Co-organised by the Health Workers for All (HW4All) project, the European Federation of Public Service Unions (EPSU) and EPHA, a policy debate took place on 5 May 2015 which discussed how the ethical recruitment principles of the WHO Global Code of Practice on the International Recruitment of Health Personnel could best be implemented. It focused on the European context where professional mobility is encouraged in the Internal Market yet posing increasing challenges for the health systems of Member States experiencing significant out-migration.
Hosted by Nessa Childers MEP (S&D, Ireland) at the European Parliament, the event included introductory presentations by Caroline Hager (DG Health and Food Safety, European Commission) who described the role of the voluntary WHO Global Code in the context of the Commission’s Action Plan for the EU Health Workforce, Linda Mans (HW4All coordinator / Wemos Foundation, Netherlands) who presented the HW4All project, its awareness-raising activities and its Call to Action to European decision-makers which supports proper WHO Global Code implementation and policy coherence, and EPHA’s Sascha Marschang, who described the health workforce advocacy activities of EPHA and its members in the context of the economic crisis and its effects on health systems, patients and professionals.
The event featured two panel debates, the first focusing on equitable distribution of health workers in a Europe marked by increased mobility in the Internal Market, the other concentrating on sustainable health systems and the rights of internationally mobile health workers.
Apart from Ms Childers, the discussants included MEPs Biljana Borzan (S&D, Croatia), Ismail Ertug (S&D, Germany), Soledad Cabezon-Ruiz (S&D, Spain) and Filiz Hyusmenova (ALDE, Bulgaria), which made for an interesting sample of perspectives by representatives of countries affected by mobility flows. As was pointed out during the event, categories such as ‘source’ and ‘destination’ are not fixed given that major migrant receiving countries like the United Kingdom, Germany or Ireland are themselves unable to retain their domestically trained health workforce. It is thus a pan-European challenge – indeed a global one – to create conditions that allow health workers to remain in their countries of origin.
Please click here to view the summary report and the event minutes: REPORT & MINUTES.
The debate touched upon many of the drivers of health workforce mobility and migration including vast differences between EU countries in salaries, working conditions and technology, insufficient opportunities for training and specialisation, mismatches between the number of graduates and available jobs, increased pressure due to shortages, etc. In addition, broader health system topics including reserving fiscal space for health, the impact of austerity measures and the potential benefits of further harmonising training contents and quality were also discussed.
There appeared to be widespread agreement that the principles enshrined in the WHO Global Code are indeed applicable in the EU context given the strong differences between Member States’ health systems and capacities to guarantee quality healthcare. However, as pointed out by Reka Kovacs (Ministry of Human Capacities & Semmelweis University, Hungary), discussions that took place as part of the Joint Action on Health Workforce Planning and Forecasting revealed that stakeholders are particularly concerned about health worker retention, solidarity and equal access, and encouraging circular migration.
Among the many points that were highlighted during the debate feature the following:
– Cross-border cooperation between countries should be increased; the recent Romanian-Bulgarian collaboration on medical specialists provides a good example
– EU Structural Funds should be available to all Member States for putting health workforce objectives into practice
– Governments should take a long term view to planning, recruitment and retention and aim for (self)-sustainability
– EPSU called for a political framework for the protection of migrants’ rights, supported by the EU and the Member States, and for regulating the authorisation of recruitment companies
– Maintaining / creating a multi-stakeholder debate on policies, strategies and financial support.
MEP Ertug stated that, while financing is a national issue, the EU has an important role to play in policy, as also exemplified by the Professional Qualifications and Posted Workers Directives. MEP Cabezon-Ruiz also stated that fair compensation measures for countries losing health workers should be considered.
Moreover, moderator Remco van de Pas (Institute of Tropical Medicine, Antwerp) pointed out that social protection mechanisms are prerequisites for reducing professional flows.
The need for further meetings on health workforce issues was underlined by the MEPs.
Further information
– Health Workers for All case studies
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