Jillian Roque of PSI affiliate, PSLINK in the Philippines delivered a clear message at today's high-level WHO event, where the World Health Organisation and the O'Neill Institute for National and International Health Law presented their groundbreaking analysis of health workers' legal protections across 180+ countries. The study was launched in the lead up to December 12 – Universal Health Coverage Day. Together with an Assessment Tool that will be launched next year, the study provides a baseline evidence to assist countries align their law and practice with the Global Health and Care Worker Compact.

Speaking on behalf of PSI, Roque emphasised how the lack of union representation remains a fundamental barrier to decent work in the health sector. She highlighted PSI affiliates' successful campaigns across Asia Pacific, including PSLINK's victories in the Philippines where, despite challenging conditions for union organising, they secured important wins including salary increases for nurses and ratification of key ILO conventions.

There can be no quality health services without health workers' rights

Roque's intervention connected the dots between workers' rights and quality healthcare, stating that "there can be no quality health services without health workers' rights." She particularly emphasised the gender dimension, noting how women – who make up the majority of health and care workers – bear the brunt of poor working conditions and inadequate protections.

PSI welcomes this comprehensive legal framework study as a crucial tool for our affiliates' ongoing struggle to protect health workers' rights and build worker power. We remain committed to leveraging these findings in our continued fight for workers' rights and social justice in the health sector.

Launched by the World Health Assembly in 2022, the Global Health and Care Worker Compact is a powerful instrument that unions can use in advocating for investment in the health workforce, ensure decent working conditions and social protections, and influence policies to strengthen health and care systems. PSI actively contributed to the development and launch of the Compact. Moving forward, PSI is committed to working with the WHO to realising the promise of the Compact to secure health and care workers’ rights and protections as the foundation of sustainable health and care systems.

Full speech

Its an honor to be part of this historic launching of the first ever global study of national legal and policy environments for health and care workers, assessing how countries are doing in terms of ensuring rights and protections for health and care workers. I represent PSLINK, we are a national umbrella federation of unions of public service workers in the Philippines. We are affiliated with the Public Services International (PSI), the global union federation of public workers. Health and care workers make up a substantial number of most government workforces across the world and PSI has a long history of organizing health and care workers into unions, pushing for enforcement of standards and better rights protections.

Our health and care workers serve as the backbone of our health system. There can be no quality health services without health workers rights. But in every part of the world, there are persistent gaps in the protection of health care workers’ rights. And it is the women – who make up the majority of health and care workers, our nurses, our community health workers – who suffer disproportionately when wages are low, when jobs are not enough, when jobs are informalized, when adequate PPEs are not provided, when staffing ratios are unsafe, when working conditions are unhealthy and dangerous, when care work is not valued properly, when care work is not recognized as work. And in many areas, public health workers are denied their fundamental right to freedom of association and collective bargaining. This is absolutely unacceptable.  The right to organize and bargain is so fundamental in realizing all other rights. The lack of union representation - whether through explicit prohibitions or through intimidation and other disincentives – is a key barrier to decent work for health and care workers. And when health and care workers report wrongdoing and unlawful practices, they often end up suffering from retaliation for lack of whistleblower protection laws and enforcement.

Rights violations against health and care workers can happen anytime, anywhere, and its important that standards are in place to ensure that we are protecting the people who are responsible for providing the health and care needs of everybody else. By ensuring robust legal and policy environments, we are protecting not only their labor rights, but also the right to health care of everybody else, including the most marginalized sectors of our society – the youth, women, elderly, persons with disability, persons of diverse SOGIESC, the poor. And it is when workers unionize that they are able to fight for their rights at work, ensure implementation of policies and bargain for better conditions for patients also - including improved staff to patient ratios and life-saving interventions.

As the global federation of health and care workers, PSI is leading efforts to ensure fair pay, decent work, equality and non-discrimination in the health care sector through organizing unions, building workers power to represent, negotiate and lobby for their rights. In the Philippines, despite the killings of unionists, harassment, red-tagging and other attacks on freedom of association making our country one of the top 10 worst countries for workers in the world, PSLINK together with the other PSI Philippine affiliates have successfully lobbied for the ratification of important Conventions on Occupational Safety and Health and the Elimination of Violence and Harassment in the World of Work. PSLINK also compelled the government to raise the salary grade of nurses due them after filing a petition at the Supreme Court. As the Philippines is a major country of origin of migrant health workers, we have been leading efforts to promote rights-based bilateral labor migration agreements, ensuring fair and ethical recruitment practices, aligned with the WHO Global Code of Practice on the International Recruitment of Health Personnel.

Across the Asia Pacific region, PSI affiliates are showing how health care workers are organizing to win. The Maldives Health Professionals Union has recently won significant pay increases for health support staff. PSI is organizing community health workers who are often marginalized, unpaid and excluded from labor laws and social protection.  PSI’s recent success in organizing the first national community health workers union in Pakistan, in increasing the number of local governments in Nepal recognizing community health volunteers as workers with rights, are testament to how unions are making real changes on the ground, leveraging international labor standards and improving the lives of our health and care workers, leaving no one behind, including our community health workers, as well as migrant health care workers.

The global care compact and assessment tools are very important tools and they come at a crucial time when health and care systems around the world are grappling with multiple crises – from pandemics, to extreme weather events and disasters due to climate change, to social and economic inequalities, to aging population, to rising wars and conflicts. But just like any other tool, they are only effective when they are used. And PSI which has actively contributed to the development of the care compact from the beginning is very much committed to using it, leveraging it to build workers’ power. As public sector unions we will continue fighting for workers’ rights and social justice for all, and put people over profit.