Employment in the health care sector

From 25 to 27 October 2018 took place in Vilnius / Lithuania a seminar about “Employment in the health care sector”, organized by EPSIN (European Platform for Social Integration), with the support of EZA and of the European Union.

The seminar was opened by Bartho Pronk (chairman of EZA), Danguole Boguseviciene (director of the Network to Initiatives Association) and Bruno Machiels (secretary of EPSIN).

Bartho Pronk explained the importance of this seminar by indicating the many changes in the health care sector in Europe and the policy to do more for less which has negative consequences for patients, workers and society.

Danguole Boguseviciene memorized the Baltic Way in 1990 and the human chain that has inspired many people then and still now. She wishes this seminar the same inspiration.

Bruno Machiels stressed the important role of Social Dialogue in health care. The midfield and civil society provide chances and the dialogue between workers, employers and the Government is an essential element.

A new vision on Health Careby Nancy Fobe, director Social Insurance Christian Mutuality, Belgium

A redefinition on what is health care can provide new possibilities for employment and for the role of volunteers. We have no choice as the population is getting older. The costs will rise increasingly. If health care is the absence of illness, we need to define positive health in a meaningful life with a pro-active attitude and self-government. Health care insurance policy should be aimed at prevention. Socialisation can play a role in that respect in creating circles of care with networks of workers and volunteers. There are already examples of social innovation by way of apps and social vouchers that develop to social economy. Social economy is dependent from the social dialogue at all levels.

Elderly care and employment by Tom van der Vreken, director of IKOO Elderly Care

The shortage of staff is compensated with recruiting unemployed workers that can take over a number of activities. In the same time they develop basic skills that can bring them eventually to a new job in which they can develop further professional skills.

In the discussion-round there was much appreciation for these ideas. It was generally accepted that there is here an important role for the Governments (Health Departments), employers in the healthcare- and social sector and the trade unions and other workers’organisations.

The Baltic Health Care situation by Laimutte Puidokiene, director Family Clinic Riese

There are a number of severe problems that health care has to face. More funding is needed. Emigration leads to an increasing elderly situation. The workload for doctors and nurses is too heavy and often leads to burn out situations. The bureaucratic system also contributes to a high degree of uneasiness. This will lead to more and more emigration of doctors and nurses with the result that the remaining doctors and nurses are even more under pressure. It must be noted that the bureaucratic system not only influences the workload in healthcare in the Baltic states but also in Central European- and nearly all western countries. This negative race to the bottom can only be stopped by a change of policy and a powerful co-operation between employers, employees and the Government. Good Human Resources management is needed.

Serious problems for the Health Care sector by Jurgita Sejoniene 

70 % of the workers in the Health Care sector all over Europe have a severe chance of suffering from burn out syndroms. In Lithuania this is investigated among doctors, nurses, surgeons and physiotherapists. The younger you are, the more chance to meet with this professional disease. It’s no surprise that this is an important reason to consider emigration.

Palliative Care as possibility for social innovation by Jonas Balaika, director Hospice Alytus

Palliative care can be offered both in hospices and at home. There is an increasing need to this kind of care. Because the palliative care mostly is set up by private initiatives, there is a strong need for raising money. An excursion to the Michael Sopocko Hospice in Vilnius learnt that here they had to raise 70% of the exploitation-budget by themselves. The hospices and the palliative services at home are a good example of the social midfield as there is a good co-operation between workers and volunteers. The hospices are also a place of education in which (future) workers develop specialist skills.

The health care situation in Albania by Dritan Korumi, president of the Trade Union for Health Care, Albania

Because Albania has not had the opportunity to develop civil society in the past, there are now new efforts made to construct civil society and work at social dialogue. The trade union for doctors and nurses fits into this pattern. The position of doctors and nurses are in general the same as in the Baltic States. The medical staff suffers from the management in health care, they face an overload of duties and there often are unpleasant situations with inadequate reactions of the authorities by complaints. The local government’s attitude is not encouraging. As a result, a lot of doctors and nursing are emigrating with increasing consequences for those who stay behind. This a serious situation that can only be coped with by effective co-operation between employers, workers and trade unions and the Government. The social midfield can certainly contribute to solutions. Employers’ organisations and trade unions should combine efforts to influence the Government.

