Hospital sector social dialogue: skills mix, workforce planning and leadership

The European Social Dialogue Committee in Hospitals held a ‘New Skill Needs’ seminar on 16 September 2009. HOSPEEM and EPSU participants exchanged experiences in these three areas (skills mix, workforce planning and leadership).

The seminar was chaired by Kim Ost-Jacobsen of the Danish Nursing Organisation. Concretely, the main decision was to establish a drafting group to explore these issues further and to submit a position paper to the Hospital Social Dialogue Plenary session, scheduled for 8 December 2009.

The Social partners identified that one of the main challenges was to improve the status of healthcare staff by offering clear and attractive career paths for both women and men. It is therefore important to find the right mix of skills in order to free up more staff time for the treatment of patients. Potential avenues to practically apply this include: proper identification of new skill, identifying and addressing where skill shortages (and over-capacity), occur, and outlining clear leadership ‘paths’ to ensure retention of highly qualified staff.

Background: At the Plenary meeting on 4 December 2008, EPSU and HOSPEEM decided to develop a social dialogue instrument either in the form of a framework of actions or guidelines. The instrument should cover skills mix, leadership in the hospital sector at all levels and in all areas and workforce planning at macro level.

New Skill Needs Background Paper

Joint Framework Agreement on prevention from sharp injuries

The Joint Framework Agreement on prevention from sharp injuries in the hospital and healthcare sector

The European Hospital and Healthcare Employers’ Association (HOSPEEM) and the European Public Services Union (EPSU) today signed an EU-wide agreement to prevent injuries from needlesticks and other sharp objects.

The Joint Framework Agreement was concluded after five months of negotiations by the European social partner organisations in the sector, which employs around 3.5 million people.

Background
In 2006, the European Parliament adopted a resolution requesting the Commission to submit a legislative proposal on protecting healthcare workers from blood-borne infections due to needle stick injuries.
After the two-stage consultations on this issue, in 2006 and 2007, the EU social partners decided to organise a technical seminar with all stakeholders (nurses, doctors, surgeons and so on), which highlighted the many causes of injuries in hospitals and healthcare services.
In December 2008, they informed the Commission of their intention to negotiate on a wider basis covering all types of sharp injuries (including needle sticks). The negotiations, to which the commission provided technical and logistical support, started in January 2009 and were completed on 2 June 2009.

The agreement aims to:
– achieve the safest possible working environment for employees in the sector and protect workers at risk;
– prevent injuries to workers caused by all types of sharp medical objects (including needle sticks);
– set up an integrated approach to assessing and preventing risks as well as to training and informing workers.

At the request of the European social partners and after having examined their representativeness and the legal conformity of the text, the Commission intends to submit, after the summer, a proposal to the Council for implementation of the agreement by a directive, in accordance with article 139 of the Treaty. The agreement specifically addresses one of the priority objectives of the EU’s current strategy for health and safety at work (2007-2012).

FULL TEXT: HOSPEEM-EPSU Sharp injuries signed joint agreement

EU health ministers to let the national experts run their national healthcare systems

Press release

Hospital Social Partners urge EU health ministers to let the national experts run their national healthcare systems

We cannot let market forces run healthcare systems or we will end up with a two-tier system of healthcare delivery” said Godfrey Perera, General Secretary, European Hospital and Healthcare Employers association (HOSPEEM).

The Hospital sector employers and trade unions in Europe today joined forces to send a message to EU Health Ministers. The Social Partners for the sector were speaking on the draft EU directive on cross-border healthcare which is being discussed by EU Health Ministers in Luxembourg today.

The European Federation of Public Service Unions (EPSU), represented by Karen Jennings (UNISON, UK) and the European Hospital and Healthcare Employers association (HOSPEEM), represented by Mr. Perera sent the joint message to the EU Health Ministers before 600 public service trade unionists at the EPSU Congress in Brussels.

They urged the EU Ministers to base the directive on a joint legal basis of public health and the internal market. The joint basis would have allowed Member States to ensure that all citizens have equal rights to high quality healthcare based on medical need, and not just the ability to pay their travel, accommodation and other costs.

EPSU Chair of the Healthcare Committee, Karen Jennings:
“The EU Ministers, meeting today, have a chance to put this health debate back on the right track, by recognizing that the universal principles of healthcare solidarity are the starting point and not the internal market”.

Secretary General of HOSPEEM, Godfrey Perera:
“To guard the principle of healthcare systems based on solidiarity, national healthcare systems must have the right to organise those systems – to do this, they need proper prior authorisation abilities”.

