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The challenge of the changing health labor market

The challenge of the changing health labor market . Gilles Dussault EUREGIO III 3rd Master Class Programme 2 3 March, 2011 . Overview. Why discuss health workforce issues (HW) now ? What needs to be done to find the right balance?. Why discuss HW issues now ?. Needs change

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The challenge of the changing health labor market

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  1. The challenge of the changing health labor market GillesDussault EUREGIO III 3rd Master Class Programme 23March, 2011

  2. Overview • Why discuss health workforce issues (HW) now? • Whatneeds to bedone to findtheright balance?

  3. Why discuss HW issues now? • Needschange • Demandchanges • Supply changes • Many alerts: WHO reports, EU Green paper/Conclusions • Time lag

  4. Education pipeline Nationals trained abroad Immigration Contracting Statutoryretirement Stock/ supply of health workers Composition Distribution Attrition Emigration Returners A simple model of health labour market dynamics (stock and flows) • Socio-demographic, economic, • organizational, legal determinants

  5. Needs change • Agingpopulation • Epidemiological profile (chronicdiseases, mental health, re/emergingdiseases) • Values (religiousrequests, palliative care, euthanasia) • New diagnosis/treatmenttools and strategies

  6. Aginginthe WHO-EUROPE Region, EU and CIS

  7. Demand changes • EU HealthPolicy, Cross-border directive • WHO renewedprimary care policy • New organizationalstrategies: team work, integration of services, ambulatory/home care. Telemedicine • Medicalization of healthylife • Betterinformed, more demandingusers (average time of consultations)

  8. Supply changes • Aging: Average/nurses = 41-45 in Den., Isl., Nor., Swe., Fra. • Scaling-up of general practice, of nursing (expandedfunctions) • Values and expectations (work-life balance, non-financialincentives) • Mobility: within countries, between countries, im/emigration(freedom of movement, Bolognaprocess, Blue EU Labour Card)

  9. GPs, Denmark

  10. Predicted shortages • England 2010: 14,000 nurses (Mooney H, 2007) • Netherlands: 7,000 nurses(Simoens et al 2005) • Norway: 3,300 nurses(Askildsen et al 2003) • Switzerland: 3000 nurses(Irving J 2001) • USA • 500000 nurses (2025) (Buerhaus et al. in print) • 44000 (2025) family practitioners (Colwill 2008)

  11. Estimated shortage of HRH(DG-SANCO)

  12. Migratory flows: ‘push’ e ‘pull’ • Compensation • Working conditions • Working environment • Better career opportunities • Access to specialized training • More security and stability • “Global CodeofPracticeontheInternationalRecruitmentofhealthpersonnel” Source: Buchan J et al 2003

  13. % physicians and nurses with foreign nationality(OECD 2007)

  14. Which workforce? • First, need to answer a few tricky questions: • Where do westartfrom? • Future healthneeds? • Which services? How willtheybeorganized? • Whowill do what? • How will supply and labour market evolve? • How much are weprepared to spend?

  15. Which workforce? • Whatisthe capacity of the country, of individualorganizations? • To attract/recruit the right type of future healthworkers • To educate/train them • To employthem • To retainthem

  16. What countries can (should) do? • HW policy in line with services and health policies • Build the information base (numbers, availability, productivity, projections, expectations, multiple employment, privatesector) • Mobilize stakeholders in support of change • Mobilize resources and capacity

  17. Conclusions • The toughest challenge: building the workforce of tomorrow • Aglobalapproach is needed • How to move from awareness to effective action?

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