nursing migration and the global health care economy dr mireille kingma international council of...

Nursing Migration and theNursing Migration and theGlobal Health Care Global Health Care

EconomyEconomy

Dr Mireille KingmaInternational Council of Nurses

International MigrationInternational Migration

What do we know?

• 3% of the world’s population

• 191 million people

• 48% female

• Industrialised countries: One out of 10

• International labour market

GlobalisationGlobalisation Better communication –

access to information

Better transport options

More bi-lateral/multi-lateral trade

agreements

Mutual recognition agreements

Shortage facilitated immigration

International recruitment practices

Current WorkforceCurrent Workforce

• Industrialised countries• Australia, Canada, UK, US• Switzerland• Ireland

• Developing countries• Cameroon• Ghana• South Africa

Projected Nurse ShortfallsProjected Nurse Shortfalls

• 2010: Australia – 40,000• 2012: USA – 1 million

• 2016: Canada – 113,000

• 2017:

– Netherlands: 7,000

– Norway: 3,300

– Switzerland: 3,000

(1%-5% of practicing registered workforce)

Supply and DemandSupply and DemandTypes of migrant nurses

– Economic migrant– Quality-of-life migrant– Career-move migrant– Partner migrant– Adventurer migrant– Survival migrant– Holiday workers– Student migrant– Return migrant

Nurse ABNurse AB

Country A

Country B

Migration PathwayMigration Pathway

ServicesGoods

Agencies Institutions

EntrepreneursRegulatory Bodies

Businesses

Education

• Training for export• Foreign student

– Fees– Language competence– Accommodation/travel/food

• Satellite campuses• Distance learning• Employment provider• Private business investment• Perks: recruitment/retention

AccreditationAccreditation

• Screening

• Testing

• Supervised clinical placement

• Tutoring

• Placement agencies

• Supervisors

The Right to WorkThe Right to Work

• Visas– Temporary– Permanent residence

• Employment– Journals– Internet– Diaspora– Individual initiatives– Recruitment agencies

Spin-Off ServicesSpin-Off Services

• Immigration lawyers

• The move– Persons– Furniture/belongings

• Housing

• Phone services

• Banking services

• Securities

Exploitation/Fraud• Agency fees• Accommodation

– Quality– Charges

• Visa fraud• Contracts

– False representation– Deskilling– Substitution

• Corruption• Freedom of association

RemittancesRemittances

• US$300 billion – 2006

• Reaching 10% world’s population– Consumption– Education– Investment

• Drain?

• Gain?

Brain CirculationBrain Circulation

• Development opportunities

• Employment opportunities

• Business opportunities

• Multicultural nursing-competitive edge

• Positive practice environments

• Innovation

• Dissemination of good practice

Global Health Care Global Health Care EconomyEconomy

• Direct impact on society and other sectors, incl commerce

• Nurse migration is part of globalization initiatives

• Recruitment and deployment must be regulated

• Self-sustainable workforces• Human rights must be respected