Trade agreements have a major international effect on health and the ability of health professionals to work in other countries. So national professional and regulatory bodies need to be more engaged with governments to ensure new agreements promote quality health services.
This was one of the main messages from a high-level conference on the regulation of health professionals, held in Geneva, Switzerland on 21st and 22nd May in the run-up to the World Health Organization’s World Health Assembly. This is the fourth international meeting on the subject organised by the World Health Professions Alliance, of which WCPT is a member.
More than 250 health professionals from 49 countries attended, including physical therapists from Australia, France, Namibia, New Zealand, the Philippines, Switzerland and the UK.
André Gariepy from Canada called for international regulation of health professions. He explained that although health workers are the most mobile professionals in Europe, trade experts don’t regard health workers as any different from other types of worker. If labour moves freely between countries under trade agreements, there are two options for regulation of health workers: harmonise requirements or develop mutual recognition agreements.
He emphasised the importance of establishing core competences on an international basis. “Ability to communicate in the local language to patients and peers is a basic competency for health workers,” said Gariepy, who is Commissioner for the Recognition of Professional Competence at the Government of Québec, Canada.
He was speaking during a half-day session on the need to protect the public, as well as facilitate commerce, under trade agreements. It was chaired by Margot Skinner, WCPT Vice President and senior lecturer at the School of Physiotherapy, University of Otago, New Zealand.
“The big message was that the regulatory authorities and the health professions need to be proactive about discussions – not just with ministries of health, but ministries of labour, industry and other ministries that look after trade negotiations. Some countries have not realised that health has been part of a trade agreement and so haven’t necessarily been prepared.”
“WCPT member organisations need to keep in close contact with what trade negotiations are being developed. For example, in the Association of Southeast Asian Nations (ASEAN), some countries with WCPT member organisations are having to consider how they work with countries where there is no member organisation. If there’s free movement of labour, there can be issues with standards of education. Inevitably, the main consideration with regulation is protection of the public – if you have haven’t got the language, that’s an immediate health and safety problem for the patient.”
Also speaking at the event was Sir Michael Marmot, Professor of Epidemiology at University College, London and President of the World Medical Association. He said that the social determinants of health should be a central concern for all health professions, and should be part of their education curricula. Development reduces health inequalities, he said. There was no point in treating people for an illness, and then sending them back to the environment that caused it.
Physiotherapist Margaret Grant, accreditation programme manager at the Australian Health Practitioner Regulation Agency, spoke about risk-based approaches to regulation of health professionals. She said that these approaches required seeking out and addressing the root cause of risk. Using data to understand the problem was essential.
“There were very positive outcomes from the event,” said Margot Skinner, “and the intention is to have another WHPA regulation meeting in two years. All the issues surrounding regulation are very important for us as a profession.”