National Reporting Instrument 2018
Background
[iBG]
Adopted in 2010 at the 63rd World Health Assembly (WHA Res 63.16), the WHO Global Code of Practice on the International Recruitment of Health Personnel (“the Code”) seeks to strengthen the understanding and ethical management of international health personnel recruitment through improved data, information, and international cooperation.
Article 7 of the Code encourages WHO Member States to exchange information on the international recruitment and migration of health personnel. The WHO Director General is additionally mandated to report to the World Health Assembly every 3 years. WHO Member States completed the 2nd Round of National Reporting on Code implementation in March 2016. The WHO Director General reported progress on implementation to the 69th World Health Assembly in May 2016 (A 69/37 and A 69/37 Add.1). During the 2nd Round of National Reporting, seventy-four countries submitted complete national reports: an increase in over 30% from the first round, with improvement in the quality and the geographic diversity of reporting.
The National Reporting Instrument (NRI) is a country-based, self-assessment tool for information exchange and Code monitoring. The NRI enables WHO to collect and share current evidence and information on the international recruitment and migration of health personnel. The NRI (2018) has been considerably shortened, while retaining key elements. It now comprises 18 questions. The common use of the instrument will promote improved comparability of data and regularity of information flows. The findings from the 3rd Round of National Reporting are to be presented at the 72nd World Health Assembly, in May 2019.
The deadline for submitting reports is 15 August 2018.
Should technical difficulties prevent national authorities from filling in the online questionnaire, it is also possible to download the NRI via the link: http://www.who.int/hrh/migration/code/code_nri/en/. Please complete the NRI and submit it, electronically or in hard copy, to the following address:
Health Workforce Department
Universal Health Coverage and Health Systems
World Health Organization
20 Avenue Appia, 1211 Geneva 27
Switzerland
hrhinfo@who.int
The data and information collected through the National Reporting Instrument will be made publicly available via the WHO web-site following the proceedings of the 72nd World Health Assembly. The quantitative data collected will be updated on and available through the National Health Workforce Accounts online platform (http://www.who.int/hrh/statistics/nhwa/en/).
Article 7 of the Code encourages WHO Member States to exchange information on the international recruitment and migration of health personnel. The WHO Director General is additionally mandated to report to the World Health Assembly every 3 years. WHO Member States completed the 2nd Round of National Reporting on Code implementation in March 2016. The WHO Director General reported progress on implementation to the 69th World Health Assembly in May 2016 (A 69/37 and A 69/37 Add.1). During the 2nd Round of National Reporting, seventy-four countries submitted complete national reports: an increase in over 30% from the first round, with improvement in the quality and the geographic diversity of reporting.
The National Reporting Instrument (NRI) is a country-based, self-assessment tool for information exchange and Code monitoring. The NRI enables WHO to collect and share current evidence and information on the international recruitment and migration of health personnel. The NRI (2018) has been considerably shortened, while retaining key elements. It now comprises 18 questions. The common use of the instrument will promote improved comparability of data and regularity of information flows. The findings from the 3rd Round of National Reporting are to be presented at the 72nd World Health Assembly, in May 2019.
The deadline for submitting reports is 15 August 2018.
Should technical difficulties prevent national authorities from filling in the online questionnaire, it is also possible to download the NRI via the link: http://www.who.int/hrh/migration/code/code_nri/en/. Please complete the NRI and submit it, electronically or in hard copy, to the following address:
Health Workforce Department
Universal Health Coverage and Health Systems
World Health Organization
20 Avenue Appia, 1211 Geneva 27
Switzerland
hrhinfo@who.int
The data and information collected through the National Reporting Instrument will be made publicly available via the WHO web-site following the proceedings of the 72nd World Health Assembly. The quantitative data collected will be updated on and available through the National Health Workforce Accounts online platform (http://www.who.int/hrh/statistics/nhwa/en/).
