By World Healthcare Journal-
On May 19 in Geneva, ahead of the World Health Assembly 2019, a group of international experts came together to discuss the issues facing the global health workforce, chaired by Stephen Dorrell, former Secretary of State for Health in the UK and Chair of World Healthcare Journal.
Specifically, the conversation centred around evidence-based policy recommendations and how they can be substantiated. The health workforce is a multi-faceted issue; it is based on people and the needs of people. Prerana Issar, Chief People Officer at NHS Improvement said of the health workforce:
“It is not a sector... it’s an ecosystem that touches every being on this planet. It covers doctors, nurses, social care workers, radiologists, porters etc. – all these professions come with a unique set of needs and issues."
The global health workforce is hurtling towards a crisis. The WHO has evidence to suggest that there may be an estimated 20% shortfall in health workers by 2030. There are not going to be enough workers to meet the population health needs on a global scale. There has never been a more pertinent time to invest in workforce strategy on a global and national scale.
Jim Campbell, Executive Director of the Global Health Workforce Alliance (GHWA) and Director of the Health Workforce Department at the World Health Organization (WHO), provided insight into Workforce 2030, the WHO’s global strategy on human resources for health. “In the 70 years of the WHO, we have never had such robust workforce data. ”
But data alone cannot affect change. Campbell was clear in his statement that evidence and ideas must come together at a point of contact that can drive change. The WHO is sitting on significant evidence that has been rigorously reviewed to inform their global strategy, but without putting this evidence in the hands of the right stakeholders there is no way to drive the change needed to solve the issues of the global health workforce.
Anban Pillay, Deputy Director General at National Department of Health in South Africa, provided the panel with examples of South Africa’s issues within their health workforce. He raised the issue of migration. In South Africa many native members of neighbouring countries will get their training at South African medical schools, as their home countries do not have sufficient infrastructure to train them. These foreign-born trained healthcare professionals then stay in South Africa to practice.
This has created significant tension on a national level. Parallel to this, thousands of patients will come from neighbouring countries to be treated in South Africa and the government has struggled to be reimbursed for the costs by the patients’ home countries, due to the high numbers of migration of their healthcare professionals into South Africa. This case study highlights the complexity of migration.
Mark Britnell, Global Chairman & Senior Partner for Healthcare, Government and Infrastructure at KPMG International and author of Human: Solving the global workforce crisis in healthcare, offered his analysis on migration:
“The history of human development is the history of human migration”. His findings have informed his opinion that migration is a fundamentally powerful and good force that can inform better practice globally. Jim Campbell reiterated this by referring to the "myth of migration" and making the statement "every single country is a source country and a destination country".
These global experts on the health workforce stand firmly behind the migration of healthcare workers as appositive force that will result in a stronger, more effective healthcare industry, on a global level. The healthcare workforce is intrinsically bonded with the needs of the population. Whilst basic healthcare needs haven’t and don’t change, the way the consumer interacts with healthcare has changed dramatically.
Niti Pall, Medical Director at KPMG’s Global Healthcare Practice and Mindy Daeschner, Chief Commercial Strategy and Marketing Officer at DoctorLink, have noticed a rising trend in the consumerism of healthcare, and do not believe that workforce is ready for this change in view.
This trend has been caused, in part, by the booming digital technology industry. The basic economic issue of the health workforce is that there is too much demand and not enough supply. If sheer numbers of bodies in the health workforce cannot meet this demand, how can digital technology be used to solve this cognitive dissonance in a new & novel way, whilst not compromising the importance of human interaction in healthcare?
Global strategy on workforce cannot be discussed effectively without covering regulation. Stephen Dorrell posed the question; how can regulation encourage clinical accountability whilst promoting dynamic service delivery? This is where the WHO can really add value to the governance of the health workforce. By utilising the significant data and evidence that the WHO sits on, it can support medical regulators across the globe in establishing that balance between accountability and dynamism.
This meeting on the global workforce established the need for evidence-based policy recommendations and strategy to inform the utilisation of workforce migration, technology and the shift in patient interaction with their healthcare system. These areas can only be truly innovative if regulation strikes the correct balance between clinical accountability and dynamic service delivery.
There is a sense of emergency about the health workforce issues and it is now the time to establish innovative and dynamic ways to solve this crisis, utilising the data and evidence that the WHO has collected.
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