HOSPEEM-EPSU response to road map consultation on Cross-border healthcare – evaluation of patients’ rights (Directive 2011/24) 

HOSPEEM and EPSU were active in the process leading to the establishment of the Directive 2011/24, which regulates parts of the fundamental cornerstones of Member States’ health systems, such as the capacity to plan for the current as well as future needs within their respective systems. Reiterating the main messages from our joint letter from 15 December 2010, we would like to take the opportunity to underline that the Directive should aim to contribute to the quality and accessibility of patients’ care. Equal access to health care is a fundamental human right, which must be facilitated – to the extent possible – in the proximity of patients’ living surroundings or directly at the patient’s home, including through the use of digital solutions.

 It is paramount to support Member States to strengthen their national health systems, address the existing challenges and identify opportunities to create resilient health systems to improve patients’ cross-border healthcare access: This includes investment in health workforce and healthcare infrastructure comprising investment in working conditions to address health workforce shortages and medical deserts, access to continued professional development and life-long learning, coherent occupational safety and health prevention practices and guidelines as well as to reinforce equality in the access to healthcare between Member States and within them, taking into account the concept of integrated care. 

Download the HOSPEEM-EPSU response to road map consultation on Cross-border healthcare – evaluation of patients’ rights (Directive 2011/24)

10-year anniversary of the EPSU-HOSPEEM Code of Conduct on Ethical Cross-Border Recruitment and Retention

MEDIA RELEASE

In their first Working Group meeting of the European Social Dialogue in the Hospital Sector, on 04 April 2018 HOSPEEM and EPSU looked back to the signing of the EPSU-HOSPEEM Code of Conduct on Ethical Cross-Border Recruitment and Retention on 8 April 2008 and renewed their commitment to promote, guarantee and defend decent recruitment and working conditions for migrant workers, from the EU and from outside the EU, in hospitals and healthcare facilities across Europe. 

HOSPEEM and EPSU issued a Joint Media Release on the 10 years anniversary of the Code of Conduct. It represents an important instrument to support the free movement of workers across the European Union while preventing unethical competition between the Member States and employers in terms of cross-country recruitment process, fair and transparent contracting and the induction of migrant workers at the new workplace. This also holds for their equal and non-discriminatory treatment regarding labour law, social protection provisions and the access to training and career progression and the freedom of association.  

The EPSU-HOSPEEM Code of Conduct on Ethical Cross-Border Recruitment and Retention was inspired by social partner-based or/and public policy tools already in use in different European Union Member States. At international level, the World Health Organisation (WHO) on 21 May 2010 adopted and set into practice the WHO Global Code of Practice on the International Recruitment of Health Personnel. The Global Code, non-binding in nature, addresses a number of similar issues already covered with in the EPSU-HOSPEEM Code of Conduct. 

In the meeting on 4 April 2018, HOSPEEM and EPSU members reiterated their commitment to the 12 key principles of their 2008 Code of Conduct and to the promotion of ethical recruitment and retention practices at European, national, regional and local level in the upcoming years, both in their own work and in the broader context of the European Pillar of Social Rights. 

Tjitte Alkema, Secretary General of HOSPEEM reflected on the impact of the Code of Conduct: “10 years ago, our Code of Conduct was an inspiration for the work of the World Health Organisation. Nowadays, given the migration flows to and within the European Member States, it is still very relevant. 

EPSU General Secretary Jan Willem Goudriaan welcomed the constructive dialogue there has been with the European employers since the Code of Conduct. “We sought to ensure decent working conditions for all, to prevent the exploitation of migrant workers and to make sure public health systems are not undermined by unfair recruitment practices. Our Code was and is a significant contribution to achieve sustainable quality care for all.”  

At the meeting on 4 April 2018, several HOSPEEM members and EPSU affiliates commented on the use and positive effects of the EPSU-HOSPEEM Code of Conduct on Ethical Cross-Border Recruitment and Retention. They also referred to different models of how the 12 principles of the Code of Conduct have been incorporated in their national contexts, either into legislation, by means of collective agreements and/or by using enterprise-based agreements. 

