What role can ethical recruitment play for fair distribution of health workers? What role has Europe in ensuring that freedom of movement of health workers in the Single Market does not translate into unequitable access to health services in less affluent regions? These are two of the questions that the event “Mobility of Health Professionals in the EU: Ethical Recruitment and Policy Coherence” that took place on 5 May at the European Parliament responded to.

Jointly organised by the Health Workers for All partnership, the European Federation of Public Service Unions EPSU and the European Public Health Alliance EPHA, and hosted by Nessa Childers MEP (S&D, Ireland) at the European Parliament, the event discussed the applicability of the WHO Global Code of Practice on the International Recruitment of Health Personnel in the European context, marked by increased professional mobility. The latter has begun to have a significant adverse impact on health system sustainability due to increasing shortages and maldistribution of doctors, medical specialists and nurses. A phenomenon that is hitting hard in some Southern European countries, but also in Poland, Bulgaria and in particular Romania, where since 2007 several thousand physicians and nurses have received certificates that allow them to work in another European Union (EU) member state.

Austerity measures are altering the balance between health workforce investments and mobility, which is at the heart of the WHO Global Code of Practice: new wage imbalances between countries are being shaped and have the potential to further increase health worker brain drain. This means that Member States have to orient their health workforce planning towards self-sufficiency, while EU Cohesion Policy can have a role in supporting countries in retaining their health workers, to avoid mounting health inequalities and safeguard universal access to healthcare.

Crucially, what emerged from the debate is that mobility in the healthcare sector is different than in other areas such as IT or construction where the loss of qualified professionals does not pose a danger for public health. Therefore, Health Workers for All issued a Call to European decision-makers in 2014 in support of proper implementation of the ethical principles contained in the WHO Code.

“It is about time for policy-makers to realise that investment in public health systems, and in a sustainable health workforce help advance Europe’s economic recovery,” said Linda Mans, global health advocate at Wemos Foundation and HW4All coordinator. “The EU, with its Cohesion Policy instruments, should do a better job to help retain health workers in their home countries,” Mrs Mans went on to say.

In a Europe of increased labour mobility, it becomes even more important to safeguard the rights of workers. “Fair and transparent contracting and equal access to training and career development need to be ensured by employers, who should also go to great length to guarantee a safe and healthy work environment,” added Mathias Maucher, Policy Officer on Health and Social Services at EPSU.

Although terms like ‘source’ and ‘destination’ country are becoming blurred in the face of increasingly volatile professional flows, all EU countries must consider how their planning and recruitment practices affect individual decisions both at home and abroad. Both out-migration and reliance on a foreign workforce are indicative of systemic challenges that must be tackled through actions that make working environments more attractive for health workers to stay.

“Professional mobility boosts growth and job creation in the Single Market. Yet, in the health sector the playing field is far from level: if you can earn ten times more in another member state while developing your professional skills, it’s hard to resist the call,” concluded Sascha Marschang, EPHA’s Policy Manager for Health Systems.

Event documentation

global health policy