Human resources in healthcare feel pressure through increased demand and a shortage of staffs. The HR department of healthcare overcomes the issues through a better understanding of the challenges. In Australia, the healthcare sector is growing very fast and HR professionals are gaining importance in the Healthcare industry (Wilson et al., 2009). This paper focuses on the challenges of human resources in healthcare sector by investigating five different themes. In the healthcare sector, the HR department is currently facing the issues of employee relation challenges, diversity and work-life balance, employee turnover and retention, performance management and motivation, rewards and compensation. Each of the challenges is discussed in the following section. It is the primary objective of the HR department in healthcare to strengthen the healthcare infrastructure, its coverage and accessibility by developing the conditions of the human resources who are working in the healthcare sector.
Key stakeholders of industrial relation in healthcare are the employees, employers, employee association, employer association, government and courts and tribunals. The concept of employee relation is associated with industrial relations and it includes the process like employment relationships and the management of conflict between employers, trade unions and workers. In the healthcare sector, industrial conflict is avoided by developing harmonious relations among the staffs (Bailey & Peetz, 2014). According to Unitary approach, the industrial relation is grounded in mutual co-operation, teamwork, shared goals and individual treatment. Unitary framework assumes that common interest and promotion of harmony; the employer seeks the direct negotiation with employees (Bilen et al., 2013). On the other side, Pluralistic approach perceives that it is quite inevitable to understand the conflict between staffs and the management. This conflict is perceived as helpful in innovation and the growth of the organisation. In order to manage the conflict between the staffs and the management; it is needed to have a strong union. In employment relations; Australia is facing the issue of growing representation gap at workplace created by declining union density. The rise of managerial unilateralism is being weak for non-union forms of employee representation.
In the healthcare sector in Australia, employee relation is steeped in a myriad regulation due to an exhaustive list of guideline on life safety, emergency management, environment of care and human resources. In human resources; health care sector is verifying staff orientation, on-going training and staff qualification and ensuring the staff sensitivity. In Australia, the healthcare sector sets the minimum employment standards to protect the employees from being in troubled due to the labour market. Safely Net provides the ease to the employees who are working in the healthcare sector and this award was deeply compromised during the year of Howard Government (Gartner, Schank & Schnabel, 2013). In the healthcare sector, the employee relation has been facing the issue due to the wrong structure of payment paradigm. Australia has been observing the decline of union density in the healthcare sector as employees in healthcare may face the struggle to speak and to be heard about the workplace problems. In the year 2009, the Fair Work Act was passed and it focuses on the three key issues in employment relations; employee representation, managerial unilateralism and safety net under the Fair Work regime. In addition, the continuous technological shift is creating an issue in healthcare staffs.
Diversity and Work-Life Balance
Diversity management is a process of managing the people’s differences and similarities. Managing diversity is built on a set of values which recognises the differences between people which create the potential strength for the organisation. Diversity management is the process of creating the environment which allows contributing organisational experience, goals and personal goals of the employees. According to Richard, Roh & Pieper (2013), diversity within the workplace includes everyone and it extends to personal, corporate background, function, education and personality. Diversity within the organisation includes the sexual preference, lifestyle, geographic origin, exempt status and tenure with the organisation. In the healthcare sector; the staffs must have the idea of diversity as the staffs have to deal with the service users who might come from the different ethnic background. The staffs have to treat and assist the service users from the different race, creed or from a different religion. As opined by McCarthy, Darcy & Grady (2010), in the healthcare sector; the staffs have to work in the multidisciplinary team in which the staff members may come from different class, creed and ethnic background or from a different religion. The staffs need to manage themselves to work within the team and share the work goal. Equal Employment Opportunity (EEO) must be given to all the candidates to ensure from the government to all the individuals to have the equal right regardless of sex, religion, race and national origin. In addition, the Australian government takes the affirmative action providing quotas and reparation to compensate for the past injustice suffered by a group.
