However, THCs remained under the management
of township government in Xinluo County.
The management of human resources
Appropriate number of staff
There is evidence that managers in both county
hospitals were trying to control their establishments. Recruitment figures fell after 1988 (see
Table 2). This appeared to be in response to (1)
falling workload (4.5 admission days per doctor in
1988 and 4.1 in 2000 in Xinluo County hospital, and
3.4 and 2.2, respectively, in Liancheng County
hospital), and (2) rising employment costs (from
1987 to 2000 the average health worker salary—
based on adjusted price index of 2000—in Liancheng county hospital rose by nearly 70% and by a
massive 380% in Xinluo county hospital in 2000).
Reduction of staff was also achieved through
resignations. However, these included senior and
experienced staff. Whilst Xinluo was able to stem
the outflow (from an annual average of 6.5 in the
mid-1990s to just 2 by the end of the decade), in
Liancheng the losses continued to increase.
In township health centres in both counties,
however, managers did not control recruitment
levels until 1998 (see Table 3). This was most
dramatic in Xinluo county.
Whilst the data indicates that managers might
have been adjusting staffing levels according to
workload to some extent and taking employment
costs into their planning, due to the ‘loose’ labour
market there were also co-existing pressures on
hospital and township health centre directors to
employ unnecessary staff. One manager reflected:
‘‘many people introduce their relatives and friends
to our hospital. We cannot refuse’’.
The process of staff transfers was greatly simplified after 1988 and only required the agreement
between the two health institutions concerned.