Time to Act -  Improving working conditions for health workers

2nd Joint EPSU/ILO-ACTRAV 2-day Regional Health Conference in Almaty, Kazakhstan October 2023

2nd Joint EPSU/ILO-ACTRAV 2-day Regional Health Conference in Almaty, Kazakhstan

(6 November 2023) On 20-21 October EPSU affiliates from the health and care sectors in Central Asia and South Eastern Europe participated in  a two day conference Time To Act: Joint EPSU/ILO-ACTRAV Regional Health Conference on improving working conditions for health workers. in Almaty, Kazakhstan.  The joint event was hosted and organised by the EPSU affiliated trade unions in Kazakhstan and supported by ILO/ACTRAV and Bakytzhan Tazhibay, the President of AQNIET also announced they are celebrating 100 years of the Trade Union of Healthcare Workers of Kazakhstan (AQNIET).

The meeting brought together 36 affiliates from 7 EPSU member unions from across the region and representatives from World Health Organization (WHO European Region), International Labor Organization (ILO/ACTRAV) and the European Health Management Association (EHMA). Social Partners were also present including the Head of the Almaty Public Healthcare Department and the Vice Minister of Healthcare of the Republic of Kazakhstan.  Speakers were represented both in person and virtually, and reflected on issues facing health care workers such as staff shortages, changing technologies, an aging workforce, psychosocial risks, third party violence, not just in Europe but also all around the world.

EPSU General Secretary, Jan Willem Goudriaan, framed the conference purpose as an opportunity for workers and experts to take part in discussions about the problems facing the health and care sector, which have also been exacerbated by the COVID pandemic, and our common vision of better working conditions and good quality jobs for health and care workers. The resilience of the sector is also facing additional challenges with the cost-of-living crisis and climate change, and we need to work to make the sector stronger.

We heard updates on the situation from the countries represented which included staffing (retention and recruitment) and shortages, along with the increasing incidents of violence (from patients or their families) towards health workers, psychological burn-out, low or falling salaries, lack of management support and lack of possibilities for learning and progression, were identified as some of the priority issues facing the sector in trying to protect the existing workforce and make it more attractive for recruitment.

Sergejus Glovackas, Desk Officer for Europe and Central Asia, ILO Bureau of Workers' Activities (ACTRAV) and Gocha Aleksandria, Sr. Specialist for Workers’ Activities, ILO regional office for Eastern Europe and Central Asia provided an overview of the main decision adopted at the last ILC including on quality apprenticeships, climate change and just transition, CAS discussions of the cases of most blatant incompliances with ILS including in Europe and Central Asia. They also reflected on the challenges with labour and trade union rights in Kazakhstan and wider subregion dwelling on increasing incidents of Trade Union leaders being imprisoned and activists losing their jobs and with some governments placing restrictions on Unions right to strike. It was emphasized that the current political climate is not always conducive to changing legal frameworks to respect social dialogue. Union leaders should not be in prisons, there is a right to freedom of association and a right to strike.  Social Dialogue, collective agreements and strong Unions are needed to support and protect workers. However, they also highlighted some of the positive actions and progress that has taken place in the region.

Participants listened to a presentation by Yana Andersen – representative of WHO Europe on the activities of WHO Europe and the Framework for action on the health and care workforce.  The Bucharest Declaration was discussed with Adam Rogalewski (EPSU Health and Social Services Policy Officer) summarizing the 10 priority areas contained in the Declaration.  It was noted that there are twice as FEW essential health care workers in the Central Asia and Eastern European regions than the average indicator for European Regions, the numbers of nurses and doctors is very low, although it was also acknowledged that data collection is fraught with difficulties.  The Bucharest Declaration urges changes in the retention of health care workers and reductions in staff shortages. This also led to a discussion on migration and the problems of qualified health care personnel migrating to other countries for better pay creating problems in countries where staffing is already stretched.

The topic of Third Party Violence in the workplace was discussed and Adam Rogalewski presented the Multi-sectoral project on “the role of social partners in preventing third-party violence and harassment at work" | EPSU.  Afterwards and Gocha Aleksandria, Sr. Specialist for Workers’ Activities, ILO regional office for Eastern Europe and Central Asia presented the ACTRAV’s perspective on trade unions role in promoting ratification and effective application of the ILO Convention 190 on Violence and Harassment . he also spoke about the importance  of protection of health and safety including mental health and stress and how that affects staff. It was agreed that violence and harassment can come from employers, coworkers, patients or their families and that this is a major source of stress and participants shared some of their own experiences.

The European Union Pact for Skills in health ‘BeWell’ project was presented in an online video by George Valiotis, European Health Management Association (EHMA) Executive Director. The BeWell project is a strategy that contributes to Life Long Learning for European Health and Care professionals.  Discussion on the differences in CPD/LLL and requealification between countries took place. Refresher and recertificaiton courses should be free of charge and paid by the employer.

The conference delegates agreed after the 2 days of discussions, exchanges and presentations that in order to protect the health and care workforce the problems surrounding Third Party Violence, Continuing Professional Development and the ILO Convention 190 and working conditions are important and highly relevant issues. In order to not only be able to provide high quality care to recipients, but also ensure care and protection for themselves, workers need to be protected and supported.  Workplace health and safety conditions not only affect the health care workers but also the health of a nation. EPSU is committed to supporting and strengthening the Region and will continue the joint annual conference with ILO/ACTRAV tradition started in Batumi, Georgia in 2022.