WHO European Region’s lessons learnt from the pandemic echoes EPSU position

©CanStockPhoto obencem Giving helping hands for elderly people

(22 September 2022) This year the main focus of the Committee were the lessons learnt from the pandemic, improvements in Primary Health Care (PHS) and mental health.  

EPSU, the Standing Committee of European Doctors (CPME) and others led the joint statement on the need to support health and care workers, this being one of the main lessons learnt from the pandemic. The statement was support by the European Nurses Federation, as well as by 7 other organisations including the European Forum of Medical Associations (EFMA), European Medical Students' Association (EMSA), Humatem, International Federation on Ageing (IFA) and the World Federation of Occupational Therapists (WFOT).

The statement underlines the need to have an integrated approach to health and social care, developing measures to achieve adequate, needs-based staffing levels (safe staffing levels), improve working conditions including addressing psychosocial risks and stress as well as sustainable investment in the public services. These reflect long-standing demands of EPSU. The statement calls on governments to put pressure on employers to strengthen social dialogue as well as to address the problems of international trade agreements.

The statement reads:

We welcome the acknowledgment given to healthcare professionals and all workers in our health and social care systems in the document on lessons learnt from the pandemic and the general work of the WHO European Region. We also welcome that one of the lessons learnt is the region needs to invest in the workforce and infrastructure. 

We would like to draw the attention of governments to the necessity of increasing their efforts to have more funding in public health systems in order to retain the existing workforce and increase recruitment.  This implies a stronger commitment from governments towards a sustainable and adequate financing of public services, including health and social care to enable universal access to them.  We still need more pressure on employers to strengthen the social partnership.   To that end we would like to stress the importance of developing measures to address adequate and binding levels of qualified staffing, not only during health emergencies but also in normal times and guarantee the rights to patient-centred quality care for all including vulnerable population such as older persons.

Furthermore, we urge governments to provide all healthcare staff and healthcare students with a safe working environment and adequate mechanisms to prevent any type of violence so as to decrease the risk of exhaustion and burnout for all healthcare professionals, and to deploy all necessary means to protect the physical and psychological integrity of our colleagues during this pandemic and beyond. The health sector should be, and must remain, a safe and attractive place to work.

Lastly, supply chain practices including international trade agreements must be reviewed to prevent future shortages of personal protective equipment, medical devices and therapeutics.

During the meeting the report Drawing light from the pandemic: A new strategy for health and sustainable development was presented. It was commissioned by the WHO and drafted under the leadership of Professor Monti, the former prime minister of Italy and former European Commissioner.

The report echoes many of EPSU demands in particular in relation to its objective 4: Invest in strong, resilient and inclusive national health systems. The document, among other things, recommends to the Member States to:

4.1 Increase all investments in health systems, particularly in those parts of systems that have traditionally attracted fewer resources, such as primary and mental health care, while ensuring that this investment is directed in ways that maximise the ability of health systems to deliver the best possible health for those who use them.

4.2 Invest in and strengthen the health workforce in the light of experiences during the pandemic, with a focus on ways of attracting, retaining and supporting health and care workers throughout their careers, coupled with reviews of how the roles of health workers can evolve, given the rapidly changing nature of medicine and technology.

4.3 Reassess and strengthen the links between health and social care in the light of experiences during the pandemic, with the goal of increasing integration between them.

4.4 Prioritise prevention of communicable and noncommunicable diseases and scaling up of investment in public health capacities.

Regarding the workers salaries the report rightly states, like EPSU, that applause is not enough.  The workers’ struggles have ……

……. been recognised, with politicians offering public thanks and other gestures of appreciation. However, this is not enough. In many countries, health workers are poorly rewarded. Their salaries are lower than those with similar levels of education and, in some countries, there is a tacit understanding that they will supplement their incomes with informal payments. Their prospects for career progression are limited, with rigid hierarchies and, as a consequence, many of them leave the health systems in their countries for better prospects abroad, for opportunities in other sectors, or simply to exit the workforce altogether. This is not just a problem of wasting scarce skills and expertise. There is also compelling evidence that health facilities that attract and retain staff, such as hospitals with Magnet accreditation, provide better quality care, including, crucially, fewer hospital-acquired infections.

For these reasons, the Commission calls on governments to undertake reviews of their strategies to strengthen the health workforce in the light of the experience during the pandemic, with a focus on ways to support these essential workers throughout their careers.

Of particular importance is the recommendation 4.3. which echoes EPSU’s calls to strengthen the links between health and social care and to increase better integration among them.  We wrote about this earlier for the Social Europe. The report goes on to say:

The avoidable deaths of so many people living in residential facilities will, for many families, be remembered as a defining characteristic of the pandemic. For too long, social care has been the poor relation of the health system. Few governments have put in place systems to fund it adequately, despite clear warnings from demographers about ageing populations. The necessary decisions can no longer be postponed, especially given evidence from several countries of further declines in birth rates during the pandemic. [...] The Commission recommends that governments and agencies involved in the funding and delivery of health and social care should undertake a reassessment of the links between these different elements of care in the light of experiences during the pandemic, with a view to overcoming the systemic failures that were magnified during the pandemic.

These are important recommendations which should remind governments about the need for improving working conditions including wages of health and social care workers and draw enough attention for the social care sector by, among other things, reversing its privatisation.

These recommendations are also valid for the EU in terms of its initiatives in relation to European Health Union and the 5 billion euro budgeted for the EU4Health programme from 2021 to 2027. We expect them to be reflected in the announced Long-Term Care report and the European Strategy on Care announced by the Commission President in her State of the Union address: https://www.epsu.org/article/newly-announced-european-care-strategy-must-prioritise-critical-workers

EPSU will continue its work to ensure that the money and initiatives focus on directly improving working conditions of health and care workers and social care.

From 15th to 18th September 2021 the Regional Committee for Europe of the World Health Organisation held its annual meeting. EPSU/PSI are the only European federation of trade unions accredited to the WHO European Region. This region gathers 53 countries from Western Europe to Central Asia. EPSU was represented by Adam Rogalewski, Policy Officer responsible for health and social services.

Here are links to EPSU written statement

and joint position with other recognised partners

Here is the link to Monti’s report in English, Russian, German and French