The right to health has repeatedly been em­phasised in the global context over the last few decades. The 1944 Universal Declaration of Human Rights notes that “everyone has the right to a standard of living adequate for the health, and well-being of himself and his family”. In 1966, the United Nations called for the “right of everyone to the enjoyment of the highest attainable standard of health” in article 12 of the International Covenant on Economic, Social and Cultural Rights. More recently, in 2000, the UN sought to further define the right to health through extensive detailing and discussion of the characteristics of an effective health-care system as should be provided by states and NGOs and through clearly determining that the right to health actually extends beyond the provision of comprehensive health-care systems.

We are committed towards embedding measures that would accommodate retention and sustained motivation of our workforce- Joseph Cassar

In general comment 14, the UN Committee on Economic, Social and Cultural Rights determines that other rights and freedoms address integral components of the right to health, as are the rights to education, housing, work and food.

It is against this backdrop that I insist that my ministry, in its central quest to address the right to health of the people of this country, has to keep the following two items at the top of all and any of its agendas: an effective and free health-care system and close collaboration with other ministries.

In turn, it is hard to argue against the fact that a good supply of human resources, that is an appropriate and adequate workforce, is a prerequisite for both above items.

Hence, securing an adequate and appropriate workforce is a main underpinning obligation of the work of my ministry in its quest to address the people’s right to health.

What have we done, so far? What are we doing? What are our plans? What are the main challenges?

We have primarily sought to study the nature, composition and workings of the health workforce in the specific context of Malta and also in the context of the international scenario. The world is now increasingly looking into and adopting integrated workforce planning and supplies, where all the different workers within a health-care system are collectively planned for and sought. Doctors and nurses are planned for and supplied against a wider context of plans and supplies of allied health professions and workers, as are physiotherapists and podiatrists, the domestic staff and administrative and management members. I am confident we too are, diligently and cautiously, moving in this more efficient direction.

Over the last few years we have worked hard at shifting the emphasis of our recruitment programme and of our efforts at building exciting career opportunities in the health-care area away from the exclusive domains of the medical and nursing professions. Indeed, allied health professions have increasingly received significantly more attention. In fact, a directorate for allied health professions has recently been established within the ministry, which seeks to secure the necessary structures for the planning and provision of all allied health professions, in tandem with nurses and doctors and all the other essential domestic and technical staff who work in our health-care system. The ministry has clearly understood that its workforce needs to comprise significant administrative and management talent, potential and skills. Only then can the ministry secure a health-care system that is effective and only when such characteristics are present can it collaborate efficiently with other ministries in order to really address the right to health of the people.

We have also actively sought to collaborate with the main educational entities in Malta: the Malta College of Arts, Science and Technology and the University of Malta. The cornerstone of all our collaborative work with these entities has been the need to address the demand for a health workforce that is sufficient in terms of both quantity and quality. Our support towards the educational initiatives of the University and Mcast, for example by offering full cooperation to their efforts to place students needing to practise in the clinical areas, have translated into favourable outcomes in that intakes of students to the various programmes at the University and Mcast have been on the increase.

Last month, a record number of applicants sought to pursue programmes in health care. Surely the ministry has been successful in its recruitment campaign but, although we are pleased with this because we acknowledge that recruitment is indeed essential, we are fully aware that it is not sufficient for an adequate health workforce!

Hence, we will continue to seek to maintain optimal retention and motivation across our health workforce. This is indeed a significantly tall challenge because, in the light of pockets of skills (not necessarily staff) shortages, both locally and internationally in view of the increasing flexibility and widening roles and remits of health-care professionals, continuous development and advancements in health- care provision and various opportunities for employment locally and overseas, many members of the workforce choose to move on after a while.

We are committed towards embedding measures that would accommodate retention and sustained motivation of our workforce. The ministry takes pride in the introduction of the foundation programme for doctors, which provided an apt vehicle to retain students who graduate from the medical school at the University. Very few medical graduates leave the country nowadays. We are dedicating much effort in developing similar vehicles, which will mirror the outcomes of the foundation programme for doctors, across other facets of the health workforce. We are hoping for similar success.

Our aim is to address one’s right to health. It is a continued right of our people, hence, our efforts to ensure an optimal workforce that can secure this right will be equally continued.

Dr Cassar is the Minister for Health, the Elderly and Community Care.

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