Intended for healthcare professionals

Observations Border Crossing

Who will care for us when we are old?

BMJ 2010; 341 doi: (Published 29 September 2010) Cite this as: BMJ 2010;341:c5341
  1. Tessa Richards, assistant editor, BMJ
  1. trichards{at}

Europe joins the global debate on who should deliver tomorrow’s health care

The phrase “Don’t waste a good crisis” has become something of a political leitmotiv in the past two years—a backdrop to proposals for reform in many spheres, not least health care.

Currently the “crisis in the health workforce” is being seen as an opportunity to radically rethink the way that health professionals are educated and trained. Prominent among the advocates for change is the Global Commission on Education of Health Professionals for the 21st Century, which is shortly to publish its blueprint to develop a new generation of health workers (

In poor countries the shortage of health professionals, particularly skilled ones, is acknowledged to be a critical constraint to progress towards achieving the United Nations’ millennium development goals. But what about Europe?

Here the “crisis” pales by comparison, but all countries have serious concerns. Some, Hungary and Romania among them, report that the migration of skilled staff has left them unable to keep certain essential services staffed.

Dealing with current workforce problems is hard enough. Predicting future ones and devising …

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