|Plenary session PL04, Tuesday, May 27 2008, 9:00-10:30, Room 2|
|Chair(s): Mireille Kingma, Consultant, International Council of Nurses, Switzerland, Jean-Dominique Vassalli, Rector, University of Geneva, Switzerland|
|Health Workers for All and All for Health Workers: From Commitment to Action|
|Mubashar R. Sheikh, Executive Director, Global Health Workforce Alliance, WHO, Switzerland|
|The Medical Professionals of Tomorrow|
|Richard Smith, Director, Ovations/National Heart, Lung and Blood Institute Chronic Diseases Initiative, UK|
|Development of Hospitals in the 21st Century|
|Per-Gunnar Svensson, Director General, International Hospital Federation, France|
|Erasing the Boundaries: New Patterns in Nursing Care|
|Deborah Ward, Associate Professor, School of Nursing, University of Washington, USA|
Submitted by: Alessandra Sauven (ICVolunteers); Contributors: Janina M. Mank (ICVolunteers)
Looking to the challenges of the future, participants reflected on the changing needs and demands of a global health workforce confronted with globalisation, climate change and an evolving perception of what healthcare entails. Integrating new technologies and the means through which to obtain and use funding and resources were just some of the challenges addressed by participants. All, however, focused on the need for a new approach, a new way of thinking, and a new way of acting to ensure that healthcare needs are met.
Dr. Mubashar R. Sheikh, Executive Director of the Global Health Workforce Alliance, stressed the need to tackle the severe shortage of health workers who act as "the cornerstones and drivers of health systems." A shortfall of over 4 million health workers, along with huge disparities in health expenditure across the globe, has led to a growing crisis within the health sector. The Global Health Workforce Alliance (GHWA) was created in May 2006 as a common platform for joint action on the crisis. Dedicated to identifying and implementing solutions to the health workforce crisis the Alliance has a vision of access for all to a skilled, motivated and supported health worker as part of a functioning health system. In achieving this goal Dr Sheikh highlighted the importance of working as a team. The healthcare sector cannot tackle the problem alone but must instead work to build up partnerships with a wide range of stakeholders, including national governments, civil society, financial institutions and international agencies.
The Kampala declaration and agenda for global action signed by participants at the first Global Forum on Human Resources for Health in Kampala, 2-7 March 2008, represented a breakaway from traditional approaches and a move towards a new way of thinking and working, as well as a new way of using resources and funds. In particular, the declaration focused on the need to create a more enabling environment for health workers to ensure an effective, responsible and equitably distributed health workforce. There is increasing recognition of what must be done at both the global and country level. It is vital to join hands and work together to share issues and challenges, and to find common strategies and approaches. As Dr Sheikh points out, "we should all work for health workers because health workers are working for us".
Dr. Richard Smith, Co-Director of Ovation/NHLBI Chronic Disease Initiative, challenged the audience with his view of what the future of health, including its workforce and its skills as well as its institutions and their management, has in store for us. He introduced to this future- and solution-oriented session the idea of the self-educated patients' health and wellbeing rather than their diseases being at the core of prospective health care systems.
Having identified the shortages in today's heath care, Dr. Smith emphasized the need to meet upcoming challenges by addressing a 'new professionalism' amongst health workers: Thus, some of the health worker's skills will have to be managerial and technical, focusing on evidence, efficiency and the entire health system. This system should be one of prevention and should essentially embrace a broader approach on who to classify as health workers. Hence the need should be acknowledged for a 'real contract' which breaks down professional boundaries by recognizing the limits of doctors and by empowering nurses, as well as the patients' closer community, as potential drivers of health care. This is a future trend.
Professor Per-Gunnar Svensson, Director General of the International Hospital Federation, picked up on Dr. Mubashar's elaboration on the critical shortage of the global health workforce and related to this the prospective managerial challenges of complex institutions like hospitals. As future health care management will become more system-centred, experienced managers will have to be capable of dealing with the problems of the future such as globalization, climate change, an ageing society, tailor-made pharmaceuticals and integrative community care. They will also have to cope with the international tendency towards privately funded solutions instead of public funding through, for example, taxation.
Professor Svensson's vision of hospitals of the 21st century is one of health promotion and integration, being IT engineered as well as partly privately funded. He recommended training specifically for hospital managers to meet future demands in health care and put forward the request for government regulation for cases in which private sources of funding, be they non-profit or for-profit, fail to cover disadvantaged components of the population.
Dr. Deborah Ward, of the University of Washington, Seattle, reinforced the need to reconsider roles and functions within the health workforce. She focused in particular on the need to recognise and expand the role of nurses who play a fundamental part in the health workforce and operate in a wide variety of healthcare settings. It is necessary, not only to ensure a change in the way we view the role of nurses, but also to adapt professional boundaries in order to activate and benefit fully from this change.
The session highlighted the need to consider anew the image and role of health workers, and to adapt skills and training accordingly. The increasing promotion of health, well being and prevention, in contrast to a more traditional 'diagnose and treat' perspective brings with it new challenges, and new opportunities to health care. In particular, participants focused on the need for integration, both within the health sector itself, and at a global level to work together to ensure a global health workforce capable of addressing the challenges and needs of a constantly changing world.