Institut für Europäische Gesundheits- und Sozialwirtschaft GmbH Joint Action on Health Workforce planning and forecasting Lisbon, June 16 th 2014 Meiko Merda Project Manager, IEGUS Institute Migration of Health Care Professionals The triple win idea in bilateral agreements

Institut für Europäische Gesundheits- und Sozialwirtschaft GmbH Joint Action on Health Workforce planning and forecasting Lisbon, June 16 th 2014 Contents (1) Our institute (2) Legal implementation of the WHO Code in Germany (3) Practical implementation (4) Challenges and solutions

Institut für Europäische Gesundheits- und Sozialwirtschaft GmbH Joint Action on Health Workforce planning and forecasting Lisbon, June 16 th 2014 (1) Our institute

Institut für Europäische Gesundheits- und Sozialwirtschaft GmbH Joint Action on Health Workforce planning and forecasting Lisbon, June 16 th 2014  IEGUS Institute has been founded in  Located in Berlin-Mitte, Reinhardtstr. 31  Website:  Main Topics: Demographic transition, strategies to meet the increasing demand of healthcare personnel (e. g. migration), use and funding of assistive technologies, sector and market analysis, cooperations at European and international level.

Institut für Europäische Gesundheits- und Sozialwirtschaft GmbH Joint Action on Health Workforce planning and forecasting Lisbon, June 16 th 2014 (2) Legal implementation of the WHO Code in Germany

Joint Action on Health Workforce planning and forecasting Lisbon, June 16 th 2014 Interpretation of the WHO Code In general: Nurses from Non-EU countries get admission to the German labor market when their professional qualification is accredited by the authority in charge. Exception: No direct recruitment of healthcare personnel from countries of origin that belong to the 2006 WHO list (critical shortage)!

Joint Action on Health Workforce planning and forecasting Lisbon, June 16 th 2014 Legal implementation of the WHO Code June 2013: General Framework for the migration of nurses from Non- EU countries with the reform of the „Beschäftigungsverordnung“. November 2013: Revision of the BeschV to follow premises of the WHO Code (= no recruitment from countries with „critical shortage“): § 38: Only the German Federal Labor Market Authority is authorized to recruit healthcare personnel from these countries. § 39: The recruitment from these countries is treated as a refringement (Ordnungswidrigkeit). Appendix: 2006 WHO list with the 57 countries with a „critical shortage“

Institut für Europäische Gesundheits- und Sozialwirtschaft GmbH Joint Action on Health Workforce planning and forecasting Lisbon, June 16 th 2014 (3) Practical implementation

Joint Action on Health Workforce planning and forecasting Lisbon, June 16 th 2014 Practical implementation of the WHO Code First pilot projects with source countries that are not on the 2006 WHO list were initiated recently with the aid of or through the German government.

Joint Action on Health Workforce planning and forecasting Lisbon, June 16 th 2014 Lessons learned from pilot projects The motivation of nurses from less developed countries to migrate to Germany, learn German language and integrate into the new environment is high. Recruitment, language courses, professional preparations or the acceptance of foreign degrees as well as the social integration and on the job take it´s time and are very costly. The willingness of governments and healthcare facilities in countries of origin to collaborate with Germany is very high.

Institut für Europäische Gesundheits- und Sozialwirtschaft GmbH Joint Action on Health Workforce planning and forecasting Lisbon, June 16 th 2014 (4) Challenges and solutions

Joint Action on Health Workforce planning and forecasting Lisbon, June 16 th 2014 Challenges with the implementation of the WHO Code The strict orientation on the 2006 WHO definition of a „critical shortage“ excludes collaboration with certain source countries even if positive development effects are likely to occur. The main focus of the pilot projects, at the recent time of implementation, is on the reduction of domestic manpower shortages (no direct measures to strengthen healthcare systems in countries of origin!). Who should pay the (initial) costs for migration schemes? Government, employers, the personnel or in parts all (two) of them?

Joint Action on Health Workforce planning and forecasting Lisbon, June 16 th 2014 Solutions for a „real“ Triple Win Migration © Attach more importance to Article 5.1 (instead of fixed thresholds): „The health systems of both source and destination countries should derive benefits from the international migration of health personnel.“ Implement „Training partnerships“: Countries of destination train (prepare) healthcare personnel in countries of origin for jobs abroad. Establish fair and sustainable financial mechanisms. Set incentives for circular/temporary migration.

Institut für Europäische Gesundheits- und Sozialwirtschaft GmbH Joint Action on Health Workforce planning and forecasting Lisbon, June 16 th 2014 Thank you for your attention! Meiko Merda Project Manager IEGUS - Institut für Europäische Gesundheits- und Sozialwirtschaft GmbH Reinhardtstr. 31 D Berlin Fon: / , Fax: / Internet: