European Hospital & Healthcare Employers’ Association

“Strengthening Social Dialogue in the hospital sector in the new Member States and candidate countries”

Project funded under budget heading 04.03.03.01 (Industrial Relations and Social Dialogue)

FULL TEXT: National Reports Overview | National reports

Introduction

After several years of pre-social dialogue process led by the Joint Representative Taskforce[1], the Committee on social dialogue in the hospital sector (henceforward: the Committee) will soon be established. The Committee aims to improve the quality of employment and quality of services in the hospital sector by means of constructive social dialogue.

Adequate representativity of EPSU and HOSPEEM is an important condition for success. However, social partners from new Member States are not yet very well represented in the European Social Dialogue. Moreover, the situation and status of Social Dialogue within some of these Member States leaves much to be desired. A strong national dialogue is a conditio sine qua non for adequate representativity in Europe. In turn, a high level of representativity will make the sectoral dialogue more effective at the EU level. Hence, capacity-building in the new Member States is a major priority in the work programme of the Committee.

In this project HOSPEEM, EPSU and national social partners from Czech Republic, Slovakia and the Netherlands have joined forces to strengthen the Sectoral Social Dialogue in the EU 27 and to increase representativity in the Social Dialogue Committee. They wish to remove some of the main obstacles for constructive dialogue on national and EU level. They will combine theoretical and practical methods to tackle problems of a different character, thus optimising the final project result.

Link to the objectives and priorities of the budget heading

This project is the first major initiative of the Social Dialogue Committee for Hospitals after the formalisation in September 2006. This project will support the implementation of a major issue of the work programme of the Committee, i.e. strengthening Social Dialogue in the new Member States and candidate countries. It will also help to increase the representativity of social partners in the EU Social Dialogue, especially from the employers’ side. Finally, the pilot activities will contribute to the development of the three major topics defined in the EPSU-HOSPEEM work programme 2006-2007(ageing, recruitment and retention, skill needs).



[1] The Joint representative task force in the hospital sector was founded in 2002 by members of EPSU and CEEP involved in an informal social dialogue since 1999.

Social Partners’ work programme 2008-2010

Work Programme 2008-2010

EPSU and HOSPEEM agreed in the Social Dialogue Committee for the Hospital Sector on 7 December 2007 to continue their work and their joint partnership approach as developed during the period of their first work programme in 2006-2007. This work will serve as basis for further activities in the Hospital Sector Social Dialogue as presented in this work programme. The work programme will cover a period starting from the date of signature until 31 December 2010. This timing gives the Social Dialogue Committee better opportunities for planning, complete and follow up on the priorities for the period. Halfway in the period the Committee will take stock on the work in order to make eventual changes in the planned activities and priorities where appropriate.

The main priority for HOSPEEM and EPSU in the coming years is to strengthen the social dialogue in the hospital sector at European, national and local level and take up our responsibilities as the recognized social partner European organizations for employers and workers in the hospital sector.

Future skill needs in health care

Thessaloniki, 22-23 May 2008

Cedefop in cooperation with the European Social Dialog Committee in the Hospital sector in the European Union (HOSPEEM and EPSU) organised a workshop aimed to identify the key trends and future skill needs in the health care sector.

It paid particular attention to the interaction between technology, ICT and skill needs, management of health care and education and training needs in the sector.

Workshop presentations and papers are available on the CEDEFOP website

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 :

 

 

Joint statement on EU and healthcare

The European Federation of Public Service Unions (EPSU) and the European Hospital and Healthcare Employers Association (HOSPEEM) have jointly signed a declaration on health services in the EU.

EPSU-HOSPEEM Joint declaration – December 2007

  HOSPEEM General Secretary Godfrey Perera, and EPSU head of Health, Karen Jennings sign joint declaration on Health Services

The declaration, which marks the first formal joint position between the EU social partners for the hospital sector, sets out clear principles upon which the management, financing and delivery of healthcare in the EU should be based.

The declaration is particularly timely as the European Commission is scheduled to publish a draft directive on cross-border healthcare in the coming weeks. The Commission draft has already caused some controversy on the way cross-border mobility of patients (a phenomenon that currently involves 1% of EU patients) should be regulated.

The Secretary General of HOSPEEM, Godfrey Perera stated that, “this declaration sends a clear signal that healthcare employers and workers have the interests of patients at the heart of our work. For that reason, we call for decisions on health services to be based on what is best for the patient, not on political theories or on the expansion of internal market rules.”

The EPSU Secretary General, Carola Fischbach-Pyttel, added that, “As the recognised social partners in the hospital sector, we hope that this declaration allows the European Commission to realise that the foundation of quality healthcare in the EU is equal access for all, based on medical need, and not an open market based on cost and ability to pay.”

