Unions demand urgent action on health workers shortage and quality of care

Global trade union organization Public Services International concluded a survey which suggests most health workers are contemplating leaving their profession as global health workforce crisis intensifies

October 19, 2023 by Peoples Health Dispatch

Trade unions representing front-line health and care workers worldwide are demanding action on the global health workers’ shortage. This call comes after new data from Public Services International (PSI) revealed that a majority of existing staff are contemplating leaving their jobs due to extreme workloads and low salaries. 

The survey conducted by PSI has shown that 4 in 5 of the respondents regularly work beyond capacity, and three-quarters of them feel increasing pressure to do more with less. Among the members of PSI’s affiliates in Africa, 88% said they were exposed to increased pressures to take on more tasks, as did 70% of the respondents located in the Asia Pacific region.

With necessary positions remaining unfilled and nonexistent public policies that would regulate staffing ratios, or not properly implemented, health and care workers are also witnessing a decline in the quality of care. Almost half of all participants of the trade union organization’s survey in Latin America and the Caribbean said their employer had no safe staffing policy. In Africa, 44% of the survey’s participants said there was a safe staffing policy in place – but it wasn’t being fully respected. 

As a result of that, one in three of all the respondents reported seeing patients suffer due to the health workers’ shortage. Bill Muriuki, a medical doctor from Kenya, stated: “I have seen both staff and patients suffer due to the extreme shortage situation in the country. I was the only doctor in the casualty and emergency department of the biggest facility in the region and this would lead to situations for example where critically ill patients would come at night and would have to wait for me to report to work in the morning or on Monday if they came on the weekend.”

Like many of his co-workers, Muriuki seriously considered leaving his job, feeling that he was unable to do enough for his patients. His experience, mirrored by those of health workers in Argentina, Japan, Nepal, and other countries, underscores the necessity for governments to strengthen health services, including ramping up health and care workers’ training and improving employment conditions. 

Read: Community health workers in South Asia forge joint struggle for rights and recognition

In fact, while inadequate salaries remain among the top reasons of health workers’ discontent, it is bad working conditions that are at least equally responsible for mass resignations in health systems. More than 85% of PSI’s members in Africa ranked an improvement of working conditions as the best way to increase employment and improve care outcomes. In other regions covered by the survey, improving working conditions and increasing salaries are rated very closely. 

Looking at the results, it becomes clear that it will be impossible for governments to find a silver-bullet solution for health workers’ shortages. In order to address the problem adequately, they will have to tackle several pressing problems, including salary levels and working conditions, but also health workers’ participation in the workplace and on-the-job trainings.

“Just a few years ago, we celebrated our health workers as heroes. Now, the vast majority of these professionals feel betrayed by their leaders. Insufficient public investment in our healthcare systems is creating life threatening risks for both patients and staff. Skilled workers like these take time to train – we are perilously close to not having enough skilled staff to train the new staff we need. As shortages become more profound, the failures of band-aid solutions will become more acute”, warned Daniel Bertossa, PSI Assistant General Secretary, when the trade union organization announced the survey results.

As ministers work towards alleviating the burden created by the health workers’ shortage, PSI warned in a letter to health and finance ministers that it is crucial they do so by strengthening public health systems. In fact, most of the survey respondents explicitly stated that public investment is the way to improve the health care situation—not turning towards market-based or private provision. Over 70% of the participants in PSI’s survey in Africa, Latin America and the Caribbean said that government investment in universal health and care would create better conditions for both workers and people in their care.

Such a turn would also imply a radical change in how high-income countries have been dealing with the health workers’ shortage, relying on immigration from the Global South. This brain drain has left some regions, including Africa, with a health worker-to-patient ratio several times below those suggested by the World Health Organization (WHO). Meanwhile, OECD countries have recorded a 60% increase in the number of migrant health workers arriving in their health systems. 

The existing shortage of 15 million health workers, expected to worsen without decisive action, calls for a decisive break with the austerity and neoliberal policies that have undermined health services for decades. As the mobilizations of health and care workers around the world continue and intensify, PSI and its members demand from all governments that they honor the promises made during the COVID-19 pandemic. 

“You clapped for us, now we need you to act for us,” said Daniel Bertossa and Baba Aye, PSI Health Officer, in the conclusion of their letter to ministers. 

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.