Health professional mobility in the WHO European Region and the WHO Global Code of Practice: data from the joint OECD/EUROSTAT/WHO-Europe questionnaire

Abstract

WHO Member States adopted the Global Code of Practice on the International Recruitment of Health Personnel 10 years ago. This study assesses adherence with the Code’s principles and its continuing relevance in the WHO Europe region with regards to international recruitment of health workers. Data from the joint OECD/EUROSTAT/WHO-Europe questionnaire from 2010 to 2018 are analyzed to determine trends in intra- and inter-regional mobility of foreign-trained doctors and nurses working in case study destination countries in Europe. In 2018, foreign-trained doctors and nurses comprised over a quarter of the physician workforce and 5% of the nursing workforce in five of eight and four of five case study countries, respectively. Since 2010, the proportion of foreign-trained nurses and doctors has risen faster than domestically trained professionals, with increased mobility driven by rising East-West and South-North intra-European migration, especially within the European Union. The number of nurses trained in developing countries but practising in case study countries declined by 26%. Although the number of doctors increased by 27%, this was driven by arrivals from countries experiencing conflict and volatility, suggesting countries generally are increasingly adhering to the Code’s principles on ethical recruitment. To support ethical recruitment practices and sustainable workforce development in the region, data collection and monitoring on health worker mobility should be improved.

Importance of work engagement in primary healthcare

“…The above-mentioned developments put healthcare workers and healthcare systems under pressure, resulting in numerous challenges: employee retention, attracting the new workers, burnout prevention and maintenance and/or improvement of service quality. Research [ 9 , 10 ] has also shown that healthcare workers are inclined to search for work abroad due to better conditions, supported by increased mobility driven by rising East–West and South–North intra-European migration, especially within the European Union—as is also the case in Slovenia. Failure to address these challenges will inevitably affect the healthcare system, as it is unlikely that simply training more healthcare workers will help to avoid a shortage given the continuing reduction in healthcare costs and increasing prevalence of expatriate healthcare staff [ 4 ].…”

Lessons learned from the history of postgraduate medical training in Japan: from disease-centred care to patient-centred care in an aging society

“…When LMICs face strong recommendations from international partners pushing for investment in a high-level medical education system, consideration should be given to what the country can afford and how greater equity and distribution of limited resources can be ensured in the longer term. In fact, the establishment of an ‘elite’ education system could result in the migration of local physicians to wealthier countries, since their education is not aligned with the economic condition in their own country [ 59 ].…”

Migrant GPs and patients: a cross-sectional study of practice characteristics, patient experiences and migration concordance

“…Global migration has led to increases in doctors and patients with migration backgrounds [ 1 ]. They may experience difficulties in their host country, including communication problems, cultural differences, or discrimination.…”