Open Days Zorg - 20 september 2011, provinciehuis Hasselt - presentatie Willy Palm

1. EU 2020 and
the healthcare labour market
Future proof for cure and care
Hasselt, 20 September 2011
Willy Palm
Dissemination development Officer

2. The importance of the health workforce
Developing sufficient, capable, After the EU Commission’s health
motivated and supported health strategy « Together for Health »
workers is essential for overcoming (2007)
bottlenecks to achieve national and
global health goals. Developing effective and efficient
health systems, with the capacity
Working Together for Health to improve health and prevent
World Health Report 2006 disease, depends on having a high-
quality, efficient health workforce
with the right skills – throughout the
EU Member States
2008 EU Commission’s
Green Paper on the
European Workforce for Health
2

3. The EU policy context
• EU = 27 Member States, 493
million citizens
• Health sector
• Total expenditure on health:
8.2% of GDP (OECD 2006)
(with 70% of budget allocated
to salaries and other charges)
• Employer for 10% of the EU
workforce (15 million people)
• EU2020 strategy for smart,
sustainable and inclusive
growth
• New skills and new jobs
• Youth on the move
3

4. The health workforce crisis
• Increasing needs • External factors
• Ageing workforce – Labour market dynamics
• Changing expectations (work- – Economic crisis
life balance, career planning) – Societal perception and
• Unattractive remuneration and appreciation
working conditions (workload,
etc.)
• Evolving skills and
competencies (quality and
safety)
• Organisational change
• Regulation and policy
• Mobility (within and between
countries) 4

5. Main concern: growing shortages
• By 2020: nearly 1,000,000* Health
professionals
Estimated
shortage by
Estimated % of
care not
health workers missing 2020 covered
• Representing almost 15% of Physicians 230.000 13.5%
the necessary care to be
covered Dentists, 150.000 13.5%
pharmacists,
physiotherapists
Moreover Nurses 590.000 14%
• The figure of 1.000.000
doubles if long-term care and Total 970.000 13.8%
ancillary health professions
are taken into account Source. European Commission,
DG Health & Consumers
(internal estimates)
5

6. “Workforce stocks and flows”
Working time
Working Directive
time 2003/88/EC
Parental
leave reduction Other
Retirement occupation
Death
Health
Immigration Emigration
Workforce
PQ Directive
2005/36/EC
Education Re-entry
6

7. The EU mandate on health workforce?
• Union action to respect • Working Time Directive
responsibilities of the 2003/88/EC
Member States for the – Currently under revision
organisation and delivery
of health care, incl.
management and • Directive on the
allocation of resources recognition of
(art. 168.7 TFEU) professional qualifications
2005/36/EC
– Currently under evaluation
– Community to complement
policies of the Member
States
7

8. 8

9. PROMeTHEUS - the Project
Health PROfessional Mobility in THe European Union Study
Matthias Wismar, Claudia Maier, Irene Glinos,
Gilles Dussault, Josep Figueras (eds.)
1. What is the magnitude: reliance &
trends?
2. What are the geographical patterns?
 Effects of EU enlargement?
3. What are the motivations to move?
4. What are the impacts on HS
performance?
 Policy relevant?
5. What are the policy options?
The research leading to these
results has received funding from
the European Community's Seventh
Framework Programme (FP7/2007-
2013) under grant agreement
n°223383.

10. Magnitude of mobility: significant but diverse
INFLOWS
Proportion foreign inflows/ all new entrants (2008):
• Foreign medical doctors: UK (43%), BE (25%),
AU (13.5%), HU (5%), POL (3%)
• Foreign nurses: IT (28%), UK (15%), BE (14%),
HU (2%)
• Foreign dentists: FIN (43%), AU (41%), UK (34%),
BE (19%), HU (10%), POL (3%)

11. After EU enlargement:
Outflows Significant
but lower than expected
• Annual emigration intentions in
EU-12: ca.3%
• Peaks e.g.: EST 6.5% of MDs 2004;
SK 7.4% nurses 2005-6
• Decreasing trend after accession
– Return flows, e.g.: Polish MDs
• New surge in outflows (2009-10)
e.g.: EST, HU, RO
• East-West asymmetries worsened
– Outflows in all MS but EU-15 have
significant inflows

12. Prof. JM Martin-Moreno, WHO/Europe, 2010

13. Policy relevance and implications
• Migration is rather a symptom of broader health
workforce problems, but it can aggravate them
significantly
• In the face of growing shortages, there is a need for a
more integrated approach at EU level
– Improve transparency and monitoring
– Support planning and training capacity
– Foster skills and competences
– Strenghten general workforce strategies (retention and
recruitment)
13

14. Green paper and consultation
1. Demography and the promotion of • Overwhelming support for a
a sustainable health workforce European dimension and need for
2. Public Health Capacity EU action
3. Training • Action needs to be cross-cutting
4. Managing mobility of health (human resources, education and
workers within the EU training) (EU employment, social
5. Global migration of health workers affairs, internal market and cohesion
policies)
6. Data to support decision-making
7. Impact of new technology on • Priorities
efficiency and effectiveness of 1. Assessing future needs
health workforce
(workforce forecasting)
8. Role of health professional 2. Mapping skills and
entrepreneurs in the workforce
competences (training)
9. Cohesion policy 3. Raising attractiveness by
improving working conditions
4. Addressing the challenges of
global migration and mobility
within EU
14

15. Investing in Europe’s Health
Workforce of Tomorrow: Scope for
Innovation and Collaboration
– Assessment of future health workforce needs
– Adapting skills to new needs and lifelong learning
– Create an attractive and supportive working
environment
– Improving performance for quality and safety

16. BE Presidency conclusions
• Need for collaboration on the short, medium and long
term
• Involving MS, EC, patient representatives, and other
relevant stakeholders
• Develop by 2011 a joint action providing a platform for
cooperation between member states on forecasting
HWF needs and workforce planning
• Development of comprehensive action plan on HWF by
2012
• Implementation of the WHO Code of Practice and
continue taking up EU leading role in this process

17. EU action on health workforce
• Green Paper on the European Workforce for Health
(Dec 2008)
• Followed by a public consultation and a series of policy
dialogues in 2009-10
• BEL Presidency 2010:Investing in Europe’s Health
Workforce of Tomorrow: Scope for Innovation and
Collaboration
– joint action on forecasting HWF needs and workforce planning
– Implementation of the WHO Code of Practice international
recruitment of health personnel
• HUN Presidency 2011:
– health professional mobility and health systems
– Towards modern, responsive and sustainable health systems
17

18. EU 2020 Strategy for smart,
sustainable and inclusive growth
• Exit from the crisis, entry into structural change
• 5 target areas, including employment, innovation,
education
• 7 flagship initiatives, including
– Youth on the move
– An agenda for new skills and jobs
• Instruments
– Structural funds
– Joint actions
– European Innovation Platform "Active and Healthy Ageing”
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19. Thank you
for your attention
wpa@obs.euro.who.int
Analysing
Health
Systems and Policies