Sustainable and high-quality healthcare
The provision of financially sustainable high-quality healthcare is a key priority of Switzerland’s Health2030 strategy. At the international level, two issues are particularly important here: health worker migration and the promotion of patient safety.
International health worker migration
The quality of healthcare provision depends to a large extent on the health workers providing it. A sizeable proportion of these may come from other countries. Migrations of this kind often lead to personnel shortages, however, in their countries of origin. The growing global awareness of this issue has prompted various measures to be taken in response; and Switzerland is playing its part in these, at the national and the international level.
A global shortage
Health workers are defined by the World Health Organization (WHO) as “all people primarily engaged in actions with the primary intent of enhancing health” (World Health Report 2006). The WHO reports a global shortage of health workers, especially in developing countries. And the shortfalls are exacerbated by the movements of local health workers to countries offering more attractive terms of employment.
As a result, a significant proportion of the domestic health workforce is lost to international migration in some low-income countries. Current estimates suggest that by 2030, the numbers of health workers active in developing countries may be as much as 18 million short of the levels required to achieve the UN’s Sustainable Development Goals (SDGs).
Action by the international community
The WHO Global Code of Practice on the International Recruitment of Health Personnel, which was adopted by WHO member states in 2010, represents a global response to this issue. The Code offers a set of ethical principles for all such international recruitment. It also makes various recommendations, particularly in the areas of:
- recruitment practices
- the treatment of foreign health workers
- personnel training
- personnel retention
- international collaboration practices and
- data collection
Two subsequent studies (in 2015 and 2020) have established both the importance and the effectiveness of the Code, and have also confirmed its continued value to the international healthcare sector.
In May 2022, the 75th World Health Assembly adopted the Working for Health 2022-2030 Action Plan, which details how the WHO, its member states and its further stakeholders can collectively help countries to develop, strengthen and optimise their health and care workforce.
The Plan is a response to Resolution WHA74.14 “on protecting, safeguarding and investing in the health and care workforce”, which was adopted by the 74th World Health Assembly of 2021 and which calls for a clear set of actions to be devised with the aim of accelerating investment in the training, qualification, employment, safety and protection of health workers between now and 2030.
Reducing Switzerland’s dependence on health workers from other countries
Switzerland also benefits from the international mobility of health workers, albeit primarily from neighbouring European countries. According to the OECD, the Swiss healthcare system employs larger proportions of physicians and nursing staff who were trained in other countries than the average of its member states.
Some actions have already been taken by the Swiss authorities to counter this trend:
- Switzerland has supported the implementation of the WHO Code of Practice, particularly by submitting national reports on the issue in 2012, 2015, 2018, 2021 and 2024.
- On 28 November 2021 the country’s cantons and its population voted to approve the Nursing Care Initiative, which the Federal Council subsequently resolved to implement in two stages. As part of the drive to promote the corresponding training, the Federal Nursing Training Promotion Act and its ordinances came into effect on 1 July 2024. The Initiative’s further aims (regarding employment terms and conditions and professional development) are being addressed under the Federal Nursing Working Conditions Act project and the project to revise the Federal Healthcare Professions Act, which now need to be debated in the Swiss Parliament.
- As part of the drive to combat the shortages of suitably qualified personnel, the Swiss Confederation has invested some CHF 8 million in projects designed to promote efficiency in basic medical care and (in particular) in healthcare interprofessionality.
- A number of actions relating to basic care provision were launched by Federal Councillor Elisabeth Baume-Schneider on 26 November 2024. These actions are aimed at ensuring that everyone in Switzerland continues to enjoy access to sufficient and adequate healthcare. They should help advance the sustainability of the healthcare system through measures that develop and integrate innovative models and approaches, refine professional profiles and exploit the opportunities offered by digitalisation; and they should also complete the implementation of the Nursing Care Initiative, and thereby help ease the present shortages of suitably qualified personnel.
The issue of international health worker migration is also regularly discussed in the context of broader bilateral relations with European Union countries. The migration of physicians to Switzerland from EU/EFTA states cannot be directly restricted, however, as such persons can have their qualifications recognised under the Agreement on the Free Movement of Persons, which entitles them to work in Switzerland.
Strengthening global patient safety
Patient safety is a central issue in public health worldwide and is fundamental to strengthening health systems and providing high-quality healthcare. Switzerland puts a firm focus on patient safety, too.
Further information: Strengthening global patient safety
More information on patient safety activities in Switzerland will be found at:
Further information
Index
Federal Office of Public Health FOPH
Global Health Section
Schwarzenburgstrasse 157
Switzerland - 3003 Bern