Global commitment to public health care

International conference agrees on central role of public system and need to invest in health care workforce.

Governments should not offload their responsibility for delivering health care to private operators. And public spending on the health care workforce should be seen as an investment rather than a cost.

These were the key messages endorsed by governments, unions and employers at an international conference on ways to improve employment and working conditions in health services.

Held by the International Labor Organisation in Geneva, Switzerland, it was the first tripartite meeting of its type in almost 20 years.

Assistant General Secretary Judith Kiejda said it was an honour for the NSWNMA to be invited as one of only eight delegates representing unions that cover about 10 million health workers.

Other union representatives came from France, Germany, Korea, South Africa, the USA and Argentina.

They were matched by eight employer delegates – including an Australian – and representatives of 53 governments. The Australian government was invited but did not attend.

Judith said the NSWNMA was invited partly in recognition of its work with the global union federation Public Services International (PSI).

Judith has been the PSI’s Asia Pacific health coordinator since 2010 while NSWNMA staffer Michael Whaites is the PSI’s sub-regional secretary for Oceania.

“The invitation also reflects the fact that Australia is the only regional country to have won mandated ratios or staffing levels in a number of models across various states,” Judith said.

“The language of most government speakers was very helpful and in most discussions were very close to the worker perspectives.

“Importantly, all three parties agreed that mandated staffing is the only way to guarantee decent working conditions in health services.

“As the Brazilian government representative said, delivering safe and quality health care will be difficult without the right numbers of staff with the right skills in the right place at the right time.

“The conference recognised that quality health care is a human right and its decisions can now be used when lobbying governments in Australia on issues of staffing and maintaining quality public health services.

“The conference decisions will be particularly useful in our discussions with future governments which might be more in tune with our thinking on health matters than some current governments.”

Judith said employer representatives spoke in favour of public private partnerships (PPPs) but unions successfully argued against tripartite support for PPPs.

“We all acknowledged there were private systems in every country that complemented the public system but we shouldn’t be handing over public services to private operators.”

PSI General Secretary Rosa Pavanelli told the conference there was “a rich evidence base” for concluding that PPPs simply amount to the subsidising of private interests with public funds.

“While private investments cannot be discountenanced, these have to be adequately regulated and should not be passed off as being in partnership with public health, which is the mainstay of universal access to health care,” she said.

Judith said the NSWNMA would work to organise a similar tripartite meeting on health workforce issues to be attended by Asia-Pacific countries including Australia.

“Through the PSI we are establishing a strong network of Asia-Pacific health unions. We have the same issues everywhere – not enough staff, inappropriate skills, and governments seeking to privatise services.”