Code of conduct on cross-border recruitment in European hospitals

On 7 April 2008, the European social partners engaged in hospital activities signed a code of conduct on ethical cross-border recruitment and retention in this subsector of health and social work. On the basis of the agreement, the social partners are committed to promoting ethical recruitment practices in hospitals at European, national, regional and local level. The code also sets out particular requirements in terms of implementation, monitoring and follow-up.

Aims of code of conduct

Within the framework of the hospitals European sectoral social dialogue committee ([EU0610039I](/search/node/eiro OR 2006 OR 10 OR articles OR eu0610039i?oldIndex)), the European Hospital and Healthcare Employers’ Association (HOSPEEM) and the European Federation of Public Service Unions (EPSU) have jointly signed a code of conduct (50Kb PDF) on ethical cross-border recruitment and retention. Through this code, the European social partners want to address inequalities and unnecessary burdens on healthcare caused by unethical recruitment practices.

In order to guarantee cross-border recruitment beneficial for the employers and workers concerned, a framework supporting ethical recruitment and retention practices should be in place. When looking for an appropriate framework in addition to European and national legislation and collective agreements, the already existing conventions of the International Labour Organization (ILO) should also be taken into account.

Key principles and commitments

The new code of conduct is based on key principles and specific commitments, as outlined below.

Access to quality healthcare

One basic principle involves guaranteeing that everyone within the EU has access to high-quality healthcare, which is affordable and based on solidarity principles. Effective healthcare systems largely depend on having an adequate supply of well-trained and committed health workers.

Workforce planning

To assess the impact of any policy on ethical recruitment, the social partners need to have access to reliable and comparable data on migration and migrant health workers.

According to the code, effective workforce planning and human resources development strategies at local, regional and national level are important to ensure a balance between supply and demand of healthcare personnel, while offering long-term prospects for employment to healthcare workers.

Training and career development

Moreover, the code stipulates that it is essential to invest across the EU in educational programmes and the continuing education of staff. Equal access to training and career development must be guaranteed.

Availability of information

Notices of hospital vacancies across the EU should be made available by publication on the internet. In order to guarantee a fair and transparent employment contract, workers and employers need to be protected from false information, misleading claims and exploitation.

Information about the formal requirements for living and working in the host country should be provided to the migrant health workers prior to their arrival. Furthermore, employers and workers must develop a comprehensive induction policy for all internationally recruited workers to ensure that they are able to adapt to their new environment as quickly as possible.

Fair treatment and safe environment

Non-discrimination and equal rights for migrant health workers should be guaranteed by the right to fair treatment and a safe and healthy working environment. Migrant hospital workers – like all other workers – should have the right to join a trade union. Finally, employers should commit to the continuous promotion of ethical recruitment practices.

Implementation, monitoring and follow-up

HOSPEEM and EPSU are convinced that the implementation, monitoring and follow-up procedure is of crucial importance for guaranteeing the effectiveness of the code of conduct. Therefore, the European social partner organisations have agreed to implement the code, through their respective member organisations, within three years. During this period, the social partners will monitor the implementation and report back to the sectoral social dialogue committee at least once a year. By the end of the fourth year, a report on the overall implementation will be published.

Moreover, the European social partners state that the code of conduct, in its current version, does not address all of the challenges related to workforce retention in the health sector. Therefore, they are committed to developing further activities in the area of retention within the next work programme for the period 2008–2010.

Support of social partners

The European social partners consider healthcare as an important aspect of the European social model and, therefore, all key actors should be committed to its fair and effective functioning.

The Secretary General of EPSU, Carola Fischbach-Pyttel, stated that ‘EPSU and HOSPEEM want to encourage, and as far as possible contribute to, the development and implementation of policies at local, national and European level with the purpose of enhancing workforce retention.’

On behalf of the employer representatives, the Secretary General of HOSPEEM, Godfrey Perera, added that: ‘the promotion of ethical recruitment practices all over Europe clearly calls for a multifaceted strategy, including not only social partners but also governments, regulatory and professional bodies, and other relevant stakeholders at local, regional, national and European level.’

The cross-border movement of healthcare professionals is an expanding development that extends beyond European boundaries. Thus, the European social partners also hope that the code will set a precedent both within and outside of Europe’s borders.

Volker Telljohann and Davide Dazzi, Institute for Labour Foundation, Bologna