31st Plenary Meeting of the SEE Health Network takes important decisions

On 20-21 June 2013 the SEE Health Network held its regular 31st Plenary Meeting in Chisinau, Republic of Moldova under the Presidency of Dr. Andrei Usatii, Minister of Health.

The meeting was organized by the SEE Health Network Executive Committee and Secretariat with the excellent and full support by the Ministry of Health of the Republic of Moldova.

Over 40 representatives of the 10 countries, Member States of the SEE Health Network and their partners, the Council of Europe, the International Organization for Migration, the Regional Cooperation Council, the International Network of Health Promoting Hospitals and Health Services, Project Hope, the European Health Forum Bad Gadstein, the Regional Center for Policy Analysis and Research "Studiorum", Slovenia, Switzerland and WHO Regional Office for Europe participated actively in the discussions that lead to important deliberations and decisions.

Extended partnerships

The Network signed two new Memoranda of Understanding for collaboration with the International Organization of Migration and with the Regional Center for Policy Analysis and Research "Studiorum". This is an important step forward in the partnership policy and practice for the Network which will further enhance their joint effort to boost up health development in the region.

Report on the SEE Health Network activities during the Presidency of the Republic of Moldova


Dr. Andrei Usatii, Minister of Health, Republic of Moldova, presented the main activities and achievements of the Network in the period 01 January - 30 June 2013. Among all, several major events have to be highlighted:

1. The Inauguration of the SEE Health Network new Secretariat in Skopje, Republic of Macedonia on 07 March 2013; the fact, by itsself, that the Network already has its own legal entity is a major breakthrough in the development towards full ownership, independence and sustainability of the regional collaboration for better health under the auspices of the Regional Cooperation Council (RCC); of course, much more need to be done to have the Secretariat fully operational and the representatives urged the SEE Health Network Governments to complete the process of making their yearly financial contributions as stupulated by the signed memorandum of Understanding of 2008, as well as to facilitated the process of recruiting international staff;

The Representatives expressed their appreciation to the Government of the Republic of Macedonia for their commitment to the establishment of the Secretariat;

The Representatives expressed their sincere gratitude to WHO Regional Office for Europe and specifically to Ms. Zsuzsanna Jacab, Regional Director for the never failing continuous support to the SEE Health Network;

The representatives thanked the ministries of health of Bosnia and Herzegovina, Croatia, republic of Moldova and the Republic of Macedonia for transferring their financial contributions for 2013 to the SEEHN Secretarita´s bank account;

The continuous support of Belgium, Slovenia and Switzerland was also highly commended particularly in view of their financial and in-kind support for both the Secretariat and the activities for implemening the Banja Luka Pledge;
The Representative acknowledged highly the pro-active work of the designated Regional Health Development Centres in Albania (on communicable diseases surveillance and control), in Bosnia and Herzegovina (on mental health), in Croatia (on organ transplantation and donation), in the Republic of Moldova (on health workforce) and in the Republic of Serbia (on accreditation and quality of health services).

Health on the political agenda of the SEE 2020 Growth Strategy

The 31st Plenary discussed the draft Health Chapter to be incorporated into the Inclusive Growth pillar of the SEE 2020 Growth Strategy. The latter is in the process of development under the auspices of the SEE regional Cooperation process and the Regional Cooperation Council and is expected to be endorsed by the SEE Governments in October 2013.

The Health aspects of the SEE 2020 Growth Strategy were developed by an ad-hoc SEEHN Working Group with participation of senior experts from Croatia, Romania, WHO Regional Office for Europe and the RCC under the chairmanship of the Chair of the SEEHN Executive Committee. It was based on the findings and defined priorities of a snapshot analysis of the current state of Health Policy development and implementation in all 10 SEEHN Member States. This work was also inspired by the WHO Europe Health 2020 Policy Framework and the European Action PLan on Strengthening Public Health Capacities and Services, endorsed by all 53 European countries during the WHO Europe Regional Committee 62nd Session in September 2012 in Malta.

The Banja Luka Pledge calls for immediate action to introduce Health in All Policies in the region and to strengthen their public health capacities and services with the sole objectives  to reduce health inequities and to prevent and control noncommunicable disease which are the main reasons for the significant shortfalls in health in  SEE . These  have negative effect on the countries economic and social developments as foreseen in the SEE 2020 Strategy, the WHO/Europe Policy “Health 2020” and the EU 2020 Strategy.