In the healthcare sector; diversity is very important and staffs sometimes do the mistake of not understanding the diversity management. The healthcare sector is facing the challenges due to not selecting the diversity management like strategic, managerial and operational. These diversity management factors provide two definite goals, workplace culture and best outcomes of managing the human resources. According to Wilson et al., (2009), healthcare staffs mainly do not have fixed schedule as they have to work for long hours and they do not have proper work-life balance. The staffs in the healthcare industry face the issue of not maintaining work-life balance as a pervasive healthcare problem starts with loss of mental, emotional and physical energy due to job stress. Work-life balance is making the perfect harmony between the family and work; however, healthcare industry affects the commitment of perfect work-life balance.
Employee turnover and retention
There are two types of turnover within the workplace, the first one is voluntary turnover and the second one is involuntary turnover. Employee turnover in an organisation is the employee leaving rate and the organisations most of the time try to retain the employees. In order to manage the involuntary turnover; the organisations focus on distributive fairness, procedural fairness and interpersonal fairness. Distributive fairness is the judgment that the employees make with respect to the result received in relation to contribution and the procedural fairness is the concept of justice which focuses on the methods utilised to determine the result they received (Hom et al., 2017). In New Zealand and in Australia, the healthcare industry turnover of the employees is 30% worse than other industries. The rate of employee retention is higher due to poor employee selection strategies and recruitment procedure. Employee turnover challenge is major in healthcare sector due to the involuntary termination as the employees do not have the proper personality traits, interpersonal behaviour, professionalism, lack of emotional intelligence and poor decision-making capacity. The employee turnover in the healthcare sector is high due to workload as the demands of healthcare professionals is getting higher nowadays and the healthcare firms are trying to roll out the new quality along with cost-control initiative. The organisations are trying to evaluate the candidates' ability to handle the stress and adapt the ability to making the employees more important (Kramar et al., 2013). Moreover, in the healthcare industry; the staffs do not like the immediate supervisor and it assesses each candidate's leadership potential so that the healthcare professionals do not become poor leaders. In addition, the healthcare professionals sometimes may have the poor relationship with the colleagues and the employees do not have the desire to collaborate with other colleagues. The staffs in healthcare lack in work-life-balance and the employees find the rest by leaving the employment.
The management in the healthcare industry is trying to manage the voluntary turnover of the behaviour of dissatisfied' employees to avoid the work situation. There are three categories of employee turnover; behaviour change, physical job withdrawal and psychological job withdrawal. There can be several causes of job dissatisfaction; personal disposition, tasks and roles, play and benefits and supervisors and co-workers. Employee retention rate in the healthcare industry is not high due to the bullying in the workplace in Australia. Indigenous people in the workplace face the bullying; the employees do not have a clear understanding of the roles and meaningfulness of tasks (Vardaman, Allen & Rogers, 2018). The management of healthcare sector tries to improve the retention rate by job enrichment, work teams, job rotation and job customisation. The intervention of the roles within the healthcare can be done through role analysis technique. In healthcare, the management of healthcare can improve the culture and shared values of the employees, developed social support and clarification of paths and goals. The selection process of the healthcare staffs needs to be improved and the staffs need to be involved in social activities and families in social activities.
Performance management process uses by the managers to ensure the employees’ activities and outcomes of the congruent organisational objectives. Performance appraisal is the process to allow the progress towards achievement of desired objectives and other performance standards (Decramer, Smolders & Vanderstraeten, 2013). Healthcare industry in Australia is one of the fastest growing industries and it offers quality professional care to the patients through well-trained employees and dedicated medical representatives. Performance management issues in healthcare are facing due to the limited performance management opportunities in healthcare industries. The management of healthcare industry communicates, defines what good performance looks like and it enables people to understand the level of their actual performance and expectation from the employees. In addition, performance management acknowledges what people do well in the job and it demonstrates the performance of the organisation is differentiated in the company to recognise the fair reward system. Performance management clearly articulates the system through which the management can judge the performance of the employees (Kramar et al., 2013). There are mainly four factors of performance management; organisational strategy, individual attributes, objective results and situational constraints. The individual factor of the employees is also associated with the skills and abilities of the employees. According to Connell & O’Sullivan (2014), the management of the organisation seeks to tie the formal performance appraisal process to the strategy of the company by specifying the beginning of the evaluation that can be accomplished to gain the strategy. In general, performance management system gas five features; alignment of employee performance with objectives, clear articulation of the work culture, clear specification of the results to be achieved. Management style encourages simple processes and documentation to enable the senior management to see the performance of the employees.
