and job responsibility. Although the authors mentioned testing
individual capability, but they also argued that no single test can fulfil requirement for all
kinds of job. Indeed, HRM can use many forms of tests for particular time period to gain
knowledge about applicants and their necessity for the vacant position.
Workplace have become prime discussion topic for debate regarding making
improvement within oneself and for the team members. Learning and development are key

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strategies that can help organisations to gain economic development as well as bring
significant changes into the workplace that demands considerable time investment along with
training and development. However, Kramar et al. (2014) argues that “Not all learning that
occurs in the workplace is the result of a training intervention” (p. 382). The authors
emphasize on those learning that generally occurs informally and incidentally that means
every people learn all the time when they are working. Undeniably, since every employee are
adults, they can realise their responsibility and even learn out of new experiences. Training
programs further provide workforce with opportunities to learn in more formal and structured
manner other than what they have learnt during their formal training systems or universities.
In fact, they carry lot of experiences that can be utilised in workplace along with those they
develop during their work time.
According to Latif, et al. (2014), workforce with access to development and training
programs have benefit over workforce in other organisations who remain unaware about
training needs and workforce have to develop training opportunities of their own. The
investments made in training shows that organisations value their employees and training in
return creates supportive workplace ( Kabene, Orchard,, Howard, Soriano, & Leduc, 2006).
Even employees may feel more satisfied towards their job if they are given training
opportunities to eliminate challenges recognised by them. Retention and attraction of
workforce is significant but, it can be argued that what is the point behind retaining those
people in positions who are unable to meet job specifications? Justly, issues relating to skill
and self-competencies plague healthcare organisation’s especially in public sector. For
example, doctors are posted to primary healthcare facility and the same are expected to
monitor health related programs even after they lack in necessary health program related
skills. Since they lack basic training or are placed in unfit position, they end up performing
adversely.

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According to Andre, et al. (2013) contemporary healthcare organisations are not
forestalling the external environmental changes by developing their management strategies
and general HRM. The ongoing education and training of healthcare professionals who hold
significant positions are not aligning according to current trends that results in showing
improper exercises ( Ali & Aameed, 2016). Previously, healthcare human resources were
based exclusively on technical grounds, but today they demand competent training. In
literature, therefore, healthcare managers are suggested to align theory with current industry
needs and practice (Henriksen & Dayton, 2006). The HR mangers of firms need to
understand the of very basic requirement of training and development that can provide fresh
recruits as well as already working employees with appropriate skills within healthcare
sector. It is necessary to ensure that there are appropriate number of skilled staffs, but if they
are unable to deliver quality service without showing effectiveness in performance,
organisation’s demand installation of performance management techniques ( Khan, Khan, &
Khan, 2011).
Performance management can be defined as a process where work environment is
created or is set to enable people perform according to their best capabilities. Performance
management is indeed a whole working system that begins with the job and ends when the
employees leave the organisation. According to Kramar, et al. (2014), organisations who
pursue to increase competitive advantage through workforce must have capability for
managing employees and their behaviour results. Performance appraisals is another part of
performance management system that are widely used in Australian region where companies
utilise it for maintaining their workforce. However, the authors further argues that
performance appraisal is only a single part of broader perspective in performance
management.

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In literature, performance management can be measured by following various
criteria’s: strategic congruence, reliability, specificity, validity and acceptability. Strategic
congruence in performance management is the extent in which system prompts job
performance and whether it is in alignment with organisational strategy or not. Validity, also
known as content validity refers to the extent where performance management measure
relevant and accessible aspect of performance. Reliability is the consistency measurement of
performance while acceptability refers to the extent people accepts the performance
measurements. Lastly, specificity refers the extent in which performances management gives
guidance to workforce about what is required from them and ways through which job can be
accomplished ( Kramar, et al., 2014). Hence, the entire process of performance management
shows involvement of employee managing efforts that are specifically based on performance
outcomes. However, Hartog, et al. (2004) further argues that performance management must
be aligned with HRM practices to enhance development and employee performance to fulfil
the objective behind maximising of organisational performance.
In public healthcare sector, it was found that planning in central level have killed
many initiatives while adopting argumentative health planning programs. According to Ali
and Aameed (2016), public healthcare institutions lacks in developing new healthcare plans
and even do not allow taking assistance from foreign experts or collaborating with private
partners without clearing rigid governmental procedures. Even performance appraisals follow
routine and subjective methods instead of depending upon individual capability. Increments
and promotions are linked to vacancy and systematic availability which means staff who are
present and provide full day service also get same salary like the staff who remains absent for
three to four hours. Crema & Verbano (2013) further adds to the issue stating that despite
implementation of several performance management practices, errors in public healthcare
remains highly visible. The overlapping gaps between integration and emerging HRM

