Jamaica welcomes the report of the High-Level Commission on Health Employment and Economic Growth. We recognize the contribution that a strategic approach to health employment and economic growth can make to global health security and economic development. At the same time, we wish to focus attention on the immediate challenge of the loss of healthcare personnel to international recruitment. This loss of personnel is creating a crisis in the delivery of health services in vulnerable countries such as my own. This problem, if not given urgent attention, will undermine the very goals that we have recognized in the Commission’s timely and important report and impede the achievement of the 2030 agenda for sustainable development.
The challenge we face is not altogether new. Indeed, in 2010, we adopted the Global Code of Practice on the International Recruitment of Health Personnel, to address this very problem. While the Code provides a framework for both source and destination countries, to enter into bilateral agreements, in order to properly manage migration; we are still short of the mark in fixing this problem that threatens global health security.
More recently, the Caribbean sub-region has been experiencing increasingly large-scale, targeted recruitment activity by many well-resourced countries to address growing domestic shortages. A World Bank Study in 2009 revealed that 15 years after graduation, about half of trained nurses from English-speaking CARICOM countries were working abroad; three times as many CARICOM-trained nurses work outside of, rather than within the Region (one of highest levels in the world); and that the regional shortage of nurses was expected to triple to over 10,000 within 13 years.
This “brain drain” has virtually crippled the delivery of certain health care services and has had a dramatic effect on the overall quality of health care. A report on Human Resources for Health in the Caribbean (2011) indicated that three countries in the Americas Region: Antigua, Dominica and Grenada, averaged a net loss of about 10 health workforce emigrants per 1,000 population. Overall, twenty-nine territories in the Caribbean reported a net loss in health workforce due to migration in this same period.
We have, in this agenda item, a platform on which we can move to action to address this grave challenge. We must:
- Take urgent steps to mitigate the adverse effects of migration of health personnel through the effective implementation of the WHO Global Code of Practice.
- Encourage developed and developing nations to adopt a more self-sufficient approach to health human resources management.
- Pursue enhanced dialogue and partnerships, including bilateral agreements, where appropriate, to address the acute challenges facing source countries. Such agreements should address enhanced training of skilled personnel from source countries and provide frameworks for orderly movement of skilled health personnel to address the needs of destination countries without undermining heath security in source countries.
I am pleased that in the Decision Point proposed under this agenda item there is a clear call for the Director General to work with member states to adopt measures for the development of intersectoral plans and investment in transformative education, promoting decent job creation in the health and social sectors and mutual benefit from international mobility of health workers. This mutual benefit from the international mobility of health workers can only be secured through collaborative approaches to training and orderly movement of skilled health workers which we support. These approaches would enable source countries to address their critical domestic human resource gaps in the health services while securing destination countries’ access to skilled health workers in a sustainable manner – A win win scenario for all through new and innovative collaborative measures.”
Minister Tufton will on his way from Switzerland make a brief stop in the United Kingdom to meet with key Parliamentarians and Councils to deepen discussions on human resources for health. The Minister intends on having both countries agreeing on a coordinated orderly flow of migration of critical care nurses.