Summaries of contributions
Wendy Johnson, Health Alliance International; Donna Barry, Partners in Health; Shariful Islam, Partners in Population and Development; Eric Friedman, Physicians for Human Rights; David Egilman
We suggest the following changes:
Add to Article 1: “Promote practices that foster development of adequate health workforce levels, particularly in countries experiencing health worker shortages.”
Change ending of 3.7 to: “…merit support from wealthier Member States and donor institutions to avoid further weakening of health systems.”
In Article 4 or 5, discourage active recruitment of health workers from countries experiencing severe health worker shortages.
In Article 6, encourage international agencies and NGOs to examine their own practices that lead to "internal" brain drain or recruitment of health workers away from Ministries of Health and direct provision of care into private or non-governmental administrative roles.
In Article 6, encourage greater development assistance to “train, retain and sustain” the health workforce in developing countries.
Emphasize in 11.2 the importance of aid and economic policies in providing incentive for health workers to remain in their country of origin.
The draft does not explicitly distinguish between destination countries and source countries as some previous WHO documents on health workforce have done. It would be useful to acknowledge the power differentials between these two groups, perhaps in Article 3, and clarify which provisions of the code are most appropriate for each.
Valerie Tate, Nurse Alliance of SEIU Healthcare, Washington, DC, USA
While we support the recommendation that recruitment and placement services are rendered free of charge to healthcare workers, we think the Code should go further and call for:
- a ban on breach fees and
- set limits on recruiter compensation/profit margins.
We believe the Code should specify:
- migrant healthcare workers and
- labor unions among the stakeholders it recommends for involvement in decision-making processes.
Other elements that would further enhance the WHO Code, including:
- establish a WHO monitoring entity that would survey workers to ensure compliance,
- call on employers and recruiters subscribing to the Code to provide access to incoming workers for a survey,
- direct recruiters to avoid recruitment in countries that are experiencing a healthcare crisis or a chronic shortage during which health professionals are in dire need as defined by WHO,
- call on recruiters to provide a copy of the Code to prospective migrant health workers,
- promote remediation – an internal correction of system problems and
- de-list employers and/or recruiters who do not correct problems.