The situation in Hungary by Pal Csonka, manager Maltese Charity Service, Hungary

It appears that there are a lot of similarities between Albania, Hungary, the Baltic states and Bulgary and Romania. There is a need for structural reforms in health care concerning funding and administration. The paternalistic system is dominating. The doctors, nurses and the staff know how to make it better but their experience is not used. We should invest in social dialogue as the way out to this situation. Trade unions from different European countries can support with best practices in social dialogue.

The youth care situation by Mariska Doornkamp, Basisgroep Social Security, the Netherlands

The youth care situation in the Netherlands shows resemblances with other countries. The system is here leading too and not in favour of the patients and the workers. The Government should act together with the workers’ representatives and the employers to improve the situation and prevent that the many volunteers in youth care will be frustrated and will leave.

The community level by Roswitha Gottbehüt, Member of the Board KAB, Germany

There are developments in the municipal infrastructure with new impulses for the community. This has led to the re-introduction of the Community Nurse Plus that has an important role in care prevention. Expert care and social care are here combined. The circles in neighborhood contribute to an early warning system and prevention. The introduction of new and existing jobs can contribute to creating employability in the health care sector.

Trends in Emigration by Zsuzsanna Torok, Eldery Care, Germany

There are more and more statistics available on the mobility of workers and especially for the doctors and nurses. Emigration offers chances but also produces threats for the health care and for society.

Employment projects in Belgium by Nancy Fobe

She describes projects performed in the Christian Mutuality in which unemployed and ill people help each other by using the capacities and powers they still have. This is a good way to mutual help and also it contributes to self-esteem and self-confidence. Also refugees are engaged in this process. An important method to make these support-actions possible is carving jobs out of tasks. You are not able to perform the whole job but you can do a number of tasks. Trade unions and other workers’ organisations can participate in job carving and can help in creating new jobs.

Project with volunteers by Danguole Boguseveviciene

The project is on how to involve volunteers in the palliative services as a personal assistant. It’s a durable project with a training course in internet which can result in receiving a certificate.

Project long life learning by Pal Csonka

This project is also meant for building networks and based on the complementary activities of the work that the community nurse cannot do, such as cleaning, doing errands and taking care of the pets.

General information about projects by Bruno Machiels

We have heard short introductions about important projects. The contents of this seminar demonstrate the necessity of projects as impulses for social innovation in the midfield with help of the social dialogue. You need strong organisations to be able to obtain a project. This is certainly the case in the new EU-countries and for candidate countries.

Summary and conclusions of the seminar

We have seen that the whole Health Care sector is under pressure both in Western Europe as in the new countries. But the Baltic states, Hungary and Albania suffer from extra problems in the field of wages, funding, demographic situations, bureaucracy and dominating processes, exhaustion and burn outs of doctors and nurses and emigration.

New developments in Health Care can be a part of the solution such as self-government, prevention and socialization and social networks at the municipal level including community  nurses. Here the civil society can play an important role. We have seen that private initiatives such as in the palliative care and elderly care can produce new jobs and chances for education. In all developments the role of volunteers in the midfield is very important.

But also the social dialogue is of great importance. Employers and trade unions in the Health Care should make arrangements for improving the labour conditions and working circumstances and invest in a fair Human Resources Management. Also the Governments must play their role here and take up their responsibilities. At the European level employers’ organisations, trade unions, voluntary workers’ associations and political parties should invest in measures and policies to make it more attractive to stay in your native country and build up the health care infrastructure and contribute to social stability and wellness.