It is essential that the EU leads in preparing the second wave of COVID-19 – and potentially the next pandemic – by ultimately facilitating the creation of a “healthcare army” that can move freely throughout the EU and deploy their competences and knowledge where patients most need them.
Prof. Jozef Kesecioglu
President of ESCIM
The European Parliament Interest Group on Innovation in Health and Social Care held a virtual roundtable on 1 October 2020, entitled “Transforming Healthcare: A European healthcare workforce” to discuss how to improve healthcare systems in Europe from the perspective of healthcare professionals. The purpose of discussion was to define concrete solutions to ensure that health workers have the necessary skills and knowledge to tackle diseases outbreaks while tackling the uneven distribution of healthcare systems capacity within the European Union.
MEP Tomislav Sokol (EPP, Croatia) co-chair of the EP Interest Group on Innovation in Health and Social after welcoming the speakers and participants highlighted the problems faced by healthcare sector and the general shortage of medical professionals. A number of Member States are experiencing outflows of medical staff leading to an increasingly worrying brain drain in such a vital sector. While highlighting one of the pillars of the European Union, freedom of movement, and the need to have mutual diploma recognition across Europe and minimum requirement systems. MEP Sokol also stressed on the need to implement retention measures that strengthen the healthcare systems at a national level. The EU’s multi-annual financial framework is an important tool that could be used to address and implement structural reforms of healthcare systems. The European Commission’s original proposal on the EU4HEALTH budget was a step in the right direction, however, the Council has already decided to reduce the budget allocation earmarked for health. The EP will continue working for more funds to be directed towards improving health systems EU-wide. Cohesion policy funds even if cannot directly address the health brain drain, however, they can be used to improve working conditions and to invest in medical infrastructure which would incentivise workers to give their services at home.
The other co-chair of the EP Interest Group, MEP Irena Joveva (Renew, Slovenia) focused on the importance of the healthcare sector. “The capacity of health systems to address the changing needs for care, as well as the current pandemic, strongly depends on their workforce, its availability, its safety, skills and equipment to tackle disease outbreaks and raising demand of care.” said MEP Irena Joveva. The European Commission has taken important and concrete actions to foster healthcare workforce education across borders, also through providing funding for the training of a multidisciplinary pool of healthcare professionals supporting and assisting Intensive Care Units (ICUs), the C19_SPACE training programme. MEP Joveva highlighted the need to build a European long-term strategy that embraces innovative processes and solutions to the weaknesses of the current European health systems. She also called for a revamp of the Action Plan for EU health workforce that anticipates future needs and skills required in future emergencies and disease outbreaks.
The first speaker of the webinar was Prof Jozef Kesecioglu, President of the European Society of Intensive Care Medicine (ESICM), who emphasised the need to be prepared for the next wave of the Covid-19 health crisis especially through the assistance of personnel working in ICUs. The Emergency Support Instrument of the European Commission, which helps Member States in their efforts to address the coronavirus pandemic, and DG SANTE is funding a training programme C19_SPACE to support healthcare professionals in the European Union to acquire intensive care skills. The training will provide intensive care skills to healthcare professionals, doctors and nurses alike, not regularly working in ICUs or just starting their career in ICUs and will be available cost-free to healthcare professionals across the EU until the end of December 2020. The aim of the training program C19_SPACE is to reach professionals in all the 27 Member States and the UK, working in 1,000 hospitals with a minimum of 10,000 healthcare staff to be trained.
Ms Maria Teresa Parisotto, Executive Director of European Specialist Nurses Organisation (ESNO), stressed that currently in Europe there are significant differences between healthcare education systems. To be better prepared for future health emergencies there should be more harmonisation across the EU and enable nurses to be able to easily work in other countries should the need arise again. Ms Parisotto gave an overview of the nursing sector in Europe and highlighted the difference in nomenclatures, education levels and other criteria between the Member States. The importance of the nursing sector has been elevated during the last months and there is now a necessity of establishing a common training framework across the EU in order to ensure easier movement of healthcare workers in time of need.
Discussing the importance of a digital transformation within the health sector, Mr George Valiotis Executive Director of European Health Management Association (EHMA), highlighted the key role of: education of healthcare workforce and the need to reorganise relationships between health actors as essential elements to transform healthcare for the benefit of the entire society. The digital transformation requires dynamic and new skills, as well as embracing the potential that AI has to offer in the health field. The need for at least a certain skill level to be obtained at the end of formal training should be harmonised across the EU, even though the Treaties do not legally allow for outright harmonisation of educational requirements which remain a national competency.
As stated by MEP Sokol ‘Within the tight limitations of the current EU health policy competencies, it is possible to certain incentives that could encourage Member States to align and improve their educational systems especially for nursing through financing mechanisms, individual projects and management assistance’..
Mr Bert van Caelenberg, Secretary General of European Federation of Public Service Employees (EUROFEDOP), once again stressed how the Covid-19 pandemic highlighted the crucial role that healthcare staff play in society. The so-called “brain drain” of medical professionals has destabilising effects on the sending countries, especially since the leaving workers are usually younger in age leaving behind an aging workforce with added burdens. The outflow of workforce is not only attributable to low wages but also to poor working conditions that push personnel to look for work abroad. As previously mentioned, there is the need to harmonise training programs in Europe which would directly improve healthcare systems across the EU. It is also important to note that there exists an uneven digital capacity in Europe which also needs to be addressed through proper training of the healthcare workforce.
The last speaker of the roundtable was, Ms Kate Ling on behalf of the European Hospital and Healthcare Employers’ Association (HOSPEEM), who focused on the challenges being faced by the healthcare sector. The sector is experiencing staff shortages combined with an aging population as well as an aging workforce, but the demand for services is also increasing. This situation requires more than just an increase in recruitment but the need to tap into new ways into how services can be delivered, such as through AI and ICT solutions. Staff needs to be equipped with the adequate technologies but also must be properly trained. Opportunities for upskilling must be available for all staff and new solutions should empower personnel to better carry out their job and not threaten them. Ideally, staff should be involved in the design and development of new ways of working in order to overcome resistance and ensure that solutions actually work.
In the closing remarks all panellists agreed on duty and opportunity to rebuild and strengthen our health systems and co-create safe, innovative, robust and resilient health systems which are future proofed against any upcoming health related emergency shocks. It urges to agree, at least, on a minimum requirements in health workers` education and training to build an effective European health workforce able to tackle public health emergencies and to enable greater freedom of movement of staff, while still allowing the flexibility for Member States to add requirements domestically.