Summaries of contributions
The objectives of the WHO code seem to have taken the important elements into consideration, i.e., equity in employment conditions, the facilitation of dialogue between recipient and donor countries and the management of migration.
Fernando Gonzalez-Martin, World Health Organization, Geneva, Switzerland
- Replace “health personnel” with “health workers”. The word “personnel” has been replaced by “human resources” in many professional circles, but “human resources” does not fit in this context.
- Although as a general matter domestically trained health workers receive preferential treatment vis-à-vis migrant health workers, there may be instances (particularly when a physician from a developed country travels to work in a developing country) where the migrant worker has more legal rights than the domestic practitioner.
- Article 1: Add objective “(e)” which is taken from Article 2.4: to promote an equitable balance of interests among health workers, source countries and destination countries.
- Article 3.9: Suggest deleting “race, colour” after a discussion as to whether these categories are subsumed by “ethnic origin”.
- Article 8.1 This provision only mentions national law and not international legal instruments. Is this deliberate or simply an oversight? Suggest using the stock phrase “in conformity with national legislation and applicable international legal instruments to which they are a party”.
- Article 9.5: Suggest deleting “to the extent possible” because it seems redundant.
Linda Silas, Canadian Federation of Nurses Unions, Ottawa, Canada
Article 1: Include an overview of the global shortage of health workers and the problems caused by the systematic recruitment of health workers from small, remote or developing countries and states. 3.1 would fit better here.
Article 3: Begin with the need for countries to make substantial efforts to develop and sustain a pool of health workers from within their own country before turning to other nations for recruitment.
3.4 Define the principles of transparency, fairness and mutuality of benefits.
4.3 Emphasize the need for internationally recruited health workers to be well informed prior to engagement not only of position requirements, but also of country requirements, codes of practice, and any relevant cultural or community based information.
4.9 Mention the provision of mentoring and supervision of migrant nurses during a transition period.
Article 6: Emphasize that existing shortages do not validate the recruitment of migrant health workers where the system lacks a solid foundation to support the retention of existing health workers and recruitment of domestic workers.
Include regulatory bodies and unions in 5.2, unions and employers in 8.1, unions in 9.1 and 9.3, and add the International Council of Nurses to the third bullet in 10.3.