Health workforce Contributor to the Economy Professor James

Health workforce: Contributor to the Economy Professor James Buchan, WHO Europe

Health workforce: Contributor to the Economy 1. Health (Workforce) Challenges, and Solutions 2. The UN High-Level Commission on Health Employment and Economic Growth 3. The case for investment…. .

Health (Workforce) Challenges • Continuing and projected deficits • Insufficient investment and demand, particularly in low -income countries • Inequalities • Outdated education model • Poor data • Resistance to new models of care Source: Health in 2015 from MDGs to SDGs, WHO 2015

Agenda 2030 for Sustainable Development

UHC-associated shortage by WHO region, 2030

Global Strategy HRH: Workforce 2030 1. Optimize the existing workforce in pursuit of the Sustainable Development Goals and UHC (e. g. education, employment, retention) 2. Anticipate future workforce requirements by 2030 and plan the necessary changes (e. g. a fit for purpose, needs-based workforce) 3. Strengthen individual and institutional capacity to manage HRH policy, planning and implementation (e. g. migration and regulation) 4. Strengthen the data, evidence and knowledge for cost-effective policy decisions (e. g. National Health Workforce Accounts)

Mobility (and remittances? ) % working in OECD countries, 2010 -11 (actual numbers in brackets) (209, 000) India (115, 000) Nurses (282, 770) Philipines (143, 100) 0 10 20 30 40 50 % of workforce working internationally, in OECD countries Doctors

Country of training of foreign doctors, UK, 2014 (source OECD) India other Asia EU countries Ireland Africa Other

Country of training of foreign nurses, UK 2014 (source OECD) India Philippines EU countries Africa Other

The Power of Health Workers video: https: //www. youtube. com/watch? v=Te. P 0 aaf. Yv. H 0

Case for investment 1/4 of economic growth 2000 to 2011, in low- and middleincome countries, from improvements in health.

Health: A leading economic and labour sector The Health Economy: Germany From 2005 to 2012 the health economy was responsible for around 11% of gross value added, around 7% of exports, around 20% of final consumption and around 15% of total employment. Source: Ostwald, D. A. , Henke, K. -D. , Kim, Z. -G. (2013 ).

Health employment: Women’s economic participation Source: Magar et al, WHO, based on ILOSTAT (forthcoming 2016 )

Health employment: Source of future jobs (worldwide) Source: Human Development Report 2015: Work for Human Development

Health employment and productivity: new evidence Health as a cost disease and a drag on the economy Health as a multiplier for inclusive economic growth Baumol (1967) – Growth in health sector employment without increase in productivity could constrain economic growth (data from USA) Hartwig (2008 and 2011) – Confirmation of Baumol hypothesis (data from OECD countries) Arcand et al. , World Bank manuscript (2016) – larger dataset; data from low-, middle- and high-income countries – establishes positive and significant growth inducing effect of health sector employment; multiplier effect on other economic sectors – magnitude of effect greater than in other recognized growth sectors

Commission’s recommendations… 10 recommendations 1. 2. 3. 4. Job creation Gender equality and women's rights Education training and competencies Health service delivery and organization 5. Technology 6. Crisis and humanitarian settings 7. Financing and fiscal space 8. Partnerships and cooperation 9. International migration 10. Data, information and accountability

UNHLC Five Year Action Plan - Summary One Vision: Two Goals: Three Organizations: Four SDGs: Five Workstreams: Accelerate progress towards UHC and the SDG Agenda by ensuring equitable access to health workers within strengthened health systems. Invest in both the expansion and transformation of the global health and social workforce. ILO, OECD, and WHO Health and well being(SDG 3), Quality education (SDG 4), Equality and empowerment of women and girls (SDG 5), Sustained, inclusive and sustainable economic growth, full and productive employment and decent work (SDG 8). (1) advocacy, social and policy dialogue; (2) data, evidence and accountability; (3) education, skills and jobs; (4) financing and investments; and (5) international labour mobility.

More evidence…………. http: //www. who. int/hrh/resources/health_employmentand-economic-growth/en/

UN High Level Commission: The case for investment • The return on investment in health is 9: 1 • One extra year of population life expectancy raises GDP per capita by 4% • “The Commission concludes that, to the extent that resources are wisely spent and the right policies are put in place, investment in education and job creation in the health and social sectors will make a critical positive contribution to inclusive economic growth”.

THANK YOU. who. int/hrh #workforce 2030