In the healthcare sector; a performance management issue occurs due to the increased work pressure leading to the high employee turnover. The performance management system is also gets fallen due to the lack of a standard procedure to measure the performance of the employees. In addition, performance management in healthcare cannot be done properly due to the absence of measurable goals set by the management from the beginning (Carassus, Favoreu & Gardey, 2014). Moreover, the performance management process is inconsistent in performance reviews of the management. There is no such systematic way to review the performance of the employees and the management does not have a tracker to take the well-informed decision. In the healthcare industry in Australia, the HR department needs to set the performance measurement criteria to set the strategic congruence to elicit the job performance which is consistent with the organisational goal, strategy and culture. Ettner et al., (2016) commented that the HR department can take the comparative approach, attributive approach and behavioural approach to measure the performance of the employees.
Motivation, Rewards and Compensation
The healthcare employees have been facing the issue in Australia due to not having a clear pay structure in the industry. Pay structure is the relative pay of different jobs and how much they paid in pay level. In the healthcare sector in Australia, the firms do not follow the pay level as the average pay, salaries, bonus, including wages and fringe benefits (Chinag & Birtch, 2010). As stated by Kim, Sutton & Gong (2013), equity theory evaluates the fairness of the situation by understanding and comparing the people. Equity theory tries to compare the person's ratio of perceived outcome (benefits, pay, working condition) to perceived inputs (likeability, effort and experience) to the ratio of comparison others. In the healthcare sector, pay structure is not formulated correctly due to the labour-market competition. The HR department of the healthcare firm does not create the pay-policy line and the pay grade properly. Pay grade is the jobs of similar worth for pay administration purposes. HR department focuses on market pay-structure which can differ substantially across the countries in terms of the relative worth of jobs. Employee participation and communication play important role in the motivation of the employees. Compensation challenges and rewards of the employees in healthcare have been there for the job-based pay structure which may encourage the employer in bureaucracy (Van Jaarsveld & Yanadori, 2011). The organisations focus on structure's hierarchy to reinforce the top-down decision-making and information flow as well as status differentiation. The bureaucracy may require generating and updating the job description for the job evaluation to become the barrier of change.
The healthcare employees in Australia do not get the rewards and recognition properly. The employees sometimes do not get a skill-based pay as skilled employees may acquire and they are capable of getting the skill-based pay system. The important potential advantage of skill-based pay is that it is contributing to the increase in worker flexibility and it turns towards affiliating the decision-making process (Kramar et al., 2013). Lack of motivation in working in healthcare comes for the absence of extrinsic motivation in the workplace as the organisations do not have executive pay, proper wage package and extra benefits for the employees. The healthcare management does not provide the reward to the individual motivation of the employees. The HR department must motivate the employees to keep calm, make sure about staffs are trained and keep the lines of communication open.
It has been noted that the healthcare sector in Australia is emerging; however, it has been facing several issues related to HR department. Lack of planning in HR is the main issue not to resolve the employees' problem. Performance management, reward and motivation and employee relation are the major issues and the management must have the diversity training for the staffs in healthcare to have a clear idea. Therefore, the HR department in healthcare should start the union negotiation to improve the employee relations, training and development to improve diversity management, proper schedule of work to reduce the stress in the workplace and proper compensation and benefits following the governmental rules. HR management is the system in healthcare to focus on managing the employees at all levels to achieve the objectives of the organisation.
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