The issue of allowing Member State to give prior authorisation to patients, who wish to travel, remains a major issue, as is the need to consider the subject of rare diseases under separate legislations. The EU Health Ministers are expected to conclude discussions tomorrow, 10 June.

For further information, please contact:
EPSU: Brian Synnott +32 474 98 96 75 | E-mail: epsu@epsu.org
HOSPEEM: Valeria Ronzitti / Gin Ngan +32 2 229 21 57 | E-mail: hospeem@hospeem.eu

HOSPEEM is the European Hospital and Healthcare Employers Association. It regroups at European level national , regional and local 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.

EPSU is the European Federation of Public Service Unions. It is the largest federation of the ETUC. 8 million public service workers from over 200 trade unions are members. They organise workers in the energy, water and waste sectors, health and social services and local and national administration.

Social Partners announce EU-wide agreement on Medical Sharps injuries

EPSU 8th Congress: European Hospital Social Partners announce EU-wide agreement on Medical Sharps injuries

Press Communication

First EU wide text agreed by Hospital trade unions and employers set to prevent over one million injuries per year.

The European Hospital Social Partners – The European Federation of Public Service Unions (EPSU) represented by the President of EPSU health Committee, Karen Jennings and the European Hospital and Healthcare Employers’ Association (HOSPEEM) represented by General Secretary, Godfrey Perera have announced, before 600 trade union leaders attending the EPSU Congress, a European agreement, which is set to prevent over 1 million medical sharp injuries per year, for healthcare workers.

Welcoming the agreement, Karen Jennings stated that “this represents tremendous progress for the European Hospital social dialogue process, but most importantly it makes a clear and positive contribution to the working lives of Europe’s healthcare workers.”

Godfrey Perera said that “ this deal is in the interest of the Hospital Employers, who have a moral obligation to protect their workers health and safety, but who gain also in financial terms as good protection decreases any days lost for these highly trained hospital staff.”

The aim of the negotiations (successfully concluded) was to reach a European-wide agreement on measures to tackle the issue of injuries from sharps (such as needlesticks) in hospitals. This issue has been estimated to cause up to one million injuries to healthcare staff per annum.

The European Social Partners will ask for the Commission to present this agreement to the Council of Ministers to implement it through an EU directive.

The Social Partners (HOSPEEM and EPSU) met with Commissioner for Employment and Social Affairs Vladimir Spidla on 20 January 2009. Mr. Spidla expressed his support for the negotiations and stated that he was pleased that the European Social Dialogue process was being used to address such an important health and safety issue.

This is the first formal agreement between the European Hospital Social Partners.

Commissioner on ‘Sharp Injuries’ negotiations

Hospital Social Partners meet Employment Commissioner on ‘Sharp Injuries’ negotiations

Representatives of the European Hospital Social Partners met with the European Commission for high level talks on the upcoming ‘Sharp Injuries’ negotiations.

The Social Partners (HOSPEEM and EPSU for hospital employees) met with Commissioner for Employment and Social Affairs Vladimir Spidla on 20 January. Mr Spidla expressed his support for the upcoming negotiations and stated that he was pleased that the European Social Dialogue process was being used to address such an important health and safety issue.

The aim of the negotiations is to reach a European-wide agreement on measures to tackle the issue of injuries from sharps (such as needlesticks) in hospitals. HOSPEEM Secretary General Godfrey Perera and EPSU General Secretary Carola Fischbach-Pyttel (pictured with Commissioner Spidla) had previously sent a joint letter to the Commissioner announcing their intention to start formal social dialogue negotiations on the issue of sharp injuries in hospitals. The Social Dialogue talks are due to start on 26 January 2009.

HOSPEEM-EPSU ‘Sharp Injuries’ negotiations letter to Commissoner Spidla

Green paper on EU health workforce

Green paper on EU health workforce: Commissioner Vassiliou calls for social partners’ contribution

Press Communication

European Hospital and Healthcare Employers’ Association (HOSPEEM)
European Federation of Public Service Unions (EPSU)

On Monday 14 July a joint Hospital Social Partner delegation met Commissioner Vassiliou.