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Please describe
Disclaimer
[disclaim]
For more information on WHO Data Policy kindly refer to http://www.who.int/publishing/datapolicy/en/
For more information on WHO Data Policy kindly refer to http://www.who.int/publishing/datapolicy/en/
I have read and understood the WHO policy on the use and sharing of data collected by WHO in Member States outside the context of public health emergencies
Designated National Authority Contact Details
[q01a]
Name of Member State:
Finland
[q01b]
Contact information:
Full name of institution:
Ministry of Social Affairs and Health
Name of designated national authority:
Marjukka Vallimies-Patomäki
Title of designated national authority:
Ministerial Adviser
Telephone number:
+358503676490
Email:
marjukka.vallimiespatomaki@stm.fi
Implementation of the Code
[q1]
1. Has your country taken steps to implement the Code?
Yes
[q2]
2. To describe the steps taken to implement the Code, please tick all items that may apply from the list below
2.a Actions have been taken to communicate and share information across sectors on the international recruitment and migration of health personnel, as well as to publicize the Code, among relevant ministries, departments and agencies, nationally and/or sub-nationally.
The Ministry of Social Affairs and Health published in 2016 recommendations on regulations, policy approaches and good practices for carrying out the quidelines of the WHO Code. The publication was prepared in multisectoral collaboration, e.g. experts from the Ministry of Employment and the Economy and the Local Government Employers KT were involved. (See 2d.) https://stm.fi/julkaisu?pubid=URN:ISBN:978-952-00-3695-9
2.b Measures have been taken or are being considered to introduce changes to laws or policies consistent with the recommendations of the Code.
Finnish legislation safeguards equal treatment of migrants in many different ways (See 13). Constitution of Finland (731/1999) regulates equal treatment of those who live in Finland and prohibits discrimination on the basis of a persons gender, age, origin, religion, beliefs, opinion, health, disability or other personal characteristics.
2.c Records are maintained on all recruiters authorized by competent authorities to operate within their jurisdiction.
2.d Good practices, as called for by the Code, are encouraged and promoted among recruitment agencies.
The Ministry of Employment and the Economy has published a generic model for the process of international recruitment. The model takes into account of the quidelines of the WHO Code and particular requirements for health care, e.g. regarding knowledge of the Finnish language. (See 2a.)
2.e Measures have been taken to consult stakeholders in decision-making processes and/or involve them in activities related to the international recruitment of health personnel.
The Finnish Parliament has adapted the Law on the acceptance of private actors to the EURES-network, due to the Regulation (EU) 2016/589 of 13 April 2016 on a European network of employment services (EURES). The new private Eures members and partners shall act following the provisions in the Regulation i.e. regarding the national provisions on the workers’ rights.
2.f Other steps:
The new statistical data base including data on foreign-trained health personnel is under construction. (See 17.c.)
[q3]
3. Is there specific support you require to strengthen implementation of the Code?
3.a Support to strengthen data and information
3.b Support for policy dialogue and development
3.c Support for the development of bilateral agreements
3.d Other areas of support:
A WHO platform for collaboration of the designated national authorities responsible for exchanging information regarding the implementation of the Code would be very desirable. At present, this kind of collaboration does not cover all national authorities.
Data on International Health Personnel Recruitment & Migration
[iq4]
Improving the availability and international comparability of data is essential to understanding and addressing the global dynamic of health worker migration.
[q4]
4. Does your country have any mechanism(s) or entity(ies) to maintain statistical records of foreign-born and foreign-trained health personnel?
Yes
[q4x1]
Please describe:
The annual national statistical report on health care and social welfare personnel published by the National Institute for Health and Welfare provides data on the international mobility of the health and social services personnel as well as data on people with qualifications in health care and social welfare resided and being employed in Finland in health and social services or other sectors. This data is available by the country of origin and the nationality.
http://www.julkari.fi/handle/10024/135915
The Finnish Medical Association and The Finnish Dental Association gather annually information about the physicians and dentists in Finland. The statistics include information about practitioners, who have been trained abroad. However, the figures apply only to those persons who are members of the respective associations. However, membership rate is high and e.g. about 95% of physicians are members of the FMA.
https://www.laakariliitto.fi/tutkimus/laakarityovoima/
[iQ5]
For the latest year available, consistent with the National Health Workforce Accounts (NHWA) Indicators 1-07 and 1-08, please provide information on the total stock of health personnel in your country (preferably the active workforce), disaggregated by the country of training (foreign-trained) and the country of birth (foreign-born). Please consult with your NHWA focal point, if available, to ensure that data reported below is consistent with NHWA reporting.
[q5x1]
5. Data on the stock of health personnel, disaggregated by country of training and birth
5.1 Consolidated stock of health personnel
5.1 Consolidated stock of health personnel
| Total | Domestically Trained | Foreign Trained | Unknown Place of Training | National Born | Foreign Born | Source* | Additional Comments# | |
|---|---|---|---|---|---|---|---|---|
| Medical Doctors | Data on the place of training is incomplete. | 13413 | 1237 | 9912 | 24351 | 2179 | Country of Training is based on register of The National Supervisory Authority for Welfare and Health. The latest register year available is 2015 for statistical data base. Health personnel by country of Training includes persons (18-68 year olds) that have granted the right to practice a profession, but we don’t have data where they live/work in the statistical year. Country of Birth statistics is based on the employment statistics of Statistics Finland. (http://www.stat.fi/til/tyokay/meta_en.html). The latest register year available for statistical data base is 2014. The country of birth includes persons working in health care sector, but this data doesn’t yet give information on where the degree has been completed. | This comment concerns all professions: Data is based on two old statistical data bases of National Institute for Health and Welfare. These data bases are under construction. |
| Nurses | Data on the place of training is incomplete. | 87645 | 1430 | 204 | 80184 | 2628 | See previous | - |
| Midwives | Data on the place of training is incomplete. | 4719 | 42 | 7 | 6451 | 146 | See previous | - |
| Dentists | Data on the place of training is incomplete. | 734 | 20 | 5081 | 6066 | 376 | See previous | - |
| Pharmacists | Data on the place of training is incomplete. | - | - | 10671 | 12346 | 320 | See previous | Old statistical data base excluded non-health care sector examinations, eg. pharmacists and psychologists. |
[iq5x2]
5.2 Country of training for foreign-trained health personnel
Please provide detailed data on foreign-trained health personnel by their country of training, as consistent with NHWA Indicator 1-08. This information can be provided by one of the following two options:
Please provide detailed data on foreign-trained health personnel by their country of training, as consistent with NHWA Indicator 1-08. This information can be provided by one of the following two options:
[q5x2x2]
Option B: Uploading any format of documentation providing such information (e.g. pdf, excel, word).
Please upload file
[Q5fn]
*e.g. professional register, census data, national survey, other
#e.g. active stock, cumulative stock, public employees only etc.
#e.g. active stock, cumulative stock, public employees only etc.
Partnerships, Technical Collaboration and Financial Support 1/2
[q6]
6. Has your country provided technical or financial assistance to one or more WHO Member States, particularly developing countries, or other stakeholders to support the implementation of the Code?
6.a Specific support for implementation of the Code
6.b Support for health system strengthening
For example, the Ministry of Social Affairs and Health as well as the National Institute for Health and Welfare are actively contributing to the WHO cooperation in order to improve global health security.
6.c Support for health personnel development
6.d Other areas of support:
[q7]
7. Has your country received technical or financial assistance from one or more WHO Member States, the WHO secretariat, or other stakeholders to support the implementation of the Code?
7.a Specific support for implementation of the Code
7.b Support for health system strengthening
7.c Support for health personnel development
7.d Other areas of support:
Partnerships, Technical Collaboration and Financial Support 2/2
[q8]
8. Has your country or its sub-national governments entered into bilateral, multilateral, or regional agreements and/or arrangements to promote international cooperation and coordination in relation to the international recruitment and migration of health personnel?
Yes
[q8x1]
8.1 Please provide the text and/or web-links to the agreements or arrangements
Please upload file
[q8x1wl]
Web-links:
Several health care and social welfare organizations and recruitment agencies have carried out projects on international recruitment in recent years. However, this kind of international collaboration is currently less common.
