Summaries of contributions
Ministry of Public Health, Thailand
The title should be “The WHO code of practice on the ETHICAL international recruitment of health personnel”.
Health workers should be distinguished between professionals and non-professionals. Priority should be given to health professionals and specialists who required licensure, since they have high disruptive impact to the health systems of source countries. In addition, paramedics are not priority in international recruitment and not difficult to produce.
Constructive and feasible measures to mitigate the negative impact to source countries should be emphasized; Article 5 should be elaborated and exemplified.
Before 3.3 add: “Recognizing the moral imperative and social obligations by all health workers, especially when they are trained at the societal cost by the source countries or using the poor patients for their training, to serve the country health systems and public health interests”.
Add 3.6bis: Member States should work towards effective retention of health workforce in order to prevent exodus of international migration of health workers. Policies and measures for health workforce retention should be appropriate for the specific conditions of each country and should be integrated with national health, social and development policies/programmes.
The Ministry of Public Health made several others specific comments which will be taken into consideration in the next iteration of the Code.
International Labour Office - Comments provided by the following ILO departments and branches: International Labour Standards (NORMES), International Migration (MIGRANT), Sectoral Activities (SECTOR), Workers’ Activities (ACTRAV)
We wonder whether the draft (e.g. 3.3 and 3.4) provides adequate direction and guidelines to the stakeholders on the issues it is supposed to cover. It would be helpful if the code would be accompanied by guidance providing more details on how to translate the principles into practice.
We suggest making reference to specific relevant standards and instruments in 3.5 and 4.2, such as UN and ILO conventions, for a better guidance of the stakeholders in the application of the Code.
It is noted that the draft Code does not make reference to the need for social dialogue in formulating policies and taking relevant measures. It is therefore proposed that a standard reference to “full consultations with representative employers and workers organizations concerned” be inserted in a number of provisions, for instance 3.6, 4.1, 4.7, 6.1, etc.
The definitions of stakeholders in 2.2 and 3.10 need to include references to “trade unions” or “representative workers organizations”, in addition to the “health professional organizations” mentioned.
ILO made several specific comments on the articles which will be taken into consideration in the next iteration of the Code.
Tijsma Anke, Wemos Foundation, Amsterdam, Netherlands
- 3.2 should be: “All Member States have the sovereign right and obligation to develop and strengthen their health systems”.
- Add a principle to Article 3 recognizing the obligation of all Member States to international assistance and cooperation, to fulfill the right to health particularly developing countries and avoid weakening of health systems.
- 3.6 should be: Member States should ensure establishing effective national health workforce planning that will preclude their need to recruit migrant health personnel.
- Article 4 should urge Member States and private actors to refrain from active recruitment in countries with a health workforce shortage.
- Article 4.8 should make mention of recruiters and employers from both the private and public sector.
- In Article 6.1 a health workforce plan should also be rights-based.
- In 11.2 add that the financial support should be long-term and predictable, stress the importance of aid and economic policies ought to be geared towards providing incentives for health workers to remain in their country of origin. Member States that tend to be “destination” countries have an obligation to avoid any active recruitment and should assist “sending” countries to retain their staff.