Commissioner Vassiliou explained the rationale for promoting the Cross-border Healthcare Directive. She underlined in particular the need for better collaboration between the Member States as well as the establishment of centres of excellence as one major objective of the directive. Christina Carlsen, while welcoming the intention of bringing legal clarity, expressed HOSPEEM’s concern that the planning capacity at national level might face new challenges. “It will be difficult to foresee what flow of patients we have to expect”, said HOSPEEM Vice Secretary General. According to the Commission services this directive would count for 1 % of the EU population with a perspective to increase to 4 % in the future. The bulk of medical treatment will continue to be delivered at home. Where medical treatment is sought abroad this will be delivered mainly under the provisions of regulation 1408, for example during major sports events. “If this is the case, why not adapt the existing regulations in accordance with EU jurisprudence?” asked Carola Fischbach-Pyttel, EPSU.General Secretary. “We therefore wonder what exactly the added value of the proposed directive will be?”

Importantly, Commissioner Vassiliou agreed on the need to develop structured cooperation with the Hospital Social Partners in the future. DG SANCO intends to publish a Green paper on health workforce, in December 2008.

The European-wide lack of qualified health professionals and the migration of health care professionals within and across the European Union borders require a common policy at European level.

Commissioner Vassiliou invited the social partners to address the questions related to health staff shortages in Europe. The role of employers and workers is a key factor when it comes to successfully developing and implementing these policies”

The starting point for an had hoc input of the social partners to the ongoing Commission work will be the Code of Conduct and follow up on Ethical Cross-Border Recruitment and Retention in the Hospital Sector, signed in April 2007. The text deals with many of the aspects the Commission is intending to tackle, such as strategies to promote ethical cross border recruitment and to prevent acute staff shortages in the so called “donating countries”.

The meeting of the Health Commissioner with the EPSU and HOSPEEM leadership marks a significant step in the relations between the European Commission and European Social Partners in the hospital sector.
-ends-

For further information, please contact:

HOSPEEM: Gin Ngan +32 2 229 21 58, hospeem@hospeem.eu
EPSU: Tamara Goosens +32 2 250 10 80, tgoosens@epsu.org

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

Patient’s rights directive proposal: Further clarity needed

Godfrey Perera, Secretary General of HOSPEEM, today commented on the European Commission’s proposals in relation to the application of patients’ rights in cross border healthcare

“As hospital and healthcare employers, HOSPEEM welcomes any action that will benefit patients within the constraints of affordability for each Member State and which does not threaten the viability of health systems. Although HOSPEEM has concerns about some of the European Commission’s proposals, it is pleased that the Commission is trying to resolve the current impasse and uncertainty. HOSPEEM believes that healthcare should be guaranteed by a clear legislative framework and not be subject to uncertainty created by court judgements. It is also vital that issues such as patient safety, reimbursement of costs and the right to legal redress are resolved. However, the Directive, as currently drafted seems to go beyond the rulings of the ECJ, by making it very difficult for the Member States to ask for prior authorisation for hospital treatment abroad. This might have serious consequences for the organisation, financing and delivery of healthcare in European Member States.”

While patient’s rights to treatment abroad have been enshrined in European law, HOSPEEM believes that the Commission’s proposals also have the potential to create health inequalities. Although all patients will have rights to access healthcare in other Member States, only the mobile and well informed patients will be able to benefit. What about the patients who are not mobile? According to the Commission’s figures, they represent over 90% whose healthcare needs are met through care provided by their domestic system.

HOSPEEM takes the view that further clarification is needed about the authorisation process. We believe that patients should be required to go through prior authorisation procedures in their home country before seeking hospital care abroad and asking to be reimbursed for this care. Prior authorisation procedures allow healthcare systems to monitor their finances, plan the delivery of services and the management of the healthcare workforce.

HOSPEEM members believe it is important that when patients go abroad for treatment then their home health system, as the financer of the care, is able to decide what treatment is most appropriate. HOSPEEM takes the strong view that Member States should be able to retain the right to plan services and manage resources in order to ensure the financial viability of their health systemsand that the European Commission do not go beyond their competences in this area
HOSPEEM is concerned that the draft directive could also create extra bureaucratic burdens for health systems which could prove expensive and time consuming.

Therefore we want to ensure that all the ramifications of the Commissions’ proposals are properly considered and look forward to working closely with the European Commission, the Council and the European Parliament, so that the views of European hospital and healthcare employers are taken in to account. Moreover, we look forward to see included into the debate the position of the hospital sector social partners as expressed in the joint statement on health services in the European Union.

To conclude, said Godfrey Perera, “We hope that the co-decision procedure will provide answers to the questions we are putting forward today and will give us back a text that will genuinely be helpful to all EU patients and healthcare providers.”

EPSU-HOSPEEM Joint declaration – December 2007

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 :