Impacts of the healthcare professionals migration in the EU

1
Impacts of the healthcare professionals migration
in the EU

• Markus Schneider
• Warsaw, May 8, 2008, Confederation of Polish
  Employers
• The role of European and National Social Dialogue
  in a Changing Hospital and Health Care Structure
• (D R A F T)

2
Issues

• Current health professional distribution
• Scope and direction of immigration
• Variations
• Future challenges

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Practising physicians in the EUdensity per
100.000 population (2004)
Very unequal distribution of Physicians both
within EU15 and EU12
4

• Practicing dentists in the EUdensity per 100.000
  population (2003)

Lowest ratio in PL and UK
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Practising nurses in the EUdensity per 100.000
population (2003)
Very unequal distribution of nurses both within
EU15 and EU12
6
In contrast to doctors reduction of nurses in
most CEEC 1994 -2004
Annual change of doctors in
Annual change of nurses in
7
EU Enlargement

• The EU enlargement has undoubtedly affected the
  inflows of foreign doctors and nurses from new
  accession countries (OECD 2007).

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Results of OECD Migration Study

• The USA is the only net receiver of doctors and
  nurses vis-a-vis all other countries in the
  world.
• Immigrants make an important contribution, not
  only if one considers the sheer numbers involved
  but also if one takes into account their role in
  insuring the continuity of services at night or
  during the weekend , notably in Europe.
• The international migration is neither the main
  cause nor would its reduction be the solution to
  the worldwide health human resource crisis,
  although it exacerbates the acuteness of the
  problem in some countries.

9
Foreign born as a percentage of practising nurses
and doctors in OECD countries, circa 2000

• Major EU-Importer of doctors and nurses IR, UK,
  LU, SE, PT, FR, NL, AT
• In UK about 1/3 of doctors and 1/6 of nurses are
  foreign born
• In Poland 3.2 of doctors have foreign
  background and 0.4 of nurses
• OECD Migration Outlook 2007

10
Intra OECD migration of nurses and doctors
exhibits a cascade type pattern toward USA as
only net receiver Net stocks, circa 2000

• The international migration of health
  professionals is characterised by multiple
  interactions between EU Countries, including
  countries outside the EU, particularly USA,
  Canda, Australia
• There is a huge variety of situation across EU
  Countries

OECD Migration Outlook 2007
11
Export of doctors from CZ, SK
Most emigrations into the austrian-hungarian
region But also exports to CAN, CH Not all data
coded from former CZSK (No data for Germany)
Source OECD Migration Outlook 2007, p.210
12
Export of nurses from CZ, SK
Most emigrations into the austrian-hungarian
region But also exports to USA, CAN, CH Not all
data coded from former CZSK (No data for Germany)
Source OECD Migration Outlook 2007, p.210
13
Export of doctors from HU, PL
Most emigrations to oversea USA, CAN, AUS But
also exports to SE, AT, CH (No data for Germany)
Source OECD Migration Outlook 2007, p.210
14
Export of nurses from HU, PL
Most emigrations to oversea USA, CAN, AUS But
also exports to SE, AT, CH, UK (No data for
Germany)
Source OECD Migration Outlook 2007, p.210
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First Assessment

• Emigration is a regional phenomena
• Emigration of health professionals means in
  general a brain drain for the delegating states
  which could seriously harm access (see results of
  waiting lists, geographical imbalances)
• Emigration of nurses hits source countries
• Further analysis necessary including CIS

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Dynamic development

• Long-term trends over the past 25 years show that
  the number and the percentage of foreign-trained
  doctors has increased significantly in most OECD
  countries.
• Recent trends in migration, over the past 5
  years, show radical upward shifts in several OECD
  countries.
• Policies matter (e.g. United Kingdom).
• Some key factors drive international migration of
  health professionals

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Factors contributing to migration growth

• Gaps in salaries and working conditions
• Health sector is faster developing in the West
  than in the East
• Information about working conditions and
  recruitment policies stimulate migration
• National unemployment

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Further developments

• Shortages of health professionals are projected
  to increase over the next 20 years
• Increasing competition between countries to
  attract highly skilled health professionals

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Questions

• Could patient mobility and telemedicine help to
  alleviate health professionals shortage concern?
• Could the more efficient use of stocks of health
  professionals by private hospitals help to ease
  health professionals shortage concern?
• What is the role of social partners to mitigate
  health professionals shortage concern?
• What is the role of national governments and the
  EU to mitigate health professionals shortage
  concern?