Informed policies for Europe’s health workforce of tomorrow.

Batenburg, R. Informed policies for Europe’s health workforce of tomorrow. In: EHMA Occasional Papers on the occasion of Ministerial Conference 'Challenges for Health Workforce Management in Europe', 9-10 september 2010, La Hulpe. p. 2-3.
Although it is widely acknowledged that health workforce planning is critical for health care systems, it is probably one of the least strategically planned resources. One could argue that there are good reasons for this: demand and supply of the health labour market are in constant flux, and policy instruments to control both quantitative and qualitative matches are limited. Others state that workforce planning restricts labour market flexibility, for instance to respond to fast spreading diseases or societal trends that impose changing demands for specific health care services. Still, before investing in tomorrow’s health workforce, it is essential to draw on reliable and systematic information about the verification of health labour market problems. In this respect, large differences between countries can be observed and also important ranges within countries between regions, professions and institutions. In some countries workforce-to-population ratios are primarily used to avoid undersupply, while some (sub) health labour markets are ruled by numerus clausus to avoid oversupply of doctors. In other cases only ad hoc policies are in place that merely react if strong fluctuations or shortages occur within the health workforce. Learning by comparing health labour markets, workforce planning policies and workforce data, provides opportunities to benefit from differences between countries and sectors. As of now, exchange and cooperation across borders and across sectors is limited. There is a need for researchers, policy-makers and professionals to jointly develop instruments for health workforce monitoring and planning, and these instruments should be validated and evaluated in both the academic and policy domain. Looking at the current situation in most European countries, a multi-level and mixed approach to meet the future workforce challenges is required. Quantitative shortages and qualitative mismatches in the health labour market are of major concern. Controlling costs and quality while finding a balance between central steering and local flexibility seems the appropriate but also most difficult way to proceed. Health services are a trust good (which means that they are different to – ex-post or ex -ante – assets), while health is considered a primary human need that is highly sensitive and related to human preferences and behaviour. This is reflected by the labour market actors, i.e. health care professions as the core group, and several stakeholders as their partners. Transparent information is a key condition for successful collaboration at all levels of the labour market. At the macro level, workforce planning can monitor and safeguard quantitative matches between labour market demand and supply, but only under the condition that health professions and organizations comply with the information systems required. At the micro/meso level, HR policies could enable and trigger health professionals to optimize their work processes and patient care but if, and only if, these policies are both innovative and strategic. The work of health professionals is naturally based on competence and trust, which implies that planning and management should primarily serve the working conditions. Reliable information at both the micro, meso and macro level remains a critical precondition for supporting a motivated workforce, to finally serve the growing future health care demand in all European countries. Both national and international health organizations have a common challenge (and task) to collect and govern the sources to achieve optimal informed health workforce policy. (aut. ref.)