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approach, concepts of perfection and value-added tools require healthcare organisation
undertake critical reformation.
Diversity management and work-life balance is another important aspect that refers to
those responsibilities that leads to healthy lifestyle, family maintenance and balanced life.
Managing diversity and work-life balance has not only became top-priority in management
initiatives among contemporary organisation’s abut also given shape by government
regulations and policy framework. However, Kramar, et al. (2014) states that successful
implementation of work-life balance and workforce diversity requires cost
acknowledgements to benefit from these initiatives. There is a greater need in HRM to
manage employee’s welfare perceptions and to make those employees aware who do not use
such frameworks. Today’s employees have to mange several responsibilities towards
organisation as well as family and society also. In the entire system, employees often tend to
forget about themselves, however, organisational perspective of work-life balance and
diversity may further depend upon industry they work in ( Shivakumar & Pujar, 2016).
In healthcare sector, establishing right balance between family and work becomes
very difficult as most of the services are of perishable in nature and have to be accomplished
instantly. This means, staff have to be present physically to serve whenever a service is
demanded. Many employees are required to work for longer period, in odd hours also, than
anticipated that causes conflict between professional and personal life. This also impacts
workforce’s personal health where employees struggle constantly to ensure making balance
between care given to customers or patients and to themselves and their family. According to
Shaikh & Dange (2017), it is very significant that HRM in healthcare sector realise the
implications of globalisation and must adapt practices that matches key challenges of
globalisation as well as workforce diversity. Effective human management is the key for
development in interesting and interactive development and training interventions through

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innovative schemes and providing extra time effort for employee engagement activities. Even
if the employees ignore family or personal life, HR managers must not remain blind to the
developing reasons behind family conflicts and health consequences. It will not only result in
demotivated and less productive workforce, but also impact employment relationships.
In literature, it has been well documented that employment relationship is an
inevitable trend and a significant dimension of diversity that demands HR managers manage
employment relationships effectively ( Duah & Danso, 2017). However, it can also be argued
that different management expectation and styles requires different individuals that further
depends on their relationship with firms. For example, older employees may get chosen as a
part time consultant rather than full time employee by the organisation. The perception of
work-life balance can strongly affect individual relationships within workplace. Some may
prefer working for long hours, may be due to career enhancement stage or limited to no work
outside workplace. For others, contradictory requirements may be applied where they
perceive taking time out of their workplace to fulfil societal and family demands. Therefore,
HRM job becomes critical in ascertaining workplace environment and efforts that need to be
distributed among workforce. In public healthcare, facilitation of such HRM can take
assistance from supportive work culture organisations to influence the ability in managing
and taking responsibility in every domain (Shaikh & Dange, 2017).
The above essay has been prepared after identifying attraction and retention issue in
public sector where healthcare industry seemed to have additional challenge as compared to
the others sectors. Many healthcare organisations face human resource challenges like
attraction, absenteeism and staff shortage along with envisaging low morale among staff
members, all which can be associated with ineffective HRM in organisational strategies.
Although managers may say that their staff are critically significant, they frequently neglect
management systems, procedures and protocols to support workforce management that often

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results in generating issues like attention and retention in healthcare HRM. In developing
nations, HRM remains weak and fragmented mainly because they do not monitor staffing of
resource professionals due to which promotions lag, vacancy rates soar high, morale becomes
lower and increased workload over employees remain consistent. Addition to it, without
effective human resource guidance and deficiency in human resource experts, managers are
unable to develop HRM skills that further results in shortfall of effective workforce. After
analysing the raising concern in past and present issue in HRM of public healthcare sector, it
can be suggested that employees must be offered combination of benefits that can boost their
morale and job satisfaction. For the same, effective retention strategy that goes beyond
financial incentives like performance appraisal, training and development, enabling work-life
balance, maintained employment relationship along with effective recruitment and selection
strategies can be prove significant for human resource management of public healthcare
organisations.

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References
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