[q8x2]
8.2 If documentation is unavailable, please use Table A on next screen to describe the bilateral, regional or multilateral agreements or arrangements:
Table A Description of bilateral, multilateral, regional agreements or arrangements
Table A Description of bilateral, multilateral, regional agreements or arrangements
1.
2.
3.
4.
5.
[q8x2fx1]
Title of Agreement
Information is not available.
[q8x2ax1]
Type of Agreement
Bilateral
[q8x2bx1]
Countries Involved
The Philippines,
Spain,
Greece
[q8x2cx1]
Coverage
Subnational
[q8x2dx1]
Main content of agreements (Include all that apply)
Education and training
Institutional capacity building
Promotion of circular migration
Retention strategies
Recognition of health personnel
Recruitment of health personnel
Twinning of health care facilities
Introduction of the Finnish culture and health and social service system Orientation to work in the health and social services in Finland
Other mechanism (include details if possible)
[q8x2ex1]
Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Practical nurses
Other (include details as necessary)
[q8x2gx1]
Validity period
E.g. particularly in the 2010´s.
[q8x2fx2]
Title of Agreement
[q8x2ax2]
Type of Agreement
[q8x2bx2]
Countries Involved
[q8x2cx2]
Coverage
[q8x2dx2]
Main content of agreements (Include all that apply)
Education and training
Institutional capacity building
Promotion of circular migration
Retention strategies
Recognition of health personnel
Recruitment of health personnel
Twinning of health care facilities
Other mechanism (include details if possible)
[q8x2ex2]
Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
[q8x2gx2]
Validity period
[q8x2fx3]
Title of Agreement
[q8x2ax3]
Type of Agreement
[q8x2bx3]
Countries Involved
[q8x2cx3]
Coverage
[q8x2dx3]
Main content of agreements (Include all that apply)
Education and training
Institutional capacity building
Promotion of circular migration
Retention strategies
Recognition of health personnel
Recruitment of health personnel
Twinning of health care facilities
Other mechanism (include details if possible)
[q8x2ex3]
Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
[q8x2gx3]
Validity period
[q8x2fx4]
Title of Agreement
[q8x2ax4]
Type of Agreement
[q8x2bx4]
Countries Involved
[q8x2cx4]
Coverage
[q8x2dx4]
Main content of agreements (Include all that apply)
Education and training
Institutional capacity building
Promotion of circular migration
Retention strategies
Recognition of health personnel
Recruitment of health personnel
Twinning of health care facilities
Other mechanism (include details if possible)
[q8x2ex4]
Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
[q8x2gx4]
Validity period
[q8x2fx5]
Title of Agreement
[q8x2ax5]
Type of Agreement
[q8x2bx5]
Countries Involved
[q8x2cx5]
Coverage
[q8x2dx5]
Main content of agreements (Include all that apply)
Education and training
Institutional capacity building
Promotion of circular migration
Retention strategies
Recognition of health personnel
Recruitment of health personnel
Twinning of health care facilities
Other mechanism (include details if possible)
[q8x2ex5]
Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
[q8x2gx5]
Validity period
[q8x3]
8.3 Are recommendations of the WHO Global Code reflected in the agreements (e.g. taking into account the needs of developing countries)?
Yes/Partly
Health Workforce Development and Health System Sustainability
[q9]
9. Does your country strive to meet its health personnel needs with its domestically trained health personnel, including through measures to educate, retain and sustain a health workforce that is appropriate for the specific conditions of your country, including areas of greatest need?
Yes
[q9x1]
9.1 Measures taken to educate the health workforce
In 2017, in health care centres the shortage of physicians was 4.5% and of dentists 5.2%. In specialist health care, the mean physician shortage is 6% and the mean shortage of dentists 2.6%. However, there is great regional variation and variation among different medical and dental specialities. To compensate missing workforce, the amount of new medical students has been raised from the year 2000 on. Admittance has been increased to 750 new students per year by the year 2016. In addition, the number of Finnish medical students studying abroad has been increasing substantially, and majority of them plan to return to Finland after graduation. Dentist education has been re-started in one additional university (namely, the University of Eastern Finland).