In follow-up, the Representatives came to the following:

Decision on the Health Chapter of the South East Europe 2020 Growth Strategy

Recognizing that health is not just a value in itself - it is also a driver for growth; that only a healthy population can achieve its full economic potential; that keeping people healthy and active for longer has a positive impact on productivity and competitiveness; that innovation in healthcare helps take up the challenge of sustainability in the sector in the context of demographic change’, and that action to reduce inequalities in health is important to achieve ‘inclusive growth;

Taking into account the vast amount of global European and our own, SEE Health Network´s, the evidence and significant new knowledge about the complex interrelationship between health and sustainable human development;

Strongly believing that health needs to be transformed from being perceived merely as a medically dominated, money-consuming sector to a major public good bringing economic and security benefits and contributing to attainment of key social objectives as there is now a broad consensus that the health of populations is critical for social coherence and economic growth and a vital resource for human and social development,

Having reviewed the health status and current priorities and discussed ways and means of building concerted political action in the field of prevention and control of the preventable life-style related chronic noncommunicable diseases in the SEE region;

Committed to the Global and European new policies and strategies for health in the 21^st Century, and in particular to the EU 2020 Strategy, the WHO Europe Health 2020 Policy, as well as to the thrusts and commitments of the Skopje (2005) and Banja Luka (2011) Pledges;

Commending the SEE Regional Cooperation Process and the Regional Cooperation Council (RCC) for developing the SEE 2020 Growth Strategy; and

Taking the opportunity of the SEE regional cooperation processes;

We, the Representatives:

·         consider that it is the right time for the SEE Health Network and the Ministries of health of its 10 member States to place health high on the political agenda of the SEE region and each and every Government in the frameworks of sustainable economic development and inclusive growth;

·         believe that new policies to promote health for all in our societies, aligned with improved legislation,  and universal and high quality individual and population-based services would provide the appropriate instruments  to resolve the major health challenges of SEE and raise levels of well being in the region., From a public health point of view, these measures combined will have a positive impact on the populations ´health, productivity, standard of living and, thus, to the overall growth and inclusive development process in this part of Europe.

·         note that existing health system reforms in the region need to be re-assessed and updated in the light of the Council of Europe’s conventions and recommendations on health, human rights and ethics, the European Union Article 152 of the Amsterdam Treaty, the EU Public Health Programme of Work, and the WHO Regional Office Health 2020 Policy and the European Action Plan for Strengthening Public Health Capacities and Services.

·         conclude that the health sector needs to acquire sufficient standing in all government policies, legislation and regulations, as well as in future obligations of the countries to implement EU legislation in this field, based on Article 152 of the Amsterdam Treaty. We believe that political input by the SEE countries would be beneficial to the processes of the EU Stabilization and Association, as well as to strengthening the public health and well-being in the SEE region.

To achieve these objectives, we, the Representatives:

1.      approve the Health Chapter, presented in Annex 1 of this Decisions, of the SEE 2020 Growth Strategy, the latter being subject to subsequent governmental consultations as well as endorsement by the end of 2013;

2.      request the SEE Health Network Presidency, Executive Committee and Secretariat together with the Regional Cooperation Council (RCC) and its all initiatives  to contribute to the finalization of the SEE 2020 Growth Strategy;

3.      request the SEE Health Network Presidency, Executive Committee and Secretariat, supported by the Regional Cooperation Council (RCC to develop the SEE Health Network own Health 2020 Strategy aligned to the SEE 2020 Growth Strategy, the EU 2020 and the WHO Europe Health 2020; the draft SEEHN Health 2020 Strategy and Action Plan to be submitted for approval to the 32^nd Plenary Meeting in Podgoritza, Montenegro, November 2013;

4.      commit ourselves to the thrust, goal, objectives and expected results of the SEE 2020 Growth Strategy ant its health for inclusive growth;

5.      request the Ministers of Health of the 10 SEE countries to endorse the above decision, to maintain continuous political commitment and support by mobilizing human and financial resources for the implementation of the SEE 2020 Growth Strategy, in particular the health objectives and actions;

6.      request the Governments of the SEE countries to place high political commitment to improving health of their countries ´populations and to take urgent measures for reducing inequalities in health by working with other sectors and stakeholders in society to address underlying determinants of existing gaps and to strengthen the equity focus of all health sector policies and services, thus directly contributing to inclusive development and cohesion locally, nationally and across the region.

 

7.      thank the Regional Cooperation Council and WHO Regional Office for Europe for their political, technical and financial support for incorporating the Health agenda in the Inclusive growth pillar of the SEE 2020 Growth Strategy;

The full text of the Health Chapter to the SEE 2020 Growth Strategy will be posted in the coming months as it is currently subject to multi-governmental consultation process.

