Beyond market access domestic regulation and mutual recognition
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Beyond Market Access – Domestic Regulation and Mutual Recognition. Mode 4 of the GATS – Taking Stock and Moving Forward September 2008 David C. Benton Chief Executive Officer Designate International Council of Nurses. Three issues:. MRAs their role and the challenges

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Beyond market access domestic regulation and mutual recognition

Beyond Market Access – Domestic Regulation and Mutual Recognition

Mode 4 of the GATS –

Taking Stock and Moving Forward September 2008

David C. Benton

Chief Executive Officer Designate

International Council of Nurses


Three issues

Three issues:

MRAs their role and the challenges

Stakeholder involvement and contribution

Pragmatic Facilitation of Mode 4


The international council of nurses icn

The International Council of Nurses (ICN)

Is a federation of 131 National Nurses Associations

Strives to improve the standards of nursing care through better education and regulation of nursing

Believes the overriding purpose of statutory regulation is to serve and protect the public


The context for mode 4 and nursing

The Context for Mode 4 and Nursing

The global nursing shortage

Practice environments

Public demands/expectations

Governments interest in changing roles and frustration with the professions

Money

Professions’ interest in a global view

Trade

Entrepreneurship

Migration


Beyond market access domestic regulation and mutual recognition

Policy

Net Sum & Fears

Trade and Safety

Divergence in Health Sector (Taskshifting)

Education Policy Disincentives

Immigration controls

Regulatory coherence (Private and State Sectors)

Process

Regulators

Systems

Resources

Adaptation

Technical

Languistic and Cultural

Specialist

Rogue Practitioners

Role and Challenges


Mode 4 as part of a complex adaptive system

Mode 4 as Part of a Complex Adaptive System

Failure to recognise the GATS and MODE 4 as part of a complex adaptive system is a real barrier to progess in reaching agreements and will lead to longer term practical problems


Beyond market access domestic regulation and mutual recognition

Japan


Beyond market access domestic regulation and mutual recognition

Canada


Dealing with complex adaptive systems general points

Dealing with Complex Adaptive systems (General Points)

Increased transparency and accountability

Better communications

Better and timelier data collection and information generation

Involve, negotiate, think future as well as now, pragmatism and feedback.


Stakeholder involvement and contribution

Stakeholder Involvement And Contribution

More than Trade Ministries

Health, Education, Immigration (Government)

Professionals and Regulatory Bodies

All on the Same Page

Knowledge, Time-scales and Vision/Outcomes

Systems Impact and planning for success

Normative Approaches and Networking


Pragmatic facilitation of mode 4

Pragmatic Facilitation of Mode 4

  • Support the concept of strengthening regulatory infrastructure before introducing disciplines

    • Where none exists introduce regulatory bodies and legislation that is flexible and facilitative

    • Update outdated and rigid legislation

      • Be dynamic in adapting to the changing needs of the health care environment and the evolving and expanding capabilities of nurses

      • Leave domestic regulation broad and general

      • Encourage countries with strong frameworks to help others

      • Encourage international model frameworks


Pragmatic facilitation of mode 41

Pragmatic Facilitation of Mode 4


Pragmatic facilitation of mode 42

Pragmatic Facilitation of Mode 4

  • Facilitate normative working across countries and jurisdictions

    • E-based data exchange and minimum data sets with shared data element definitions

    • Compatible systems of credential assessment

    • Calibration of Educational Credit and Qualification Frameworks

    • Domestic Disciplines for Nursing


Pragmatic facilitation of mode 43

Pragmatic Facilitation of Mode 4

  • ICN and ICM Regulators Forum

    • Support for developing country participation

    • Support for multi-lingual participation

  • ICN Research into the Role and Identity of the Regulator

    • Database of Jurisdictions

    • Comparative analysis of legislation

    • Compendium of legislation and regulatory best practices

    • Lexicon of terms


  • Thank you

    Thank you

    International Council of Nurses

    3, place Jean-Marteau

    1201 Geneva

    Tel.: +41 22 908 0100

    Fax: +41 22 908 0101

    Email: [email protected]

    Website: www.icn.ch


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