Global migration of health Global migration of health professionalsprofessionals

Dr Tricia ScottDr Tricia Scott

CZ EU AccessionCZ EU Accession

Immigration rates increased markedly after Immigration rates increased markedly after 1993 when, 1993 when,

“… “… the more economically advanced EU the more economically advanced EU candidate states like Poland, Hungary and the candidate states like Poland, Hungary and the Czech Republic became immigration havens Czech Republic became immigration havens overnight”overnight”

Mensah et al (2005)Mensah et al (2005)

Motivation to migrateMotivation to migrate

Push factors:Push factors: Staff shortagesStaff shortages Poor working conditionsPoor working conditions Relaxation of immigration rulesRelaxation of immigration rules

Motivation to migrateMotivation to migrate

Pull factors:Pull factors: Career opportunitiesCareer opportunities Higher salariesHigher salaries Better quality of lifeBetter quality of life

Gender-blind policiesGender-blind policies

Increasingly impact on female health worker Increasingly impact on female health worker migrationmigration

Detrimental loss of expertiseDetrimental loss of expertise

Create geographically segregated familiesCreate geographically segregated families

Objective policiesObjective policies

““the objective migration policy is not the objective migration policy is not limitation of mobility but equity of health limitation of mobility but equity of health care as soon as possible”care as soon as possible”

Mensah et al (2005)Mensah et al (2005)

The code of practiceThe code of practice

Introduced in 1999, strengthened 2001 and Introduced in 1999, strengthened 2001 and 20042004Recruitment agencies contracting to NHS Recruitment agencies contracting to NHS prohibited from actively recruitingprohibited from actively recruitingHealth professionals from developing nationsHealth professionals from developing nationsUnless special agreement with UKUnless special agreement with UKContractual obligation for independent sector Contractual obligation for independent sector and private recruitment agenciesand private recruitment agencies

Department of Health (2007)Department of Health (2007)

Codes of practiceCodes of practice

InductionInduction

TrainingTraining

Working conditionsWorking conditions

High levels of mobilityHigh levels of mobility

National manpower planningNational manpower planning

Bilateral agreementsBilateral agreements

UK overseas registrationsUK overseas registrations

2002/7 added 46,000 nurses and midwives2002/7 added 46,000 nurses and midwives

2003/4 = 13,6002003/4 = 13,600

2005/6 = 8,6732005/6 = 8,673

EU is not classified as overseasEU is not classified as overseas

Categories removed from Shortage Categories removed from Shortage Occupation List (Home Office)Occupation List (Home Office)

UK nursing admissionsUK nursing admissions

2002/32002/3 2005/62005/6

IndiaIndia 1,8301,830 3,5513,551

PhilippinesPhilippines 5,5935,593 1,5411,541

AustraliaAustralia 920 920 751 751

South AfricaSouth Africa 1,3681,368 378 378

ZimbabweZimbabwe 485 485 161 161

RomaniaRomania - - 57 57

ConclusionConclusion

Migration is a manpower issueMigration is a manpower issue

Migration is also a gender issueMigration is also a gender issue

Global health systems respond to advances Global health systems respond to advances in the practise and organisation of carein the practise and organisation of care

Growing ethical response from regulators to Growing ethical response from regulators to protect the public and practitionersprotect the public and practitioners

ReferencesReferences

Castles, S. and Miller, M.J. (2003) The age of migration, Castles, S. and Miller, M.J. (2003) The age of migration, Hampshire, Palgrave.Hampshire, Palgrave.

Department of Health (2007) Health is Global, London, The Department of Health (2007) Health is Global, London, The Stationery Office [accessed 12 March 2007 Stationery Office [accessed 12 March 2007 www.dh.gov.uk/publicationswww.dh.gov.uk/publications] ]

Mensah, K. Macintosh, M. Henroy, L. (2005) The ‘Skills Drain’ of Mensah, K. Macintosh, M. Henroy, L. (2005) The ‘Skills Drain’ of Health professionals from the developing world: a framework for Health professionals from the developing world: a framework for policy formulation, London, Medact.policy formulation, London, Medact.

Nursing and Midwifery Council (2007) Overseas applicants, Nursing and Midwifery Council (2007) Overseas applicants, NMC News, May, Number 20: p8.NMC News, May, Number 20: p8.