Kate Ling, NHS Confederation, United Kingdom, gave an overview on the use by the employers in the NHS and about the effects of the Code of Conduct in the United Kingdom, showcasing some good practice examples: “NHS organisations should only use recruitment agencies that comply with the Code, which includes guarantees to give overseas recruits good induction, training and employment protection. A key tenet of the UK Code is that recruitment of staff from abroad should not damage healthcare systems in developing countries.  Active recruitment from developing countries shouldn’t take place unless there is a government-to-government agreement. For example, the UK and India have a scheme called Earn Learn and Return where staff from India can come to the UK to fill shortages in specialist areas, and in return they get the opportunity to gain specialist expertise and develop skills that they can then take back with them after they leave the UK to improve healthcare in India. So, both countries benefit.” 

Tjitte Alkema wrapped up the Working Group meeting, reflecting on the freedom of movement of persons in the European Union and the respective aim of the Code of Conduct: “We are in the European Union: one of the fundamental rights is the freedom of movement of people within the European Union. Our Code of Conduct is trying to establish a fair system of mobility in which people are not exploited and countries are not suffering from the mobility of workers. The Code of Conduct is however only as strong as the partners that support it. It only works if we also identify incorrect application, put them on the table and make them transparent. The WHO Code and the Code of Conduct of the Social Partners are complementary in the European setting.”

PDF - 304.4 koMedia release

EPSU has also published an article on the event and the 10-year anniversary celebration.

A new book sheds light on health professional mobility in a changing Europe

Published by the European Observatory on Health Systems and Policies this new book sheds light on health professional mobility in Europe. As health professional mobility is growing in importance, relevance and complexity, new insights and tools to understand it, measure it and manage it are needed. The aim of this 2nd volume is to provide just this by focusing on the changing dynamics, mobile individuals and diverse responses. The book’s 16 chapters are written to inform the ongoing policy processes and enrich debates between decision-makers and observers across countries, sectors and disciplines.

“Health professional mobility in a changing Europe. New dynamics, mobile individuals and diverse responses” PROMeTHEUS volume II – Edited by James Buchan, Matthias Wismar, Irene A. Glinos and Jeni Bremner, the European Observatory on Health Systems and Policies, 2014

To download the book for free click here

Tjitte Alkema speaks at the WHO meeting on mobility and recruitment of healthcare workers

2–3 May 2013, Amsterdam

World Health Organization Regional Office for Europe, in cooperation with the Western Pacific Region and the Royal Tropical Institute in Amsterdam, organised a meeting on policy dialogue on International health worker mobility and recruitment challenges.

The meeting took place at the Royal Tropical Institute in Amsterdam on 2-3 May, 2013. It aimed at analysing the challenges in implementing the WHO Code of Practice on International Recruitment of Health Personnel and identifying policy options, areas of technical cooperation to these challenges.

Among the participants invited for the second day session was Tjitte Alkema, Secretary General of HOSPEEM, who gave a presentation in the panel on “International recruitment and integration of migrant health workers”. It concerned HOSPEEM’s experience in implementation of the EPSU-HOSPEEM Code of Conduct on Cross-border Recruitment and Retention and the context of the Netherlands. The meeting was also an opportunity to discuss future WHO–HOSPEEM cooperation on the recruitment and retention issues.

The technical report of the WHO policy dialogue on international health workforce mobility and recruitment challenges is now avaible online.

Cross-border recruitment and retention: HOSPEEM-EPSU code of conduct

The European Federation of Public Service Unions (EPSU) and the European Hospital and Healthcare Employers’ Association (HOSPEEM) have jointly signed a code of conduct on ethical cross-border recruitment and retention.

Through the code of conduct the European social partners in the hospital sector want to address inequalities and unnecessary burdens on healthcare caused by unethical recruitment practices. With this agreement they establish in the European hospital sector social dialogue a full commitment to promote ethical recruitment practices at European, national, regional and local level.

The choice of the world health day 2008 as the date for the official signature of the agreement is not casual. The cross-border movement of healthcare professional is indeed an increasingly expanding phenomenon that clearly goes beyond European borders. With that global scope in mind, the European social partners wish that the code becomes a source of inspiration inside and outside Europe’s borders and remind that, in addition to European and national legislation and collective agreements, the already existing ILO-conventions in this field should be taken into account, when looking for an appropriate framework to support ethical recruitment and retention practices.