Key passages in the declaration:

• It is not for the European Institutions to impose market and/or competition mechanisms in the health care sector, which could have as consequence the lowering of standards and increasing costs of health care systems and thus diminishing the accessibility to care.

• Health care should therefore be organised on the basis of common European social values including solidarity, social justice and social cohesion.

• They should also follow the principles of general interest, like equality, accessibility and quality.

• It is essential that EU-internal market or competition rules do not limit the EU Member states’ autonomy in the implementation of these national responsibilities.

Background
The launch of the European Social Dialogue in the Hospital Sector in September 2006 is a crucial step in the development of industrial relations in Europe, as it gives the recognized social partners EPSU and HOSPEEM the possibility to take joint actions on the field of human resources, employment and social policies by using the social dialogue instruments. It also gives 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.

HOSPEEM response to the Commission questionnaire on the practical implementation of Directive 2003/88/EC concerning certain aspects of the organisation of working time

Introductory comments

This paper summarises the responses received from HOSPEEM members to the Commission’s questionnaire. As a general remark, HOSPEEM members believe that patients should not be treated by tired staff and that staff are entitled to fair working conditions. While the Working Time Directive has been fully implemented by HOSPEEM members, the Directive and the subsequent rulings of the European Court of Justice (ECJ) have caused the hospital and healthcare sector problems and have imposed significant and unnecessary costs on hospital and healthcare employers.

The main problems emerging from the SiMAP and Jaeger judgments are around the interpretation of the term working time for on-call duties and the requirement for immediate compensatory rest. These rulings have caused serious problems in the operation of health systems and have led to Members States recruiting extra staff to prevent gaps in patient services at a large cost without improving productivity.  HOSPEEM members have been both gainers and losers.  In order to resolve the problems caused by the SiMAP and Jaeger judgments, some HOSPEEM members recruited staff from outside Europe as well as healthcare staff from the new Member States.  Losing staff in this way has had a large adverse impact on those health systems.

FULL TEXT: HOSPEEM Answer WTD questionnaire

HOSPEEM response to the first stage of consultation of the social partners on protecting European healthcare workers from blood-borne infections due to needlestick injuries

The Issue

The European Commission has launched a first stage consultation of the European Social Partners (according to article 138 of the EC Treaty) on protecting European healthcare workers from blood-borne infections due to needlestick injuries. The consultation follows the adoption on 6th of July by the European Parliament of a resolution (hereby “the EP Resolution”) that calls the Commission to bring forward a legislative proposal for a Directive amending Directive 2005/54/EC.

The questions that the Commission is asking are:

  1. Do you consider it useful to take an initiative to strengthen the protection of European healthcare workers from blood-borne infections due to needlestick injuries?
  2. Do you think that a joint initiative by the European Social Partners under Article 139 of the Treaty establishing the European Community would be appropriate?

Position Statement

Needlestick injuries, whilst stressful and with the potential for transmission of a blood-borne infections to staff, are not a major cause of incidents in the healthcare sector in Europe. HOSPEEM members believe that there is sufficient legislation, at European and, consequently, national level, to manage and control the incidence of needlestick injuries, provided that legislation is followed.

Effective management of needlestick injuries requires proper risk assessment, effective and regular training and updates and the provision, in those areas identified by risk assessment as being the most at risk, of safer devices that, if properly used, will reduce the transmission of blood-borne infections. It is not necessary, in areas identified as having little or no risk of transmitting bloodborne infection, to introduce more expensive safer devices.

HOSPEEM supports the principle of subsidiarity in this field. It is the responsibility of Member States to determine the details of regulations the framework of which has been set at European level. This is the approach, for instance, taken by Directive 200/54/EC. HOSPEEM would like this approach to be respected.

FULL TEXT: Response to the first stage of consultation of the social partners on protecting European healthcare workers from blood-borne infections due to needlestick injuries

Response to the Consultation regarding Community action on health services

HOSPEEM is pleased that the Commission acknowledges the general interest nature of healthcare services. These irreplaceable services perform special missions and are provided directly or are controlled by the public authorities or entrusted to specific actors who are responsible for them.  They are therefore subject to a process of public regulation under the general supervision of the Member State based on the objectives of the public policies assigned to them with respect to public health.

HOSPEEM would like to underline the important nature of health services and the requirement of access to quality health services for all citizens.  It recalls that it is the responsibility of Member States to define and to organise the services in question as well as the scope of coverage of the health and social needs to be satisfied, in keeping with the principles of subsidiarity and of universal access to healthcare services in the Member States. Furthermore, healthcare services are characterised by asymmetric information between the principal (the patient) and the agent (the doctor). Therefore, we consider as main result that economic allocation of the usual market mechanisms do not apply in this area, but rather resources are planned/organised by the respective authorities.

