International migration and recruitment of nurses

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International migration and recruitment of nurses

• Prof. James Buchan
• jbuchan_at_qmuc.ac.uk

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International migration and recruitment of nurses

• Active recruitment
• UK Case study
• Code of Conduct
• EU
• Ghana case study

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Active recruitment recent initiatives in
other importer countries
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of new nurse registrants from EEA, UK and
other countries 1993-2003
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UK Total outflow of nurses / to USA
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Net flow of nurses to/ from UK (NMC registrations)
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Ireland Home, EU and non EU nurse registrants
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EU accession Physicians intent to move(Source
Open Society,2003)
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Department of Health (England) Code

• Requires NHS employers not to actively recruit
  from developing countries, unless govt. to govt.
  agreement (India, Philippines, Indonesia)
• List of preferred provider recruitment agencies
• Issued Nov 2001 (but list of countries only
  available Jan 2003)
• Compliance difficult to monitor- NHS does not
  record international nurses
• Private sector (25 of workforce) not covered by
  Code

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Annual no. of new entrants to UK nursing
register, from selected sub Saharan African
countries, 1998-2003
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Outflow of nurses from Ghana (Ghana Nurses
Council verifications)
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Vacancy rates, Ghana Health Services, 1998 and
2002
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Impact on source countries

• Understaffing / loss of skills
• Decreased capacity in health services
• Increased costs of recruitment and retention
• possible compromises in quality of care
• Low morale- remaining nurses and
  consumers (sources DENOSA/ Caribbean,
  PAHO)

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Inflow of nurses to developed countries, by World
Bank status of source countries
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Challenges and Opportunties
OPPORTUNITIES CHALLENGES
Destination countries Solve skills shortages Efficient (and ethical?) recruitment
Source countries (Remittances) Upskilled returners Outflow causes skills shortages
Mobile nurses Improve pay, career prospects Achieving equal opportunities destination country
Static nurses (if oversupply)- improved job opportunities Increased workload, decreased morale
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Policy Issues

• High level of reliance on international
  recruitment- necessary/ desirable/ sustainable?
• UK (DH England) Code- how effective? can it be
  strengthened?
• Bilateral agreements / managed migration
  desirable?/ effective?
• Ethical frameworks / international monitoring
  whose responsibility?

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References

• Buchan J, Dovlo D 2004. International Recruitment
  of Health workers a report fro DFID.
• http//www.dfidhealthrc.org/Shared/publications/re
  ports/int_rec/int-rec-main.pdf