 

Gaining Health in SEE through Improved Delivery of Individual, Community and Population-based Health Promoting Services

Another major decision was taken in relation to the multi-partner joint proposal for action in the 10 SEE countries. The partners are: the SEE Health Network, the International Network of Health Promoting Hospitals and Health Services, Project Hope, the Regional Cepter for Policy Analysis and Research "Studiorum" and WHO Regional Office of Europe.

 

This proposal foresees a concrete and practical step to scale up health promoting services, patients´ safety, quality of services and improved governance of health services in an integrated manner by all health services providers, namely Primary Health Care, Hospitals and Public Health Services, in 10 pilot regions. This action will be a practical step in implementing the commitments of the Banja Luka Pledge in preventing and contrillong noncommunicable diseases which present the main burden of diseases in the region.

 

This action is also part of the action package of the Health Chapter of the SEE 2020 Growth Strategy.

 

 

 

 

 

 

 

 

 

 

 

 

Health workforce, its mobility, planning and forecasting in the SEE

 

 

The 31st Plenary of the SEE Health Network was presented with the conclusions and recommendation of the European Commission TAIEX multi-country workshop on the implementation of the EC Directive 2005/36 on the harmonization and mutual recognition of health professionals qualifications in Europe.

 

A decision was approved to that effect. The full taxt of the decision can be followed on the previous post: http://www.blogger.com/blogger.g?blogID=5583286910239024408#editor/target=post;postID=6957517755220085901;onPublishedMenu=allposts;onClosedMenu=allposts;postNum=0;src=postname

 

 

The Presidency of Montenegro, 01 July - 31 December 2013

 

The 31st Plenary Meeting of the SEE Health Network approved the preliminary Roadmap of its activities during the forthcoming Presidency of Montenegro in the period 01 July - 31st December 2013.

 

The main heighlights will be related to:

• Finalizing the process of the financial yearly contributions of all the SEEHN Member States;
• Starting the process of selecting and recruitment of the international staff for the SEEHN Secretariat in Skopje, Republic of Macedonia;
• Consultation and endorsement of the SEE 2020 Growth Startegy where health aspects will be incorporated in most of its main pillars, including the Free Trade area, Governance, Inclusive Growth, etc.
• A number of technical regional workshops in the areas of  patients´ safety, scaled up delivery of health promoting services, reducing salt in food products for prevention and control of noncommunicable diseases, health workforce strangthening with primary focus on nursing, antimicrobial resistance, etc.
• The 32nd Plenary Meeting of the SEE Health Network in November 2013 in Montenegro with focus on Noncommunicable diseases prevention and control;
• Further representation of the SEE Health Network at various international Fora, such as the WHO Europe 63rd Session of the Regional Committee and the European Health Forum Bad Gadstein.

 

During the Closing session, the SEE Health Network had a humble but very emotional farewell ceremony for Ms. Snezhanna Chichevalieva, former National Health Coordinator for the Republic of Macedonia and former Chair of the SEE Health Network Executive Committee, who has dedicated her last 12 years of service to the SEE Health Network and has recently taken new duties as the Head of the WHO Europe Country Office in Skopje, Republic of Macedonia. On behalf of the Network, Minister Andrei Usatii expressed the deep gratitude, appreciation and recognition for her extraordinary work and contribution to the Network development since 2002.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Regional Workshop of the SEE Health Network on harmonization and mutual recognition of health professionals' qualifications in Europe

On 18-19 June 2013 a regional workshop of the SEE Health Network Member States on harmonization and mutual recognition of health professionals' qualifications in Europe took place in Chisinau, Republic of Moldova.

The workshop was organized by the European Commission TAIEX Programme with the kind support of the Ministry of Health of the host country and the SEE Regional Health Development Centre (RHDC) and Observatory on Health Workforce.

The participants, the SEE Health Network and the local organizers in the Republic of Moldova (Ministry of Health, and the RHDC on health manpower), express to TAIEX their gratitude for having just conducted the multi-country workshop on“Harmonization and mutual recognition of health professionals’ qualifications in Europe”. 

 

The active and constant participation of the Minister of Health of Moldova, Dr. ANDREI USANTII in the workshop must be commended.

This TAIEX Workshop, in view of the over 50 experts and participants from Austria, Bulgaria, Estonia, Romania and Slovenia, as well as all the South-Eastern Europe Health Network (SEEHN) countries  highlighted the key significance of the European Commission Directive examined at the Workshop in relation to the health manpower professions (with special reference to medical doctors) and provided a better insight into the legal and practical aspects of its implementation in the EU Members States and the current state of play in the countries of the SEEHN.