In view of the diversity of the services concerned and the variety of approaches, organisational and funding methods in the Member States, HOSPEEM welcomes an in depth consultation on these matters.

At the end of this consultation process, the relationship between a possible general framework on services of general economic interest and potential legal initiatives on health services should be answered. Furthermore, any future Community action should include an assessment of the potential impact on national healthcare systems.

FULL TEXT: Response to the Consultation regarding Community action on health services

First formal meeting of the European Social Partners

Topics for discussion include International recruitment practices and hospital workforce age profile

PR EPSU-HOSPEEM SEPT 2006 | PR EC SEPT 2006EN – Speech – van der PAS | Booklet SD Hospital

  Mr François Ziegler presents the documents for signature to Mr Godfrey Perera, HOSPEEM Secretary General and Ms Karen Jennings (UNISON, UK) EPSU Standing Committee on Health and Social Services President

The European Federation of Public Service Unions (EPSU) and the European Hospital and Healthcare Employers’ Association (HOSPEEM) today met jointly in the first formal meeting of a European Sectoral Social Dialogue committee for the hospital sector.

HOSPEEM General Secretary, Godfrey Perera stated that, “To get to this point where representatives of the hospital workforce and management in the European Union can get together to discuss topics is a tremendous achievement. HOSPEEM is fully confident that this collaborative process will make a valuable contribution to the issues facing the hospital sector in the EU.”

EPSU General Secretary, Carola Fischbach-Pyttel added that, “EPSU and HOSPEEM have identified three key areas in the hospital sector where a European approach provides added value; recruitment and retention, the age profile of workers in the sector and the new skill needs required of hospital personnel are all areas that will benefit from being tackled collectively. This process will be a cornerstone in any EU debate on the hospital sector.”

The establishment of the committee represents the first occasion that there will be formal recognition of social partners in the hospital sector at the European level. This is an extremely significant step as it allows the workers and employers to have a direct formal input on EU polices affecting the hospital sector.

Over the last 5 years, as the social partners for the hospital sector at European level, EPSU and HOSPEEM have been working, with European Commission support, to formalise sectoral social dialogue at the European level. The successful agreement to establish a committee marks the end of the ’informal stage’ and the beginning of genuine social partner engagement at the European level for the sector.

The social dialogue process is supported by the Directorate General for Employment and Social Affairs of the European Commission. The formal committee will consists of trade union and employer representatives from all over the 25 EU Member States.

The social partners have agreed a work programme for 2006-2007 that will concentrate on:

  • Recruitment and retention of personnel in the hospital sector;
  • The age profile of the hospital workforce;
  • The new skill requirements for the workforce in the sector.

These items will be linked to items, which are high on the political agenda.

If you want to arrange interviews with EPSU or HOSPEEM leadership or with delegations from one of the countries, please call EPSU press officer Brian Synnott,+32 474 98 96 75 or HOSPEEM secretariat, +32-2-2292157.

For information please contact:

EPSU: Tamara Goosens or Brian Synnott, + 32 2 2501080, email: epsu@epsu.org
HOSPEEM: Valeria Ronzitti + 32 2 2292157, email: hospeem@hospeem.eu

EPSU is the European Federation of Public Service Unions. It is the largest federation of the ETUC. 8 million public service workers and their 213 trade unions are members. They organise workers in health and social services, local and national administration, energy, water, waste. In the health and social services sector EPSU organises 3.5 million members

HOSPEEM is the European Hospital and Healthcare Employers Association. It regroups at European level national employers’ associations operating in the hospital and health care sector and delivering services of general interest, in order to co-ordinate their views and actions with regard to a sector and a market in constant evolution. HOSPEEM is an individual member of CEEP.

HOSPEEM-EPSU Social Dialogue Conference, March 2006

Promoting realistic active ageing policies in the hospital sector

Introduction

This study charts the age profile of the hospital sector workforce in Europe and identifies and analyses initiatives within the hospital sector that have addressed the issue of an ageing workforce. The European Federation of Public Service Unions (EPSU) and the European Hospital Employers’ Association (HOSPEEM) commissioned the study, which received support from the European Commission under budget line 04.03.03.01.

The development of European level social dialogue in the hospital sector started with a conference in May 2000. A second conference took place in 2002, which underlined the importance of developing dialogue in the light of enlargement. The conference also highlighted two key issues for the sectoral social dialogue, issues around free movement of workers and skill shortages faced by hospitals in numerous Western European countries. While these issues remain, active ageing is increasingly topical and its profile continues to increase mainly because of the demographic changes, the poor position of older workers in the labour market and recent developments taken by governments to increase retirement ages.

