Rural Health Workforce on the European agenda

EURIPA was privileged to be invited to contribute to a WHO panel session during the Regional Meeting on Health and Care Workforce in Bucharest, Romania in March 2023. The meeting brought together a diverse group of over 200 key stakeholders working in the area of health and care workforce including representatives of the ministries of health, technical and academic experts, and multilateral partners. EURIPA was represented by John Wynn-Jones who participated in the Plenary session Panel discussion: Health and care workforce recruitment and retention: addressing the challenges of rural and remote areas.  

John, as a rural health clinician, made key points in the meeting which were reflected in the Bucharest Declaration, that identified high-level regional health workforce priorities:

  • improving the supply of health and care workers
  • improvement in retention and recruitment of health and care workers including paying special attention to retaining and attracting health and care workers in rural, remote and other underserved areas
  • optimising the performance of the health and care workforce
  • better strategic health and care workforce planning
  • increased and smarter public investment in workforce education, development and protection

The Bucharest Declaration can be found at:

John was subsequently invited on behalf of EURIPA to join a discussion at the EU Parliament in late April on Medical Deserts and Rural Desertification: A call to Action.

The event was a part of the project AHEAD: Action for Health and Equity: Addressing Medical Deserts (

The main recommendations from AHEAD include (among others):

  • European institutions should prioritise the problem of medical deserts on the political agenda throughout the next European Commission’s mandate – and beyond.
  • The national governments of European Member States should improve the quality, systematic collection and analysis of data related to the health workforce, health services, and related indicators to medical deserts.
  • Health professionals’ associations should advocate the right to health for all, especially people in areas with limited or difficult access to health services, both in rural and remote areas, as in urban areas. 
  • Citizens should call for multi-dimensional actions by duty-bearers to improve their health and well-being, especially for the most vulnerable. 

John commented that:

“There are 6 projects looking at medical deserts in Europe (including AHEAD). The emphasis has been on policy development  and a top down approach. Success must also depend on a bottom-up approach engaging with rural health professionals and rural communities. Rural communities are by nature diverse and a single top down approach will never work on its own.

To date, little has been said about education & training and the role of academic institutions and professional bodies. We need to train and develop a workforce that is inspired and trained to meet the complex needs of rural health care. The rural health workforce must be both multidisciplinary and "Fit for Purpose". We must ensure that all clinicians entering rural health care have the skills and knowledge to meet the unique challenges that they will face working on the periphery of care with confidence and positivity.

Finally, we must tackle what has been described as the Geographical Narcissism, a term developed by Marlin Fors (Finmark, Norway),   that urban prejudice ensures that rural has always been second rate.”

EURIPA is working to ensure that Europe develops a workforce that is fit for purpose and has developed a Blueprint for the future.”

John made four key points: 

  • Listen to the workforce
  • Rural is different: the nature and needs of Rural Practice
  • Evidence is limited
  • What do we know that works

You can find more about EURIPA’s forward thinking in the ‘Blueprint for Rural Practice in Europe’ on the EURIPA web site.

The opportunity now is for both EURIPA and WONCA Europe to remain engaged with the policy agenda across Europe to address the critical issues facing the primary care workforce in Europe.