https://www.hammaslaakariliitto.fi/fi/liiton-toiminta/tutkimukset-ja-tilastot/tutkimukset/tyovoimaselvityksethttps://www.laakariliitto.fi/site/assets/files/1011/ll16_taskutil_06_en_160524net.pdf
The average shortage of nurses was 1,1 % (n=334) in municipal health and social services at the national level in 2017. The average shortage of practical nurses was 3,4 % (n=872) in municipal social services and 2,5 % (n=310) in health care services. On average the shortage in municipal health and social services was 2,0 % which is 1,2 percentage units less than five years ago. However, there are still regional differences in the sufficiency of the workforce in health and social services. (KT Local Government Employers, 2018.)
https://www.kt.fi/sites/default/files/media/document/Kuntasektorin-tyovoimatilanne-2017.pdf
Each university and the Ministry of Education and Culture conduct negotiations at the beginning of every four-year agreement term, in which they set operational and qualitative targets for the universities and determine the resources required. The agreement also provides for the monitoring and evaluation of target attainment and the development of operations. Targets include e.g. the number of degrees needed for the health care sector. Targets are prepared through the anticipation process (See 9.3.).
The Ministry of Education and Culture and the higher education institutions negotiate at the start of each four-year agreement period, covering e.g. the following: common objectives for the higher education system, core areas in each higher education institution, degree objectives as well as the appropriations allocated on the basis of these. The agreement also specifies how the outcomes of the objectives will be reported. The Ministry periodically gives written feedback the institutions on their activities and development needs. When necessary, the Ministry invites the management of the institutions to discuss the special characteristics and specific questions related to different fields.
https://minedu.fi/en/steering-financing-and-agreements
9.2 Measures taken to retain the health workforce
Increase in physicians’ and dentists’ salaries has been one measure to attract workforce, especially in remote areas. The possibility to regularly update and increase professional skills, i.e. out of work Continuous Medical Education, has been a similar advantage. Helping the spouse to get work in the same region and providing help in finding accommodation have been measures taken in regions with most shortage.
As an example of retaining measures are the advanced roles of nurses which have been conducted on the basis of the national social and health policy programmes adopted by the Government. Consultations by nurses and public health nurses have been developed for patients with communicable and non-communicable diseases since 2002. Nurses and public health nurses provide consultations within multiprofessional teams or work in pairs with physicians in health centres and emergency care units. These developments were incorporated with legislation on nurse prescribing in 2010, followed by regulations on postgraduate education in 2011.
The salary remuneration system in the local governmental sector is based in the General Collective Agreement and consists of task specific salary, personal increment, work experience increment and performance pay. In addition, single payments may be made in accordance with the General Collective Agreement. The task specific salary is determined on the basis of the degree of the complexity of task in question.
The Finnish Institute of Occupational Health has published criteria on leadership and management reflecting organizational justice to be applied in work places. The criteria are defined as five entities: (1) trust and respect, (2) collaboration and networks, (3) multiplicity and individuality, (4) knowledge, skills and development as well as (5) regeneration and involvement.
https://www.ttl.fi/tyoyhteiso/hyvan-johtamisen-kriteerit/
In some municipalities, employers provide rental apartments which will be available for new personnel for a certain number of years after recruitment.
9.3 Measures taken to ensure the sustainability* of the health workforce
The long term anticipation of demand for labour and educational needs has been carried every fourth year since 1991. Health care and social welfare is one of the industries covered. The current anticipation work combines quantitative and qualitative anticipation. The work is based on alternative forecasts of e.g. productivity developments and long-term demand for labour in different industries made by VATT Institute for Economic Research and recently by VTT Technical Research Centre of Finland Ltd by using the VATTAGE model. Furthermore, the net migration is taken into account as part of forecasts of supply for labour. The Finnish National Agency for Education EDUFI using the Mitenna model anticipates changes in the occupational structures of different industries, natural wastage of labour and, on the basis of these factors, the demand for new labour needed for different occupational groups and the educational needs. The National Agency for Education also anticipates skills demands in different sectors using the VOSE model. The objective is to produce information on which skills are needed in future working life.