The HOSPEEM/EPSU conference on 16-17 March 2006 was the fourth pan-European meeting with the core aim of formalising the social dialogue in the hospital sector in the EU. The initial findings of this study were presented at the conference. This final report presents the research findings and takes into consideration comments and views from conference participants. More specifically this report provides an overview of the age profile of the hospital sector workforce in the EU (EU-25), as well as outline differences between the ’Old’ (EU-15) and ’New’ (EU-10) Member States in more detail.

In addition to an overview of the hospital sector, a series of case studies of regional and local initiatives that aim to address the challenges of demographic change and promote realistic active ageing measures among the hospital sector workforce are presented. National initiatives supported both by employers and unions have also been included.

Finally, this report also assesses ways in which sectoral social dialogue at the European level can help to address the issue of an ageing workforce.

FULL REPORTS: EN – Ageing Policies | FR – Ageing Policies

Identifying successful training initiatives in the hospital sector

Aims and objectives of the study

The key aim of this report is to analyse how the social partners in the hospital sector have addressed the issue of meeting new skill needs and the adaptation of existing job profiles to deal with the new challenges and requirements facing the sector in Europe. This study informed a key debate during the conference “Formalising the European sectoral Social Dialogue in the Hospital Sector” in 2006 and is intended to inform the ongoing dialogue between EPSU and HOSPEEM.

The report provides a short overview of categories of health professionals and workers. It also discusses skill needs and workforce challenges in the hospital sector. It then analyses the key trends in the evolution of the roles and responsibilities of these professions as well as the role of professional qualifications in the ability to undertake new roles. This analysis also examines the potential or existing difficulties in introducing new definitions of roles and new skills. The report will then provide examples of national initiatives to introduce new skills to health professional and workers and identify a route map on how the above mentioned issues could be addressed by the social partners in the framework of sectoral social dialogue. The report will summarise the main findings in the conclusions.

It is not the aim of this study to elaborate all existing job profiles among hospital sector staff and the training requirements for each role in different EU Member States. The emphasis of this study is on the key challenges facing the European hospital sector relating to technological, economic, social and demographic change and the way in which this is affecting skill requirements and job profiles. It provides examples of how training and job profiles have been adapted in different countries to meet these requirements in order to act as an inspiration for the social dialogue process.

FULL REPORTS: EN – Skills | FR – Skills

Cross-border recruitment of hospital professionals

Overview of the study

This study charts the migration profile of the hospital sector workforce in Europe and identifies and analyses initiatives within the hospital sector that have addressed the issues arising from a mobile workforce. The European Federation of Public Service Unions (EPSU) and the European Hospital Employers’ Association (HOSPEEM) commissioned the study to inform the development of a social dialogue in the hospital sector, which received support from the European Commission under budget line 04.03.03.01.

The development of European level social dialogue in the hospital sector started with a conference in May 2000. A second conference took place in 2002, which underlined the importance of developing dialogue in the light of enlargement. The conference also highlighted three key issues for the sectoral social dialogue; issues around free movement of workers, skills shortages faced by hospitals in numerous Western European countries, and the problems presented by an ever increasing workforce.

The HOSPEEM / EPSU conference on 16-17 March 2006 was the fourth pan-European meeting with the core aim of formalising the social dialogue in the hospital sector in the EU. The initial findings of this study were presented at the conference. This final report presents the research findings and takes into consideration comments and views from conference participants. More specifically this report attempts to provide an overview of migration patterns amongst the hospital sector workforce in the EU (EU-25) and to assess ways in which sectoral social dialogue at the European level can help to address the issues presented by migration and mobility among the hospital workforce.

FULL REPORTS: EN – Mobility | FR – Mobility

For information please contact:

EPSU: Tamara Goosens or Brian Synnott, + 32 2 2501080, email: epsu@epsu.org
HOSPEEM: Valeria Ronzitti + 32 2 2292157, email: hospeem@hospeem.eu

EPSU is the European Federation of Public Service Unions. It is the largest federation of the ETUC. 8 million public service workers and their 213 trade unions are members. They organise workers in health and social services, local and national administration, energy, water, waste. In the health and social services sector EPSU organises 3.5 million members

HOSPEEM is the European Hospital and Healthcare Employers Association. It regroups at European level national employers’ associations operating in the hospital and health care sector and delivering services of general interest, in order to co-ordinate their views and actions with regard to a sector and a market in constant evolution. HOSPEEM is an individual member of CEEP.