Financially sustainable and high-quality healthcare are key aspects of the Health2030 strategy. In this connection, two topics are particularly relevant for Switzerland at the international level – international migration of health workers and promotion of patient safety.
International migration of health workers
The quality of healthcare provision is largely dependent on health workers – including in particular those from abroad. Such migration, however, leads to shortages in the source countries. Growing global awareness of this issue has prompted various measures, to which Switzerland is contributing at the national and international level.
Global shortage
In the World Health Report 2006, the health workforce is defined as “all people engaged in actions whose primary intent is to enhance health”. According to the WHO, there is a global shortage of health workers, especially in developing countries. This is exacerbated by the migration of workers to other countries offering more attractive employment conditions. In certain low-income countries, a significant proportion of the health workforce is thus lost to international migration. It is estimated that, by 2030, there may be a shortfall of 18 million health workers required to attain the Sustainable Development Goals (SDGs) in developing countries.
Action by the international community
The WHO Global Code of Practice on the International Recruitment of Health Personnel, adopted by member states in 2010, represents a global response to this issue. The Code sets out ethical principles for international recruitment and provides recommendations on, in particular:
- recruitment practices,
- treatment of migrant health personnel,
- training,
- retention,
- international cooperation,
- data collection.
The effectiveness and relevance of the Code of Practice, and its continued applicability, were confirmed by two evaluations conducted in 2015 and 2020.
In 2016, the WHO also adopted a Global strategy on human resources for health: Workforce 2030. In addition, the High-Level Commission on Health Employment and Economic Growth, established by the UN Secretary-General in March 2016, was tasked with making recommendations to stimulate the creation of the millions of jobs required in the health sector by 2030.
The Working for Health Action Plan (2022–2030), adopted at the 75th World Health Assembly in May 2022, shows how the WHO, member states and stakeholders can jointly support countries to optimise, build and strengthen their health and care workforce. The Action Plan responds to the 74th World Health Assembly resolution WHA74.14 in 2021 “Protecting, safeguarding and investing in the health and care workforce”, which calls for a clear set of actions for accelerating investments in health worker education, skills, employment, safeguarding and protection to 2030.
Reducing dependence on migrant health workers in Switzerland
Switzerland is a beneficiary of international migration, largely from neighbouring EU countries. According to the OECD, compared to other member states, an above-average number of physicians and nurses trained abroad are employed in Switzerland’s health system. To counter this trend, a number of measures have been taken by the Swiss authorities:
- Switzerland has supported the implementation of the WHO Code of Practice through the submission of national reports in 2012, 2015, 2018 and 2021.
- Under the Federal Council’s national strategy Health2030, it is to be ensured that sufficient numbers of well-qualified health professionals are available for long-term care. This is to be achieved through needs-based training capacities and more incentives for carers to enter long-term care and remain in the profession.
- In addition, as the first stage of the implementation of the Nursing care initiative, a training offensive is planned. The other goals of the initiative (new regulations for employment conditions, remuneration, professional development and charging of services) are to be addressed in a second stage.
- As part of the skilled labour initiative, the Federal Council implemented a support programme for “Interprofessionality in healthcare”. This was designed to help improve the quality and efficiency of healthcare, thus fully exploiting the potential of personnel working in this country.
- In the area of medical training, the Federal Council in 2016 launched the Special programme 2017–2020 "Increasing the number of degrees in human medicine". With special funding amounting to CHF 100 million, the annual number of medical degrees awarded by Swiss universities is to be increased from around 850 in 2014 to at least 1350 in 2025. Since 1 January 2022, under the new provisions in the Health Insurance Act on the restriction of licences to practise, the cantons have been able to set maximum numbers for specific disciplines or regions. They thus have greater control over the licensing of physicians – including non-Swiss physicians – in the outpatient sector.
Lastly, Switzerland (SDC) is supporting the “Working for Health” initiative, jointly established by the WHO, OECD and ILO. This programme provides financial support for the implementation of national health workforce strategic and investment plans.
International migration of health workers is also regularly discussed in the context of bilateral relations with European countries. The migration of physicians from EU/EFTA countries cannot, however, be directly restricted, as they can have their degree recognised under the Agreement on Free Movement of Persons and thus work in Switzerland.
Strengthening global patient safety
According to the World Health Organization (WHO), adverse events experienced by patients in the course of healthcare are among the top ten causes of illness and death worldwide. These are known as “adverse events”. Patient safety is primarily about preventing such adverse events and their consequences. Patient safety is a central issue in global public health, fundamental to strengthening health systems and providing high quality healthcare. Switzerland is also focusing on this issue.
International activities
The consequences resulting from poor patient safety are a major and urgent public health challenge today. With the adoption of the resolution on "Global Action on Patient Safety" at the 2019 World Health Assembly, patient safety has also been recognized as a global health priority by the WHO member states. Global efforts to strengthen patient safety include di-verse elements:
Global Patient Safety Action Plan 2021-2030
In May 2021, the World Health Assembly adopted the Global Patient Safety Action Plan, "Towards eliminating avoidable harm in health care," as an international strategic plan for the next decade.
World Patient Safety Day
The above-mentioned resolution established September 17 as the official WHO World Patient Safety Day.
Various WHO initiatives
WHO regularly publishes evidence-based recommendations and guidelines for devel-oping strategies for its Member States and provides concrete guidance for practice.
Global Ministerial Summit on Patient Safety
Since 2016, the Global Ministerial Summit on Patient Safety has brought together high-level decision-makers and experts annually to discuss the quality of healthcare and necessary measures. The aim of the summit series is to raise awareness of pa-tient safety at all levels of the healthcare system and healthcare policy (see below ).
Other international platforms
Activities of the Organisation for Economic Co-operation and Development (OECD) and initiatives within the G20 and G7 also contribute to strengthening patient safety at the international level.
More information on national patient safety activities can be found at the following links: Quality Development in Switzerland, NOSO Strategy, Health2030.
5th Global Ministerial Summit on Patient Safety 2023 in Switzerland
As a key element of its commitment to strengthening global patient safety, Switzerland hosted the 5th Global Ministerial Summit on Patient Safety in 2023. The summit in Switzerland focused on the concrete implementation of measures to strengthen patient safety.
The 5th Global Ministerial Summit on Patient Safety took place in Montreux on 23-24 February 2023. It brought together more than 600 experts and almost 80 ministerial delegations from around the world to discuss measures to strengthen patient safety.
The participants agreed that despite the progress that has been made worldwide, further efforts are still needed to ensure effective, high-quality care for all patients. In this respect, the lessons learned from the Covid-19 pandemic offer considerable potential for developing more resilient healthcare systems. The importance of the WHO's Global Patient Safety Action Plan 2021-2030 was also emphasised. This offers a comprehensive “timetable” for strengthening patient safety. The ministers and experts also recognised key national and international initiatives and the commitment of numerous interest groups around the world.
The summit was launched in 2016 and has so far taken place in the United Kingdom, Germany, Japan and Saudi Arabia. The focus was on raising awareness of patient safety and publicising appropriate measures. Building on this, the event in Switzerland focused on their implementation. Internationally, the discrepancy between existing approaches and insufficient implementation (so-called "implementation gap") is spoken of in this context. In this sense, the motto of the summit in Switzerland was “Less harm, better care - from Resolution to Implementation”. The goal continues to be the adequate and sustainable implementation of the measures. Within the framework of the summit, Switzerland worked closely with international actors, including the WHO, the OECD and various partner countries.
Last modification 17.11.2023
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