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