4 July 2019
The need for health workers is increasing worldwide. Simultaneously, the international mobility of health workers is accelerating.
The achievement of Universal Health Coverage in many countries is dependent in large part on the service provided by migrant health workers. At the same time, international health worker mobility has the potential to compromise progress in others. This report advances important debate on this complex, and often sensitive, topic. The UK is a central player in advancing a more enlightened approach to managing international health worker mobility, as this report acknowledges.
Its National Health Service is the world’s fifth largest employer, with substantial and potentially growing, reliance on migrant health workers. And it is, and has been, one of the most outstandingly generous contributors to the development of health services in Africa and Asia, spending 0.7% of its national wealth on citizens overseas and regularly deploying its NHS staff to share skills and expertise.
It is the call for greater coherence and cooperation that sits at the heart of this report, which bravely searches for an ethical way forward, where all benefit. The WHO Code of Practice is a central pillar of such an ethical approach, and I am glad the report highlights this. But the report goes further, drawing on THET’s long history of partnering with the NHS to improve health services overseas. As such, THET, an NGO in Official Relations with WHO, puts forward evidence and an ethical position which needs to be heard and debated. Collaboration, is indeed the way forward.
Across countries, the health workforce is fundamental to achieving health and the broader-SDG related goals. At the same time, the international mobility of health workers is increasing and growing in complexity. Projections point to substantial acceleration in the period ahead.
A strengthened approach to ethically manage international health worker mobility, as called for in the report and as articulated in the WHO Global Code of Practice, is needed to ensure that all, countries and stakeholders, advance together towards the SDGs.
The main message of this report is one of coherence and cooperation. The UK has an important opportunity to advance its leadership through strengthening policy coherence at the national and international levels. This includes balancing reliance on foreign-trained health workers with targeted international support to health workforce development, employment and retention in vulnerable countries.
The full value of social spending, particularly public spending on health and education, has largely been unrecognized by economic and political actors. Indeed, social spending has been peripheral rather than central to macroeconomic policy discussions. The UN High Level Commission on Health Employment and Economic Growth, and the IMF’s recently announced approach to social spending, seeks to rectify this. Spending towards the education and employment of health workers is an investment in decent work, in health, in inclusive economic growth, and in gender equality. It is not a cost.
The UK’s role in this area cannot be overstated. As a leading global employer of health workers and a champion for the Sustainable Development Goals, UK leadership in this area has important worldwide implications.
It is hoped that all concerned – from national governments to health workers themselves – will explore and debate the report and its’ recommendations and together seek to advance coherence and cooperation in this area.