In the latest anticipation, the quantitative sector forecasts extend to the year 2030 and form the basis for the anticipation of educational needs for 2020. Quantitative anticipation data is used in decision-making regarding education policy and by the Ministry of Education and Culture for steering higher education and vocational education. Higher education and vocational institutes use the results of anticipation for planning the supply of education.
9.4 Measures taken to address the geographical mal-distribution of health workers
Education of dentists has been re-started in the University of Eastern Finland.
Arranging social and health services on the wheels and via e-consultations are new modes of services in order to ensure access to services in remote areas and districts where the sufficiency of certain professionals is a challenge.
[q10]
10. Are there specific policies and/or laws, across governmental ministries, for internationally recruited and/or foreign-trained health personnel in your country?
Yes
[q10x1]
10.1 Please provide further information in the box below:
The Act on Health Care Professionals (559/1994) contains regulations on the right to practice as a health care professional and/or to use a professional title for (1) persons trained in Finland or (2) in another EU/EEA state, (3) nationals of a third country and educated in another EU/EEA state, (4) nationals of an EU/EEA state and educated outside the EU/EEA and (5) nationals of a third country and educated outside the EU/EEA.
https://www.finlex.fi/en/laki/kaannokset/1994/19940559
National Supervisory Authority for Welfare and Health (Valvira) grants, upon application, the right to practice as a licenced or authorised professional and authorises the use of the occupational title of healthcare professional.
https://www.valvira.fi/web/en/healthcare/professional_practice_rights
The National Supervisory Authority for Welfare and Health (Valvira) requires a verified document of medical graduation so that a physician who has graduated outside the EU/EEA can seek a right to practice medicine in Finland. Then a special examination is required, and at present, the Faculty of Medicine and Life Sciences of the University of Tampere organizes these (hence they are called “Tampere- examinations”). Before taking part of the examination, the candidate must have completed a language examination of Finnish or Swedish, the two official languages of Finland, and must have been working for six months in a Finnish hospital of health center.
In accordance with the internationalisation strategy for higher education, universities of applied sciences may provide education for immigrants free of charge with a view to providing them with language proficiency and other knowledge and skills needed for studies at a university of applied sciences (Act 932/2014, section 10).
https://www.finlex.fi/en/laki/kaannokset/2014/en20140932_20160563.pdf
There are multiple policies across the ministries to support education and familiarisation of immigrants and multicultial workplaces. The focus of these policies is not particularly on health care personnel but in general on immigrant employees.
The Ministry of Economic Affairs and Employment has published a website Online manual on the Act on the Promotion of Immigrant Integration. The manual provides an up-to-date information package about the application of the act for parties working to integrate immigrants and offering measures promoting integration. The manual contains information about the different stages of immigrant integration. These issues are mainly examined from employees’ perspective. https://kotouttaminen.fi/en/online-manual-on-integration
The Finnish Institute of Occupational Health conduct research and training regarding multicultural workplaces and work well-being at these workplaces. In addition, the Finnish Institute of Occupational Health has developed instruments which help workplaces to evaluate their strengths and development needs that are related to multicultural issues. The instruments help in evaluating how multiculturalism is taken into account at the workplace, e.g. in terms of familiarisation, supervision and occupational health care. These instruments also assist to develop equal recruitment, treatment and participation opportunities as well as the role of the management in a multicultural workplace.
https://www.ttl.fi/tyoyhteiso/monikulttuurinen-tyoelama/
[q11]
11. Recognizing the role of other parts of government, does the Ministry of Health have processes (e.g. policies, mechanisms, unit) to monitor and coordinate across sectors on issues related to the international recruitment and migration of health personnel?
Yes
[q11x1]
11.1 Please provide further information in the box below:
E.g. Coordination of data on in and out-flow, integration and recognition of foreign qualifications, engagement with diaspora.
The National Institute for Health and Welfare provides data on in and out-flow etc. (See 4.)
The National Supervisory Authority for Welfare and Health (Valvira) grants, upon application, the right to practice as a licenced or authorised professional and authorises the use of the occupational title of healthcare professional regardless of the health care professional´s origin, nationality or the state where the qualification was completed. Recognition of foreign qualifications is based on the Act on Health Care Professionals (559/1994). (See 10.1.)
