Département de gestion, d'évaluation et de politique de santé, School of Public Health, Université de Montréal-CRCHUM, Montreal, Quebec, Canada.
Department of Sociology, Université Laval-Vitam, Quebec City, Quebec, Canada.
Int J Health Plann Manage. 2021 May;36(S1):58-70. doi: 10.1002/hpm.3129. Epub 2021 Mar 1.
While policy-makers in many jurisdictions are paying increasing attention to health workforce issues, human resources remain at best only partially aligned with population health needs. This paper explores the governance of human resources during the pandemic, looking at the Quebec health system as a revelatory case. We identify three issues related to health human resource (HHR) policies: working conditions, recognition at work and scope of practice. We empirically probe these issues based on an analysis of popular media, policy reports and participant observation by the lead authors in various forums and research projects. Using an integrated model of HHR, we identify major vulnerabilities in this domain. Persistent labour shortages, endemic deficiencies in working environments and inequity across occupational categories limit the ability to address critical HHR issues. We propose three ways to eliminate HHR vulnerabilities: reorganize work through participatory initiatives, implement joint policy making to rebalance power across the health workforce, and invest in the development of capacities at all system levels.
虽然许多司法管辖区的政策制定者越来越关注卫生人力问题，但人力资源最多只能部分符合人口健康需求。本文探讨了大流行期间的人力资源治理，以魁北克卫生系统为典型案例。我们确定了与卫生人力政策相关的三个问题：工作条件、工作中的认可和实践范围。我们根据对主要作者在各种论坛和研究项目中的大众媒体、政策报告和参与观察的分析，对这些问题进行了实证研究。我们使用卫生人力综合模式，确定了这一领域的主要脆弱性。持续的劳动力短缺、工作环境中的固有缺陷以及职业类别之间的不平等限制了应对关键卫生人力问题的能力。我们提出了三种消除卫生人力脆弱性的方法：通过参与性举措重新组织工作，实施联合决策以重新平衡整个卫生劳动力的权力，以及投资于各级系统能力的发展。
