Healthcare: We cannot return to "normal"

In this article, Judith Kiejda, General Secretary of the New South Wales Nurses and Midwives Association (NSWNMA) and a member of the PSI Executive Board, stresses the need for fundamental steps to strengthen health systems and build a better world from the devastation of the COVID-19 pandemic.

The current COVID-19 pandemic has been devastating. It is due to years of commodification of health services and has taken the shape of cuts in the funding and privatisation of public healthcare. As a result, health facilities are left grossly understaffed and often without adequate equipment, including personal protective equipment (PPE) for healthcare workers.

As we fight to overcome the pandemic, we must also seize the opportunity, going forward, to ensure that our health systems are rebalanced in a way that ensures every person has access to quality public health care regardless of the capacity to pay. It is universally accepted that the right to health is a fundamental human right. This is the time for us to go beyond mere words and make it a reality for millions of people who lack access to quality healthcare.

The pandemic has exposed major flaws in the world’s health systems that trade unions have been warning of for years.

The pandemic has exposed major flaws in the world’s health systems that trade unions have been warning of for years. Numerous reports show that many more numbers than we currently have are needed in the health workforce.

In 2016, for example, the United Nations High-Level Commission for Health Employment and Economic Growth showed that the world needs no less than 18 million more health workers by 2030, if we are to achieve the SDG 3 i.e. “ensure healthy lives and promote wellbeing for all at all ages”.

We can no longer just assume the market will ensure that we have the capacity to deal with calamities such as this pandemic with the massive impact it has wrought on many countries. We need decent, secure, permanent, and appropriately remunerated public sector health jobs with good working conditions.

Lessons must be learned and acted upon.

Every country needs adequate numbers of health workers with the right skills and training, in the right place at the right time, so that every person on the planet can access quality public healthcare when needed. We cannot continue to privatise healthcare services either totally or partially. Private providers operate on a ‘just in time’ business model which has become very evident in this pandemic, leaving patients and staff exposed. Services to vulnerable populations are best managed within the public sector.

Report after report internationally has demonstrated that ratios for nurses and care staff are needed for appropriate staffing for health facilities in all sectors including aged care. When applied to a health environment, those ratios must have the skill mix required for best practice.

This is a moment in time to reset the health workforce, to ensure:

  • Ratios for healthcare workers in public, private and aged care health settings

  • Quality public healthcare for all in every country

  • A societal reset which entails a balance of the environment, our social fabric and the economy. These are the essential criteria for reshaping the world as we go forward.

We cannot return to normal – the normal pre COVID-19 was what put us in this vulnerable position in the first place.