This examination highlighted the importance of this Directive in relation to:

• further enhancing the quality of health care and safety of patients in all the countries of the SEEHN, and providing high quality health services to the populations;
• ensuring good quality and competent health care to all people traveling between the countries of the SEEHN and to the countries of the SEEHN;
• the appropriate management of the mobility of medical doctors without and out of the countries of the SEEHN.

The TAIEX meeting identified the need for a follow-up to provide more in-depth assistance to the countries of the SEEHN in this very sensitive area, taking also into account the revision of the above mentioned Directive, currently in the final stages of adoption, and which introduces in particular the very important and sensitive issue of language competency. The meeting considered that an initial step should be the organization of TAIEX expert missions to the countries of the SEEHN.

The TAIEX meeting also discussed the recently inaugurated European Commission (DG SANCO) funded three years “Joint Action on European Workforce Planning and Forecasting” part of the Action Plan for the EU Health Workforce – improving workforce planning” adopted by the European Commission in April 2012.

The participants considered that this initiative is closely related to the health manpower concerns of the countries of the SEEHN and recommended that a close relation be established, possibly in the form of  Memorandum of Understanding between this EU initiative and the SEEHN, following the positive preliminary discussions with the leaders of this initiative – the Federal Public Service Health, Food Chain Safety and Environment of Belgium.

Following the TAIEX meeting, at the 31^st Plenary Meeting of the SEEHN under the Presidency of Moldova on June 20 and 21, a Decision was adopted in line with the conclusions and requests formulated at this present TAIEX meeting.

 

Decision

of the SEE Health Network on human resources for health and health workforce mobility in South East Europe

The background

Human resources for health have been embedded into the work of the South-eastern Europe Health Network (SEEHN) from its establishing in 2001 and are integral part of its mission: “To promote  the sustainable development of the SEEHN member states by improving the health of their populations through better and more intense cooperation, collaboration, integration, capacity building, and coordination in public health at regional level. This includes supporting reform of their national health systems and contributing to economic and social development” (1)

SEE Ministers have pledged in Dubrovnik Pledge, in the 2001:“We will meet the health needs of vulnerable populations in SEE mobilizing human and financial resources to the extent possible”(2)

The aspirations and goals of the Dubrovnik Pledge were subsequently reaffirmed by the Second Health Ministers’ Forum on Health and Economic Development in South-eastern Europe in the 21st-century (2005). The Forum culminated in the issuing of the Skopje Pledge (3), which confirmed the commitment of the governments of the member states to demonstrate the economic potential of health as a means to increase productivity and decrease public expenditure on illness and to assume full responsibility for regional cooperation through further work in technical areas to serve this goal (food safety, blood safety, accreditation of healthcare facilities, human resources for health, strengthening public health services, etc).

The SEEHN has developed a significant number of important projects aimed at improving the health of the populations in the Region since its inception. These projects included SEE region-wide training of relevant health professionals, as well as limited exchange of staff for training purposes. However, until 2007 the SEEHN has not addressed directly the increasing perceived growing geographic unbalance which exists (as to the availability of health professionals) both within countries and between the countries of the Region.

The first discussion document “Health Professionals within the South-eastern Europe region: Manpower Needs (and Manpower Mobility)” (4) was prepared for the discussions at the 17^th meeting of the SEEHN in 2007, calling upon major European developments in the respective area and especially  the WHO Regional Committee for Europe in its Resolution EUR/RC57/R1 of 2007 (5), the 8^th Conference of Ministers of Health (Council of Europe) on “People on the Move: Human Rights and Challenges for Health Care Systems”(6) and  the EU Directive 2005/36/EC on the Professional Qualifications (7).

“Health professionals are at the core of any country’s health systems, yet there are more efforts put into the increased efficacy of the financial and organizational aspects of these health care systems, as well as into regulating the patients’ movement, than in dealing with the health personnel.”(4)

Thet SEEHN Regional report on the “Evaluation of the Public Health Services in South-eastern Europe”,2007, considers explicitly the issue of professionals in public health. “In general there is a significant imbalance in the distribution of health professionals between rural and urban areas in most of the countries of the Region. Public Health professionals suffer from their low position in the health system (low wages, long periods of training and lack of general recognition and esteem for some professional areas could lead to shortages in recruitment and training – this is particularly important in those areas with ageing professionals). Furthermore there does not seem to be systematic human resource planning strategies in most of the Region – in some countries there is a lack of a planning unit within ministries of health for human resources and a lack of an adequate, regularized planning process”.(8)

SEEHN today is in the process of implementation of its Third Forum’s Pledge. SEEHN health ministers have specifically focused on increasing sustainability and country capacity by strengthening health systems and human resources in the Banja Luka Pledge (2011) under its pillar III/p.4: Strengthening public health capacities and services for control and prevention of non - communicable diseases.

