For the first time in Spain, an international conference focusing on the health workforce migration and its negative consequences in the quality of health care in the affected countries was held in Madrid, on 5 June 2014. The conference organized by the NGO Medicus Mundi analyzed the European implementation of the WHO Global Code of Practice on the International Recruitment of Health Personnel, adopted by the World Health Assembly in 2010. The list of speakers included the General Manager in Territorial Organization of the Ministry of Health, Mr. José Javier Castro Deza, and the Manager in Multilateral Cooperation of the AECID, Ms. Laura López. The WHO was represented by Amani Siyam from the Health Workforce department.
It is estimated that in Europe there will be a deficit of one million health workers by 2020. Those present at the conference could hear, for example, the story of the Spanish nurse Natalia Sierra who worked in a German private health company. The last information, from 2013, states that Germany is currently the main recruiter of foreign doctors and Finland of nurses and midwifes. Within 20 years, Spain turned from being a receipient into a sending country of doctors and nurses. However, forecast say that in 2025 there will be a 14% deficit of physicians and specialists in Spain. Celia Gomez, General Manager of Healthcare Professionals in Andalusia, spoke about this reality: the negatiave consequences of the migration of health workers for the health of people and the health system in Spain.
European Call to Action launched
The experts invited by Medicus Mundi recommend countries to develop a policy of self-sustainable health workforce, which will reduce the brain drain and the inequality between countries resulting from the recruitment of health workers trained abroad. Educating and retaining health workers is the way to achieve long-term effectiveness and sustainability. Representing the European project "Health workers for all and all for health workers" (HW4All), advocacy coordinator Giulia De Ponte released the HW4All European Call to Action for responsible decision making in Europe, with recommendations such as long-term planning, investment in the health workforce, respecting the rights of migrant health workers, thinking and acting coherently at national, regional, and global level and contributing to the implementation of the WHO Code of Practice.
The WHO Code of Practice calls for including investment in health workforce employment in the development of modern and sustainable health systems. There are warning experiences: in the 80s, stuctural adjustment policies in many African countries led to the dismantling of existing health services. Will this happen in Europe, where the austerity plans and the pressure to obtain short-term benefits are stronger than the will to obtain long-term effectiveness?
The meeting in Madrid was supported by the HW4All project which gathers 9 European NGOs. Its objective is that Europe becomes in a role model of good practices for health workers mobility and related policies. The WHO Code of 2010 offers the possibility of leadership. Educating and retention is the way to go.
Conference report by Teresa Rosario Velasco, Medicus Mundi Spain
Conference inputs (YouTube videos)
- "The global economical crisis and unemployment prompting were not significant causes of migration of health personnel."
Amani Siyam, World Health Organization
- "We have a call to action for health workers and sustainable health systems worldwide."
Giulia De Ponte. HW4All project / Amref Italy
- "One thing is public institutions and quite another abuses in the private sector."
Kalle Kunkel, German Union of Nursing. https://youtu.be/g_B4DQKx394
- "In some private sector companies in Germany bind contracts with fines."
Natalia Sierra, Spanish nurse in Germany
- "The state registration of healthcare professionals will be launched in 2015."
Pilar Carbajo. Ministry of Health, Social Services and Equality, introduced by Carlos Mediano, Medicus Mundi
- "We medical professionals have an added responsibility to help and cooperate!"
Serafín Romero, OMC
- "A higher level of interministerial coordination with the private sector is needed."
Sergio Galán, AECID
- "We are looking for tools to develop the migration flows in the European Union and Latin America."
Celia Gómez, Andalusian Health Service