Tackling international health worker recruitment

Billions of dollars have been invested in efforts to prevent the spread of HIV and other diseases in the world’s poorest countries. Yet at the same time, qualified health workers are leaving the same areas to work in the world’s richest countries.

Despite having the resources to do so, the English speaking developed countries have historically failed to produce enough medical and nursing staff to meet their health care demands. In the USA there is a projected deficit by 2020 of 200,000 doctors and 800,000 nurses. Instead of growing their own staff, developed countries have actively acquired them from already depleted developing country health workforces.

The USA employs over 50 percent of all English speaking doctors in the world, whilst Mozambique, with a population of 20 million, has only 500 doctors. In 2004, over 12,000 health workers were recruited from overseas to work in the NHS.

The UK Government has led the way in establishing a code of ethical recruitment and the National Health Service (NHS) no longer actively poaches staff from developing countries. However, remaining loop holes mean that the code does not currently include non-public sector providers, and still allows the free movement of internationally sourced staff from privately run UK facilities into the NHS.

Putting an end to the direct recruitment of staff from developing countries is only a short term solution and does not tackle the underlying root causes in developed countries. This will require the implementation of clear and explicit commitments to meet health care needs for the next 20 years and should include:

• All countries must strive to achieve self-sufficiency in their health care workforce without generating adverse consequences for other countries.
• Developed countries must assist developing countries to expand their ability to train and retain physicians and nurses, to enable them to become self-sufficient.
• All countries must ensure that their health care workers are educated, funded and supported to meet the health care needs of their populations.
• Action to combat the skills drain in this area must balance the right of populations to good health with other individual human rights.

James Johnson
British Medical Association
BMA House
Tavistock Square
London WC1H 9JP
UK
T +44 (0) 20 7387 4499
F +44 (0) 20 7383 6400

See also

International activities at the BMA
www.bma.org.uk/ap.nsf/Content/Hubbmainternationalactivities

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