The Secretary General of EPSU, Carola Fischbach-Pyttel, added that, “Healthcare services are an essential part of the European Social model, therefore all relevant actors must be committed to their fair and effective functioning. The contribution of health care workers to good quality healthcare is essential. Social Partners therefore need to address the various challenges different countries are experiencing in terms of health workers shortages and the reasons why healthcare workers decide to migrate. Strategies which promote adequate workforce supply in all countries should be supported. EPSU and HOSPEEM want to encourage, and as far as possible contribute to, the development and implementation of policies at local, national and European level with the purpose to enhance work force retention”.

The Secretary General of HOSPEEM, Godfrey Perera stated that, “The promotion of ethical recruitment practices all over Europe clearly calls for a multifaceted strategy, including not only social partners but also governments, regulatory and professional bodies and other relevant stakeholders at local, regional national and European level. However, with the present agreement European social partners also want to firmly commit to their own responsibilities. For instance, when using the services of external agencies only those with demonstrated ethical recruitment practices should be used for cross-border recruitment. In case exploitative practices occur, these agencies should be removed from agreed lists”.

The code of conduct is based upon 12 key principles and commitments:

  1. High quality health care, accessible for all people in the EU
  2. Registration and data collection
  3. Workforce planning
  4. Equal access to training and career development
  5. Open and transparent information about hospital vacancies across the EU
  6. Fair and transparent contracting
  7. Registration, permits and recognition of qualifications
  8. Proper Induction, Housing and standards of living
  9. Equal rights and non-discrimination
  10. Promoting ethical recruitment practices
  11. Freedom of association
  12. Implementation, Monitoring and Follow-up

Background

The launch of the European Social Dialogue in the Hospital Sector in September 2006 was a crucial step in the development of industrial relations in Europe, as it gave the recognized social partners EPSU and HOSPEEM the possibility to take joint actions in the field of human resources, employment and social policies by using the social dialogue instruments. It also gave employers and workers both jointly and individually the possibility to give direct formal input on EU polices affecting the hospital sector and its workers. As employers’ and workers’ representatives we (the social partners) also want to take up our responsibilities as European social partners according to the provisions of article 138 of the European Treaty. Policy initiatives on the field of cross-border health care have many social aspects and will affect management and labour. FULL TEXT: HOSPEEM-EPSU Code of conduct – EN

The document will be soon available in 13 languages  :
HOSPEEM-EPSU Code of conduct – FR
HOSPEEM-EPSU Code of conduct – DE
HOSPEEM-EPSU Code of conduct – BG
HOSPEEM-EPSU Code of conduct – CZ
HOSPEEM-EPSU Code of conduct – ES
HOSPEEM-EPSU Code of conduct – FIN
HOSPEEM-EPSU Code of conduct – HU
HOSPEEM-EPSU Code of conduct – NL
HOSPEEM-EPSU Code of conduct – PL
HOSPEEM-EPSU Code of conduct – ROM
HOSPEEM-EPSU Code of conduct – RU
HOSPEEM-EPSU Code of conduct – SV

Example for the use and implementation of the EPSU-HOSPEEM Code of Conduct on Ethical Cross-border Recruitment and Retention from The Netherlands:

This table has been elaborated by NVZ (employers), ABVAKABO FNV, NU 91, CNV Publieke Zaak and FBZ (employees) to promote the implementation in The Netherlands : Table Dutch State of Play – EN , Table Dutch State of Play – NL

This presentation by Dutch social partners in the hospital sector describes the transposition of EPSU-HOSPEEM Code of Conduct on Ethical Cross-border Recruitment and Retention (2008) in The Netherlands: Slides by Elise Merlijn, ABVAKABO FNV, Rolf de Wilde, NU’91 and Tjitte Alkema, NVZ, 1 July 2011 – EN

Report on use and implementation of the EPSU-HOSPEEM Code of Conduct on Ethical Cross-border Recruitment and Retention (2008)

The document was adopted in the meeting of the Sectoral Social Dialogue Committee for the Hospital Sector working group 3/2012 on 5 September 2012 by EPSU and HOSPEEM. Final Report Use and Implementation – EN

Other related documents – WHO Code of Practice on the International Recruitment of Health Personnel:

The World Health Organisation Code of Practice was unanimously adopted by the 63rd World Health Assembly in May 2010: WHO Code of Practice (2010) and User’s Guide (2011)

Documents on the implementation of the WHO Global Code of Practice on the International Recruitment of Health Personnel :