The International Development Committee (IDC) recently
published a report
on the findings of an inquiry into DFID’s work on strengthening developing
country health systems. Graeme Chisholm, THET’s Volunteer Engagement Manager
talks about its recommendations and what it might mean for the future of
volunteering from the NHS.
In my previous blog, Voluntary Engagement in Global
Health, I asked, partly rhetorically, whether a leap of faith was required
for us to believe that engaging in global health can be good for everyone. I
didn’t expect an answer so quickly and certainly not one as resounding as the
one I read in the recently published report Strengthening Health Systems in Developing Countries from the House of Commons International Development
Committee. In this report the highly influential Committee states in no
uncertain terms their firm belief that volunteering overseas can indeed be of
great benefit to the NHS as well as to developing country health systems.
The report calls for volunteering schemes to be well
coordinated, structured and of sufficient scale to achieve lasting change.
Engaging in global health comes in all forms but let’s not forget that there
are a number of wonderful examples of volunteering schemes funded by the Health
Partnership Scheme (HPS) that display all the qualities called for in the
report. Take Global Links, managed by the Royal College of Paediatrics and
Child Health, for example. Since it started in the spring of 2012 36 paediatricians,
trainees as well as consultants, have volunteered for periods of six months in
some of the toughest conditions in East and West Africa. A number of Global
Links paediatricians have been working, for example, in Ola During Hospital,
the only children’s hospital in Sierra Leone, alongside Sierra Leonean doctors
and nurses. What they’re achieving is summed-up by Timur Bekir in Giving
Children a Chance: Reducing Child Mortality in Sierra Leone
below. One other thing to celebrate about Global Links though is how the RCPCH
have worked hard to ensure that paediatricians from west and east Africa get
the chance to come to the UK, 17 so far, to learn and share knowledge with us
before returning to their countries to help lead their health services. And I
know that all this hard work has helped greatly to counter the Ebola threat
currently faced by the people of Sierra Leone.
So what else does the report say? At its heart is a call for
us all, however we engage in global health, to make better use of NHS
expertise. The report recommends that NHS staff should be supported in seeking
to apply their skills where need is greatest. It rightly points out that the
new guidance, Engaging in Global Health, from the Department of Health,
Department for International Development and the NHS, should lead the way. But
it’s worth pointing out that Engaging in Global Health is simply that,
guidance rather than policy. So how do we take the next steps and create
‘formal structures to facilitate the participation of many more’ to engage in
global health as the report goes on to recommend?
There are two things that can make this happen. One is more
money and the other is policy change. But where can we find the money in these
austere times and what needs to change in terms of policy? Here are some ideas.
When it comes to engaging in global health through
partnerships, a patchwork of charitable donations and support from
philanthropic and commercial sources all provide vital funding. But the lion
share of funding is currently provided by DFID through the Health Partnership
Scheme. The report commends HPS but it also says that its level of funding is
but ‘a drop in the ocean’. There is clearly an appetite for more partnerships
that can demonstrate value so shouldn’t we be lobbying DFID right now for a
higher level of funding to allow partnerships to flourish beyond 2017 when HPS
is currently due to end?
These are exciting times we live in as Healthcare UK and UK Trade
and Industry look to markets overseas to export the UK’s healthcare knowledge
and expertise. And as profits from these commercial partnerships begin to flow
and we continue to understand more and more the value to the UK’s health sector
of voluntarily engaging in global health isn’t the time now right for us to
explore the relationship between commercial partnerships and voluntary health
partnerships and how they can mutually support one another?
As for policy change where to begin? In terms of direction
from the top, there has been some progress. Even though Engaging in GlobalHealth is guidance rather than policy it does provide solid foundations to
work from. And earlier this year a new clause supporting voluntary engagement
in global health by the UK workforce was included in the refreshed Mandate from
the Department of Health to Health Education England. But what is notable is
the absence of anything similar in the government’s Mandate to NHS England.
This is worrying. Shouldn’t we be calling for support for engaging in global
health from NHS England? I think we should for if the de facto system manager
of our health service has nothing to say on the matter then doesn’t this
legitimise inaction and insularity?
But what about more practical measures? I’m delighted to
report that Health Education England and NHS Employers are working on a Continuing
Professional Development toolkit that will help all those who volunteer
overseas to reflect on and evidence the competencies they gain whilst
volunteering. And we at THET are keen to study how this is received at
appraisals when NHS employees return to the UK. We know, anecdotally at least,
that lots of good comes from volunteering but we also really want hard evidence
to put to bed once and for all the concern that the NHS is losing vital skills
and gaining nothing in return. This is a big task so wouldn’t it be great if
Local Education and Training Boards helped to roll this initiative out to help
to really embed it across the health service?
A final thought. Model policy examples aren’t always
necessarily eye catching but my gaze keeps drifting back to the one developed
by NHS Employers in conjunction with the Ministry of Defence for NHS employees
who are also members of the reserve forces. This particular Model Policy
Example manages to tackle the many issues as well as offer solutions and it
packages it all up neatly in the one document. I wonder whether we should be
pushing for something similar for international volunteering?
