Ethical considerations

Delivering safe and high quality care requires health workers to adhere to the highest ethical standards.

But how does ethics and ethical behaviour influence the management and planning of the workforce? How can we behave ethically when recruiting and managing our healthcare workforce?

The situation of demand exceeding supply means that health workers can use their skills and talents and as a scarce resource, will take opportunities to work in other countries where the pay, work and living conditions are attractive.

High income countries such as Australia, rely on international health professionals to supplement their health workforce. According to Buchan and Dhillon (2016), about one in three of Australia’s doctors are trained overseas and this is twice the average of OECD countries. Other disciplines also employ international workers. For example, about 16% of Australia’s nurses are trained overseas, again twice the average for other OECD countries. This data shows that Australia has a high reliance on internationally recruited health professionals.

This is not a sustainable and ethical approach as emerging economies such as India and Africa also desperately need health care workers. Wealthy countries have an ethical obligation to consider self-sufficiency as a key goal for health workforce planning (Crettenden et al, 2014).

WHO Global Code of Practice

The World Health Organisation in their Global Strategy on Health Workforce has included a Global Code of Practice on the International Recruitment of Health Personnel. This Code of Practice, calls upon countries such as Australia to:

• work towards building their own human resource capacity to meet health workforce needs
• collaborate towards more ethical and fair international recruitment practices
• respect the rights of the migrant health worker (Buchan and Dhillon, 2016).

The principles in the Code are voluntary and non-binding and some studies have suggested that this has resulted in little change in health worker migration (Tam et al, 2016). Ireland has built an innovative and ethical program that enables overseas doctors to gain access to training and clinical experiences that they cannot get in their home country. International medical graduates will complete a fixed term working in Ireland where their skills are enhanced. They then return to their home country to practice. In the medium to longer term, once they return home the goal is to strengthen and improve the health services in their own countries.

The demand for health care workers is a global concern and advancing innovative models, based on ethical practices to recruitment can result in good outcomes for health professionals and health systems.

Your task

Watch this video on a new understanding of health workforce migration

Global Health Workforce Network

What other ethical considerations can you think of when it comes to workforce recruitment? Share your thoughts with the others in the course.

References

Australian Institute of Health and Welfare, (2015): (https://www.aihw.gov.au/reports/workforce/nursing-and-midwifery-workforce-2015/contents/who-are-nurses-and-midwives)

Buchan J., and Dhillon I. (2016). Health Workforce: WHO’s Global strategy to meet a global challenge. Retrieved from: (http://healthvoices.org.au/issues/november-2016/health-workforce-whos-global-strategy-to-meet-a-global-challenge/).

Crettenden et al. (2014). How evidence-based workforce planning in Australia is informing policy development in the retention and distribution of the health workforce. Human resources for health 12(1)

International Medical Graduate. Retrieved from: Health Service Executive, Ireland. Retrieved from: (https://www.hse.ie/eng/staff/leadership-education-development/met/ed/img/)

Tam et al. (2016). Empirically evaluating the WHO global code of practice on the international recruitment of health personnel’s impact on four high-income countries four years after adoption, Globalization and Health 12(62).