[q12]
12. Has your country established a database or compilation of laws and regulations related to international health personnel recruitment and migration and, as appropriate, information related to their implementation?
Yes
[q12x1]
12.1 Please provide further information in the box below:
According to the Act on the Promotion of Immigrant Integration (1386/2010, section 7) immigrants have to provided with information about their rights and obligations in Finnish working life and society as well as information about the service system and the measures promoting integration.
Several authorities and professional organizations disseminate information on legislation related to international recruitment and migration both for employers and work-based immigrants. The need for better coordination has been recognized. Some examples are given below:
The National Supervisory Authority for Welfare and Health Valvira makes available information, in English, about professional practice rights in health care, the application process for persons qualified in the EU/EEA states and outside the EU/EEA states, language requirements and legislation as well as various contact information. https://www.valvira.fi/web/en/healthcare/professional_practice_rights/qualified_in_eu_eea_member_state
Information for work-based immigrants in health care and social welfare is also available via the websites of the professional organizations, e.g. the Finnish Medical Association, the Finnish Dental Association, the Union of Health and Social Care Professionals Tehy, the Finnish Nurses Association, the Union of Professional Social Workers Talentia and the Finnish Union of Practical Nurses SuPer.
Welcome to Finland guide is an information package in compliance with the integration act. It is available, in 12 languages, on the website of the Ministry of Employment and the Economy. The authorities who apply the integration act are each responsible for their part about the contents of the guide. https://tem.fi/perustietoa-suomesta
The Finnish Immigration Service provides foreigners information about immigration and residence in Finland, applications, permits and citizenship. https://migri.fi/en/home
The website of the Ministry of the Interior (www.intermin.fi) provides information e.g. about integration matters and labour migration. https://intermin.fi/en/areas-of-expertise/migration
The Social Insurance Institution makes available information about social benefits in Finland (https://www.kela.fi/web/en) and the Tax Administration has a common service desk for foreign workers in Finland (https://www.vero.fi/en/individuals/tax-cards-and-tax-returns/arriving_in_finland/work_in_finland/ ).
The Ministry of Social Affairs and Health provides information in issues concerning occupational health and safety as well as social welfare and health care. https://stm.fi/en/areas-of-expertise
Working in Finland – Information for Immigrants guide by the Finnish Institute of Occupational Health informs immigrants in 13 languages about Finnish working life. https://www.ttl.fi/tyoyhteiso/monikulttuurinen-tyoelama/toissa-suomessa-tietoa-maahanmuuttajalle-13-kielella/
Infopankki administered by the City of Helsinki offers (Capital area), in 12 languages, information about Finnish society and culture, moving to Finland, living in Finland, housing, Finnish language study, work and entrepreneurship, education and training, social and health care services, how to act in problem situations etc. https://www.infopankki.fi/en/frontpage
KT Local Government Employers is a municipal employers organisation that promotes the interests of Finnish local and joint municipal authorities in the labour market. The website of KT Local Government Employers provides information on labour immigration:
https://www.kt.fi/palvelussuhde/alkaminen/kv-rekrytointi
and on the conditions of employment of immigrants:
https://www.kt.fi/palvelussuhde/alkaminen/kv-rekrytointi/palvelussuhteen-ehdot
Information about legislation is available from Finlands electronic legislative database. www.finlex.fi
[q9x3fn]
*Health workforce sustainability reflects a dynamic national health labour market where health workforce supply best meets current demands and health needs, and where future health needs are anticipated, adaptively met and viably resourced without threatening the performance of health systems in other countries (ref: Working for Health and Growth, Report of the High-Level Commission on Health Employment and Economic Growth, WHO, 2016, available from http://apps.who.int/iris/bitstream/10665/250047/1/9789241511308-eng.pdf?ua=1
).
