Case study Nursing Few patient

Case study

Nursing

Few patients in hospital can fail to have noticed the increased contribution to their care made by staff who have migrated from an increasing array of countries. Many EU countries as well as the USA, Canada and Australia have become increasingly reliant on internationally recruited health professionals, especially nurses. The scale of nurse migration is unprecedented and this movement highlights the feminization of migration. The recent experience of the UK health sector throws much light on the causes and consequences of nurse migration. This phenomenon is not entirely new as nurses and doctors have transportable skills and in the 1950s and 1960s came to the UK to train and stayed on to work in the National Health Service (NHS). What is different about recent experience has been the extent to which governments in source and destination countries have actively encouraged nurse mobility.
When the Labour government came into office in 1997, it committed itself to improving the NHS and it decided an important way to do this was to expand staffing levels. In 2000, the Labour government established a target for England to recruit an additional 20,000 nurses and midwives by 2004 and the target was subsequently increased to 35,000 by 2008. Taking account of existing staff shortages and the three years that it takes to train a nurse, international recruitment was identified as the preferred strategy to ensure rapid workforce growth. The Department of Health established an institutional infrastructure to promote recruitment activity. An NHS Director of International Recruitment was appointed, supported by International Recruitment Coordinators and the number of staff recruited internationally comprised a key performance target for these coordinators. Financial assistance was made available by the government to enable managers to travel to the Philippines in particular, to recruit batches of 50–100 nurses at a time. The Department of Health actively marketed the NHS to potential recruits through its website and entered into bilateral agreements with countries such as Spain to get over the message that the NHS was welcoming nurses to the UK. Between 1999 and 2004, 68,000 additional nurses were recruited by the NHS in England, a significant proportion were overseas nurses recruited to work in less popular specialties and geographical locations.
The NHS and independent care homes have relied heavily on nurses recruited from the Philippines to address its nurse shortage. Strong demand for Filipino nurses stemmed from its US colonial past which ensured proficiency in English and a US-orientated nurse education system that dovetailed with the requirements of overseas employers. Nursing schools have played an important part in ensuring a growing supply of nurses to feed international demand. Although nursing schools in the Philippines are privately owned, the government has sponsored their growth and this has encouraged nursing as a career because of the opportunities it presents to work abroad. By contrast, low levels of health expenditure and poor wages encourage exit overseas.
The NHS and independent care homes have relied heavily on nurses recruited from the Philippines to address its nurse shortage. Strong demand for Filipino nurses stemmed from its US colonial past which ensured proficiency in English and a US-orientated nurse education system that dovetailed with the requirements of overseas employers. Nursing schools have played an important part in ensuring a growing supply of nurses to feed international demand. Although nursing schools in the Philippines are privately owned, the government has sponsored their growth and this has encouraged nursing as a career because of the opportunities it presents to work abroad. By contrast, low levels of health expenditure and poor wages encourage exit overseas.

Review question

1. Does the experience of nurses coming to the UK from other countries suggest that constraints on migration are falling?

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