The SEEHN Regional Health Development Centre on Human Resources in Health (RHDC on HRH), established in Chisinau, Moldova is a result of a more of a decade activities in the SEE that have scoped indirectly and directly the issue on human resources for health. It is considered by the SEEHN member states and partners as an important vehicle for further development of the SEEHN action at both sub-regional and national level, and for implementation of the Banja Luka Pledge.

Inauguration of this RHDC on HRH is a mayor cornerstone of further SEEHN work specifically focused on human resources in health in SEE and demonstrates commitment of both the SEEHN and WHO, Regional Office for Europe, as a representative to the SEEHN Executive Committee of the SEEHN partner international organizations, to the work of the SEEHN Regional Health Development Centre on Human Resources in Health in the SEE.

In implementing our national and European commitments, we acknowledge the need to strengthen further our human resources for health nationally and SEE region-wide in line with the  Directive 2005/36 of the European Parliament and the Council of 7 September 2005 on the recognition of professional qualifications and the WHO global code of practice on the international recruitment of health personnel, World Health Assembly, 63, http://www.who.int/iris/handle/10665/3090.

Taking all above into consideration, the SEEHN, at its 31^st Plenary Meeting in Chisinau, Moldova, has endorsed on the 21 June 2013 the following  decisions:

 

The Representatives:

1. Express their gratitude and acknowledgement to the European Commission  TAIEX programme  for organizing the Workshop on “Harmonization and mutual recognition of health professionals’ qualifications in Europe” for the SEE Health Network on 18-19 June 2013 in Chisinau, Republic of Moldova;
2. Thank the Ministry of Health of Republic of Moldova and the SEEHN Regional Health Development Centre and SEE Observatory for Human Resources for Health for their professional support to the SEE Health Network on this very important challenge;
3. Consider that it is the right time for the SEE Health Network and the Ministries of Health of its 10 Member States to place the challenges of human resources for health  high on the political agenda of the SEE regional cooperation and each and every Government in the frameworks of sustainable economic development and inclusive growth;
4. Commit ourselves to take further actions to harmonize national policies and legislation of all the SEEHN Member States in line with the European Directive of 7 September 2005 on the recognition of professional qualifications, in relation to the health professions covered by the Directive,
5. Adopt and implement the WHO global code of practice on the international recruitment of health personnel, [1]
6. Request the RCC to include the topic and action on mobility of the health workforce into the “Employment” dimension of the Growth Pillar of the SEE 2020 Growth Strategy;
7. Address the European Commission TAIEX Programme to extend its further support to the SEE Health Network in implementing the conclusions and recommendations of the TAIEX Workshop on “Harmonization and mutual recognition of health professionals´ qualifications in Europe”, Chisinau, 18-19 June 2013, and in particular to support EU Experts´ missions on behalf of the SEE Health Network to the 6  SEEHN Members states, non Member States of the EU to make an in-depth assessment of the current state on implementation of the Directive 2005/36 of the European Parliament and the Council;
8. Urge the SEE Health Network Presidency and Executive Committee to develop and sign a Memorandum of Understanding with the Federal Public Service Health, Food Chain Safety and Environment  of Belgium, Main Partner of the EU Joint Action on health workforce planning and forecasting so that the SEE Health Network becomes a collaborative partner to the EU Joint Action;
9. Thank the Medical University of Varna, Bulgaria for its kind invitation to host in 2014 a Forum of the SEE Medical Universities, Colleges and Schools of Public Health to design the future SEE regional strategy and actions in that respect and to re-vitalize the former SEE Public Health Network of health education universities, schools and professional organizations under the framework of the SEE Health Network;
10. Kindly request the Government of Slovenia to support a preparatory workshop on the human resources for health, their mobility, planning, forecasting, retaining, education and continuous learning in Ljubljana, Slovenia in the autumn of 2013 in the light of the SEEH consecutive actions on health inequities, social determinants of health and health systems/public health strengthening;

 

 

 

 

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[1] World Health Assembly, 63, http://www.who.int/iris/handle/10665/3090 .;