In December 2008, the European Commission released a green paper on the Health Workforce in Europe. This initiative did not trigger any action from any of the institutions after it was launched, which raised concerns from stakeholders (see also on this subject: EUM 41). On 9 September 2010 the Belgian Presidency of the European Council held a ministerial conference to focus political attention on the matter and support investment in a sufficient, motivated and well-skilled health workforce across the EU.

The purpose of the ministerial conference was to raise awareness of the growing problem of the European health workforce, and to support the European Commission in its efforts to develop a coherent approach towards national and regional policies and actions in this field.

Considering health workforce mobility and the importance of equipping health professionals with appropriate skills to meet current and future needs and demands, the event focused on four main areas for future innovation and collaboration:

1) The assessment of future health workforce needs both in terms of numbers and types of skills
There is a need for comprehensive and integrated forecasting mechanisms and strategies to quantify and qualify the workforce required. Not only do Member States need to ensure that the numbers are sufficient but they also have to guarantee that the health workforce is geographically distributed appropriately according to needs.

2) Creating the best working environments to attract and retain health professionals, as well as to support them in their tasks
Maintaining a motivated health workforce is a key element in providing high quality health services. In order to attract health professionals, countries have to consider a mix of measures and incentives, both financial and non-financial. Due attention has to be paid to informal care workers, gender and age dimensions and young professionals.

The two dedicated sessions for exploring these issues concluded with a stakeholder panel with active participation by the European Union of Medical Specialists, the Standing Committee of European Doctors, the European Federation of Nurses, the Pharmaceutical Group of the European Union, and the European Hospital and Healthcare Federation (Pascal Garel). It recommended:

• promoting public debate on job recognition and the societal significance of health workers;
• enabling flexible employment and work-life balance;
• creating opportunities for gaining qualifications;
• promoting retention and active ageing policies;
• making use of Structural Funds (1);
• underlining the importance of competence-based Continuous Professional Development (CPD) but with no imperative;
• improving the Working Time Directive and raising awareness of the dangers of a market-based approach towards health;
• investing in leadership, ownership and professionalisation;
• promoting EU competence in prevention and health promotion rather than focusing on treatment only.

3) Assessing the changes needed in competence profiles and skills mix through training and lifelong learning
As health needs, demands and settings are continuously changing all over the EU, so are qualifications, skills and knowledge of health professionals. Whereas high-quality education and training are fundamental for skilled and competent workforce, lifelong learning is crucial for updating and advancing health professionals’ knowledge. Continuing Medical Education (CME) and CPD along with bringing back so-far inactive workforce are essential for the EU workforce for health.

In this respect, much emphasis was given to advanced roles of nurses in primary healthcare, specialised medical care and disease management, and to task shift and professionalisation of some professions (nursing, midwifery, dentistry, pharmacy).

The EU Directorate-General for Employment, Social Affairs and Equal Opportunities gave a presentation on a European network of national health observatories and called for an EU-level Health Observatory to share information and exchange best practices in the sector. The UK Royal College of Physicians presented its latest report "Future Physicians - Changing doctors in changing times" calling for action on improved care, doctor-patient partnerships and leadership in changing times.

4) Promoting a learning culture among health professionals that further strengthens patient safety and better quality of care
Health professionals are the backbone of high-quality, safe health care. As strategies and practices differ between countries and regions, there is a great deal to be learnt and shared across borders.

Health ministers present at the conference recommended:

• addressing the underlying forces of health professional mobility;
• setting up a data collection and exchange platform on the EU health workforce;
• creating an EU-wide action plan to tackle the problem and work towards a clear strategy on workforce for health;
• harmonising and clarifying qualifications and skills as well as creating a common ground for the EU health workforce;

• ensuring that existing EU-level tools and mechanisms are implemented;
• building trust and facilitating CPD.

Finally, Ms Laurette Onkelinx, Deputy Prime Minister for Social Affairs and Public Health on behalf of the Belgian Presidency of the EU Council announced that the conclusions and recommendations of the conference would be presented to the Council in December 2010.

(1) Structural funds: The Structural Funds and the Cohesion Fund are funds allocated by the European Union as part of its regional policy. They aim to reduce regional disparities in terms of income, wealth and opportunities. Europe's poorer regions receive most of the support, but all European regions are eligible for funding under the policy's various funds and programmes.

The Structural Funds are made up of the European Regional Development Fund (ERDF) and the European Social Fund (ESF). Together with the Common Agricultural Policy, the Structural Funds and the Cohesion Fund make up the great bulk of EU funding, and the majority of total EU spending.
New objectives have been defined for the current programmes, which run from 1 January 2007 to 31 December 2013. The overall budget for this period is €347bn: €201bn for the European Regional Development Fund, €76bn for the European Social Fund, and €70bn for the Cohesion Fund.