Responsibilities, Rights and Recruitment Practices
[q13]
13. Which legal safeguards and/or other mechanisms are in place to ensure that migrant health personnel enjoy the same legal rights and responsibilities as the domestically trained health workforce? Please tick all options that apply from the list below:
13.a Migrant health personnel are recruited internationally using mechanisms that allow them to assess the benefits and risk associated with employment positions and to make timely and informed decisions regarding them
13.b Migrant health personnel are hired, promoted and remunerated based on objective criteria such as levels of qualification, years of experience and degrees of professional responsibility on the same basis as the domestically trained health workforce
13.c Migrant health personnel enjoy the same opportunities as the domestically trained health workforce to strengthen their professional education, qualifications and career progression
13.d Other mechanisms, please provide details below if possible:
All immigrant workers are protected equally with the national employees by the National Labour Inspection Authority (AVI). Trade unions provide assistance for their members.
[q14]
14. Please submit any other comments or information you wish to provide regarding legal, administrative and other measures that have been taken or are planned in your country to ensure fair recruitment and employment practices of foreign-trained and/or immigrant health personnel.
[q15]
15. Please submit any comments or information on policies and practices to support the integration of foreign-trained or immigrant health personnel, as well as difficulties encountered.
On average, the unemployment rates among foreigntrained and immigrant health care professionals are higher in comparison to the native health professionals. Thus, a fluent process of authorisation as well as learning the Finnish language are key measures to support their integration.
[q16]
16. Regarding domestically trained/ emigrant health personnel working outside your country, please submit any comments or information on measures that have been taken or are planned in your country to ensure their fair recruitment and employment practices, as well as difficulties encountered
The Government adopted 2017 the Program to support the expatriate Finns with 17 policy guidelines regarding different sectors of life outside Finland. https://intermin.fi/documents/1410869/3723692/Hallituksen+ulkosuomalaispoliittinen+ohjelma+2017-2021.pdf/4ccac0d7-b7f3-453b-8df5-872fce0de27a/Hallituksen+ulkosuomalaispoliittinen+ohjelma+2017-2021.pdf.pdf
Constraints, Solutions, and Complementary Comments
[q17]
17. Please list in priority order, the three main constraints to the implementation of the Code in your country and propose possible solutions:
| Main constraints | Possible solution | |
|---|---|---|
| According to a Finnish study on recruitment of nurses from the Philippines to Finland there are challenges regarding recruitment practices, professional development paths and integration of a multicultural work community. The sudy was based on a pilot project carried out in 2008-201. The objectives were to develop ethical recruitment and authorisation practices as well as professional development opportunities. The study showed that ethical and economic points of views conflicted in some occasions. Furthermore, Philippine nurses were employed as practical nurses or care assistants in order to be authorized to work as registered nurses in Finland. Orientation to the Finnish social welfare and health care service system and multicultural work communities should also been integrated into the process of international recruitment. (Vartiainen P, Koskela M & Pitkänen P. Suomen Yliopistopaino Oy – Juvenes Print. Tampere, 2018.) | To establish a programme for recognizing and completing qualifications of nurses and other regulated professions (Excluding physicians because such a programme for physicians already exists.) who have passed professional education outside of the EU/EEA states. This kind of programme could speed up the process. In addition, resources e.g. for arranging adaptation periods, language cources etc. have to be ensured. | |
| The informal cooperation between the he Ministry of Economic Affairs and Employment and the employers in the health sector in different advisory working groups. | To discuss between relevant stakeholders. | |
| The process of developing a new statistical data base for health care professionals has some limits due to some legal constrains (the purpose of registers vs. the limits statistical use of the data, EU-degree on data protection etc. ) as well as concerning the combining data from different registers (under the basic register data we do not have the information on the update nationality of persons, the country of birth of persons or the country where persons lives/works in statistical year). | The new statistical data base is under construction and the practices / limitations of using basic register data as well as combining register data from different sources for statistical purposes is under negotiations. |
[q18]
18. Please submit any other complementary comments or material you may wish to provide regarding the international recruitment and migration of health personnel, as related to implementation of the Code.
Because all the information which was compiled in a Word version for the WHO report could not be copied in the WHO template the Word version is included.
[q18x1]
Please upload any supporting files
Word version of the report
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