Assessing future health workforce needs Policy Summary Draft for consultation Gilles Dussault, James Buchan, Walter Sermeus, Žilvinas Padaiga Leuven April 2010

2 Policy Summary The challenges of future HW needs/ requirements assessment Approaches, strategies and tools Country experiences Lessons Policy questions for the EC Key messages

Questions? Do we need future HW needs assessment? YES Is it difficult? YES, very How to get started? –What are your service objectives? –What is the HW present situation? –What are trends which will affect HW needs? –What do stakeholders say? 3

4 The relationship between needs and objectives HEALTH OBJECTIVES HEALTH NEEDS SERVICES NEEDS RESOURCES NEEDS SERVICES OBJECTIVES RESOURCES OBJECTIVES

5 A simple model of the dynamics of the supply of health workers Education pipeline Immigration Contracting Stock of health workers Retirement Attrition Emigration Returners Facilitators & Obstacles

6 The challenges of HW needs assessment Estimating future needs and demand How will supply and labour market evolve? Methodological issues: databases, definitions, sector vs occupation approach Policy/political : vision, stakeholders, continuity

7 4 approaches Health worker to population ratio Service-target Utilization and demand approach. Health and service needs

8 Country experiences England, Finland, Germany, Lithuania, Slovenia, Spain, Australia and Canada + Belgium, Ireland Most countries do not have an explicit HW development strategy

9 Lessons Assessing HW needs helps prevent/mitigate imbalances Focuses the debate on data and facts Important that policymakers declare their values, principles and policies

10 Lessons Future needs are not only numbers; skills-mix, competencies, working conditions, productivity and quality Quantitative models and tools are needed, but no substitute to judgments Importance of information base

11 Lessons Need to look at the HW as a whole Importance of engaging stakeholders Forecasting future needs is difficult when decentralized No agreement on planning horizon lengths

12 Lessons Implement strategies in a flexible manner, based on careful monitoring Not doing anything or reacting only when problems become sensitive has high costs

13 Policy questions (some...) Should there be EU standardized definitions of health occupational categories and of health labour market indicators? Should EU propose (require) the utilization of standardized data collection tools and reporting formats? What is the role of EU in that respect, relative to that of technical agencies like WHO?

14 Policy questions (some...) Would it be opportune to create a EU Observatory? –to support countries in developing their HW database, in analyzing data, in developing HW policies –to consolidate country information and produce regional analysis –to monitor, analyze and disseminate country experiences Should EU encourage and technically support inter-country HW development, for instance between countries which already experience important cross-border movements?