For the past six months, Belgium has held the presidency of the EU Council, working, among other things, to address the chronic shortage of health workers in the European Union. As the term concludes, however, progress is hard to see. In response, activists and trade unionists are mobilizing to shape a just health workforce policy in Europe.
They will meet in Brussels on June 29 and aim to tackle problems caused by regional policies, such as the recruitment of health workers from abroad to fill staffing shortages, which creates issues both within Europe and globally. According to the organizers of the conference Care for care workers, including the People’s Health Movement (PHM) Europe, Viva Salud, and the Association of Democratic Doctors (Verein demokratischer Ärztinnen, vdää), it is impossible to talk about the global health workforce shortage without addressing issues of solidarity between high-income and low-income countries, as well as power dynamics within different parts of Europe.
Read more: Europe struggles with health workers shortage but fails to address demands for decent salaries
Health workers from Eastern Europe and bordering countries like Georgia face extremely poor working conditions, caused by imposed cuts to public expenditure and a growing focus on strengthening of the private sector, leading to mass migration to Western Europe. However, upon arrival, they encounter understaffed workplaces, long hours, and excessive overtime.
Considering that this situation has persisted for decades, the organizers question if the time has finally come to address the root causes of both the migration and the poor working conditions in destination countries. “If working conditions in the health sector of many countries are so poor, it raises the question: is migration truly a choice for health workers, or is it their only option,” they ask.
Recruiting health workers from the Global South exacerbates shortages in those regions. Countries like Germany continue to recruit without reflecting on their role in global health worker shortages, claiming current agreements are fair. Most recently, German health officials described bilateral agreements with Brazil and India as “triple-wins.” These agreements, which facilitate the mass recruitment of nurses from these countries—both of which are already struggling to employ enough health workers—have further undermined the stability of India’s and Brazil’s health systems. However, they have allowed Germany to recruit well-trained health workers at a fraction of the cost of training them locally.
Read more: Will Germany’s bid to address shortage of nurses put more pressure on Brazil’s health system?
At the same time, trade unions across Europe face resistance from governments in securing adequate salaries for health workers and must find ways to include migrant workers in their organizing efforts. This has proven to be daunting at least, as migrant workers are often employed on insecure contracts and are largely too intimidated, from the fear of losing their jobs and status, to join local workers in their struggles.
The current approach to health worker training and recruitment reinforces power dynamics between the Global North and South, making it difficult for low-income countries to uphold the right to health. “Under the existing global power dynamics, the patterns of health worker migration ultimately leave the poorest populations behind,” the organizers told People’s Health Dispatch.
Strengthening links between health workers, migrant communities, and health system users is essential for a fair global health governance model, according to the organizers of the conference. The Brussels meeting is a step toward achieving this goal.
People’s Health Dispatch is a fortnightly bulletin published by the People’s Health Movement and Peoples Dispatch. For more articles and to subscribe to People’s Health Dispatch, click here.
