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Monday, June 24, 2013

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 31st 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 17th 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 8th 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 31st 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;