Policy Bite: Fourth Global Forum on Human Resources for Health

December, 2017

Photo: John Wynn-Jones, Job Metsemakers, Anna Stavdal with WONCA’s pledge


This WHO forum, held from November 13-17, 2017, in Dublin Ireland, was attended on behalf of WONCA by three members of our World Executive (Anna Stavdal, Job Metsemakers, and Ana Nunes Barata for our Young Doctors’ Movement), and a number of the WONCA Working Party on Rural Practice leaders including John Wynn Jones, Bruce Chater, Jim Rourke, as well as Amber Wheatley and Veronika Rasic for the Rural Seeds group (young rural family doctors and students).

The Youth Forum

Dr Ana Nunes Barata our Young Doctors' Movement leader, led our input to the Youth Forum, in collaboration with the Rural Seeds group. She writes:

“Overall, the first Youth Forum was very successful. It had over 100 participants, from different professional backgrounds and from different countries. The activities included keynote speeches, round tables (with one expert, one young expert and one moderator), scenarios (where participants had to find solutions for problems depending on the setting that they were given), a rural café (led by our WONCA Rural colleagues) to raise awareness about rural healthcare, and an ‘innovation lab’.”

The Youth Forum published a ‘Youth Call to Action’ that sets the momentum for the role of youth in healthcare. Our proposal to add the following phrase to this ‘Youth Call to Action’ was accepted, which was a great success: "Call for prioritising workforce developments for primary care functions: this must include the development of the family medicine workforce to ensure a strong medical workforce at the first point of medical contact, and deliver a well trained and supported workforce for rural as well as urban settings.".

The main meeting

Prof Job Metsemakers in a summary of a report made by himself, Anna Stavdal and Ana Nunes Barata, said that the main meeting had around 1000 delegates from across the globe, with representatives from many different organisations including policy makers, labour organisations, and NGOs.

Key points noted by Job, included:

- “Putting money into the health workforce is investment. The national product and wealth of the country will increase, and this should offset some of the costs of healthcare. There will be a shortage of 18 million health workers in 2030 if we do not take action.

- There is a great problem of maldistribution of the health workforce. Health workers do not want to work in rural and remote areas.

- A great part of the health workforce is female. We have to pay attention to their safety, and strive for equal pay for equal work.

- Countries have stepped up the number of students in health professions, to find out after graduation that the government can only provide a job to half of them.

- The position of labour organizations is weak in many countries

- All countries are aware of possible brain drain and pledge to adhere to the WHO Global Code of Practice on the International Recruitment of Health Personnel. On the other hand health workforce members should be able to train also in other countries.

- The focus was on health workforce in general, not on specific professions. The rural, remote, underserved populations were mentioned clearly and repeatedly as a major problem.”

A rural perspective from A/Prof Bruce Chater

“The WONCA Working Party on Rural Practice was well represented at the Dublin forum with eight members of the Working Party Council attending including Chair, John Wynn-Jones, and the newly appointed Australian Rural Health Commissioner, Prof Paul Worley.

We held a ‘standing room only’ workshop on rural issues and solutions. With our Arctic colleagues we looked at the challenges of the retention of family physicians; with our nursing colleagues the shared challenges with nursing and other professions; and with our African colleagues the particular challenges they face. Prof Sarah Strasser led another session on the evidence for retention in rural and remote areas – an area that we will continue to work on with WHO.

The most important however was the contribution of our Rural Seeds group – Amber Wheatley and Veronika Rasic, who with Ana Nunes Barata, worked tirelessly at the Youth Forum and held a live international Rural Café with chair, Mayara Floss, joining by internet from her rural placement in Brazil (pictured). Although small steps, the Global Forum communiqués recognised the role of family practice and the special needs and challenges faced by rural and underserved communities.”

The outcome

Overall WONCA’s team meant the voice of family medicine was heard, including our rural doctors, our young doctors, and student communities. Our rural team had a 90 minute track, and our WONCA Executive leaders presented during a panel session on socially accountable medical education. We commented on the ‘Dublin declaration’, although the final signoff happened at country/government level. We will reflect on the impact of the meeting over time, but know that our contacts in WHO will have seen our excellent inputs, and hope this may lead to further change towards the primary care workforce including family medicine.
Dublin Declaration on Human Resources for Health:
Building the Health Workforce of the Future
Youth Call to Action:
"Health workers re an investment not a cost”

Thanks to all involved.

Amanda Howe.
WONCA President.