Patient-centred policies must be centred on healthcare workers too

Member of the Executive Committee, Confédération Française Démocratique du Travail (CFDT), France

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The OECD Health Ministerial in Paris on 17 January has the ambition of paving the way to “The Next Generation of Health Reforms” with “people at the centre”. Representing the Trade Union Advisory Committee to the OECD (TUAC) on this occasion, and in close partnership with the Public Services International (representing public sector trade unions), I am bringing the voice of the labour movement to the table.

Health is a public good. The right to health is a fundamental human right and its fulfilment is key to achieving the UN Sustainable Development Goals. And yet, even in the advanced economies of the OECD, inequalities in access to health services persist and are being aggravated by austerity policies. It is essential to address the social determinants of health inequalities and from there to work towards sustainable funding and insurance systems that can be trusted and are inclusive for all. This should be based on public services, social protection and, where appropriate, not-for-profit insurance schemes and cooperatives. It is also critical to maintain a robust healthcare infrastructure that can absorb health shocks and epidemiological peaks. Cost-optimisation strategies aiming at “just-in-time” delivery do not offer a viable future for our hospitals.

But we agree that more can be done to eliminate waste in health spending. Monopoly distortions driven by pharmaceutical corporations need to be effectively addressed. It is equally necessary to anticipate and invest for the future. Preventive care, awareness campaigns targeted at vulnerable populations and at the youth, and better life-long health monitoring make sense in their own right, but can also offer opportunities to improve control over, and indeed reduce healthcare spending in the long term.

For trade unions, people-centred means both patient-centred policies and healthcare worker-centred policies together. Both are intertwined. Ensuring respectful treatment of healthcare workers by listening to their concerns, including through their representative institutions, is essential both to deliver quality services and to build trust with patients. Social dialogue including healthcare workers and professionals also improves process and organisation. That is particularly true for those personnel who are at the bottom of the pay pyramid , such as nurses, community workers, and healthcare assistants, but who play a vital role in ensuring a balanced working relationship between informed professionals (doctors and insurers) and the patients themselves.

The Trade Union Advisory Committee (TUAC) to the OECD is an interface for labour unions with the OECD. It is an international trade union organisation which has consultative status with the OECD and its various committees.

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©OECD Observer No 309 Q1 2017

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