The Green Paper on the EU Workforce for Health VENICE, 25 June 2009 Elizabeth Kidd Health Strategy & Health Systems Unit European Commission

Objectives of the EU Health Strategy – “Together for Health” 1.Fostering Good Health in an Ageing Europe 2.Protecting Citizens from Health Threats 3.Supporting Dynamic Health Systems and New Technologies

Challenges facing EU Health Systems ageing population/ageing workforce/threats to health (eg pandemic) Need to improve equity of access throughout EU Ever-rising expectations ; new treatments and new technology Increased mobility of health professionals

The importance of the EU Health Workforce Developing effective and efficient health systems, with the capacity to improve health and prevent disease, depends on having a high-quality, efficient health workforce with the right skills – throughout the EU Member States

Green Paper on the EU Workforce for Health EU adopted a Green Paper on the EU Workforce for Health in Dec 2008 Launched a debate on the challenges facing health systems and the health workforce, including ethical issues Asked stakeholders to give opinion on a range of soft options for EU support or actions

Health Professionals – the challenges of EU mobility EU Directive 2005/36 – mutual recognition of qualifications Mobility poses challenge for some specialties and some regions within MS Shortages in one part of EU impacts elsewhere creating regional disparities We are hampered by not knowing full picture

Health Professional global migration – the ethical question How can EU satisfy human right to migrate for economic and other reasons while solving our own shortages without destablising fragile health economies? Green Paper discusses case for recruitment Code of Conduct

Lack of comparable data Europe-wide information and robust data on the composition of the workforce is lacking – why they move - where they move to – whether/ when they return Moreover, difficult to plan properly when we don’t know if there is a true shortage – how many non-practising professionals are there?

Current Legal Framework EU Treaty Article 152 Health services responsibility of MS – fully respect subsidiarity « Community shall encourage cooperation ….and … lend support » Take any initiative to promote coordination

Legal Framework (2) How can EU add value when the competence lies with Member States? Clearly difficult – but aim of consultations is to find out extent of what MS and Stakeholders want This helps in development of future EU policy

What can we do at EU level? Shared evidence base - improving monitoring and statistical system through available funding (EU, OECD, WHO) Sharing good practice – supporting networks Guidance; Guidelines; Recommendation Support from European Social funds – train and reskill health workers; under-developed regions

What can we do at EU level? (2) Could be support for recruitment and training campaigns; return to practice campaigns Training mature workers Fostering cooperation between Member States – training /exchanges/ Veneto/Austria/Slovenia example Creating an « observatory » to assist future workforce planning, training needs, implementation of new technology

Responses to Green Paper consultation An encouragingly high number of responses –just over 200 We are now analysing the responses

Early results Similar views on certain issues – financial crisis overshadows debate Training (especially in context of mutual recognition of prof qualifications and exchange of information) Lack of comparability eg nurses;acceptance of extended roles Importance of Continuing Profess. Devel. Ethical issues

Early results (2) Public health capacity an important issue (even before flu outbreak) New technology; improved data Language training and induction/orientation for recruits Above all, robust human resource strategies to improve retention

Next steps After the analysis we will publish report We need to test ideas against principles of subsidiarity (Art. 152);Financial impacts; bureaucracy Present to new Commission

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