Towards a values-based model to manage joint academic appointments in the health sector in South Africa

Abstract

Joint appointments in the health sector in South Africa are made to serve both service and academic functions in one post. Typically the employing organisations are unequal, as one of them is the paying organisation while the other is the academic employer. This practice has been in existence for decades, and is ruled by expediency rather than being based on values. Joint employees experience role confusion, job confusion, dual loyalty confusion and being managed according to the rules of two organisations. This suboptimal situation leads to lower-than-expected performance in the eyes of both employing organisations. In this study the knowledge and problem areas of joint appointments were explored. The first part of the study consisted of a questionnaire analysis of the knowledge and view of problems as expressed by joint staff as well as by human resources (HR) practitioners. Group discussions, as well as the major part of the study, namely, interviews with senior management staff of both organisations were then conducted. In order to complete the study, an analysis was made of values that might inform on the problem. Joint staff members were found to have limited knowledge of the work requirements of a joint employee, and expressed concern about loyalty and role confusion. When the values were discussed with senior management staff, some values were identified as informing on possible solutions such as joint establishment of vision, joint objectives, respect for all components of the job, as well as generic values, including honesty, transparency, fairness, diversity and others. A framework is suggested commenting on the potential place for a values-based approach. From this a model is proposed by means of which a values-based process can be initiated by a top-level agreement meeting (“meeting of the minds”) of both employers that may lead to a single joint vision and set of objectives. From this agreement a policymaking joint body can establish the rules, while application and implementation are monitored by local joint management committees.