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there might be concerns for the receiver country also about the quality of care in host
countries. They might be due to potential differential in doctors’ skills and experience
and also the suitability to a new cultural environment.
France has three types of bilateral agreements with at least 10 countries, the majority of
which are in northern or sub- Saharan Africa. For instance, the UK has developed
bilateral agreements with China, Spain, Philippines, and India for the recruitment of
health professionals. There is also an agreement with South Africa for reciprocal
education exchange of health workers. Indeed, UK introduced a code of conduct for
international recruitment from countries with workforce shortages in 2001. Switzerland
has also an agreement with Canada to facilitate mobility of health care workers. Spain
has also signed agreements with other European countries to send nurses (France, and
UK) as it has a surplus of nurses. Germany has also signed agreements with ECE
countries for the recruitment of foreign nurses. In general, we can distinguish four types
of bilateral agreements: (1) Agreements which limit or exclude recruitment from
countries with workforce shortages (for example, as that use in the UK), (2) Those that
facilitate mobility of health professionals by establishing mutual recognition of diplomas.
Thus, France has agreements with countries in north and central Africa, Monaco and
Switzerland. (3) Those who promote active recruitment; for instance the UK between
2001 and 2005 signed agreements for the recruitment of medical doctors from Spain,
Italy, Germany, and Austria (4) those that allowed temporary opening of labour markets
to accession countries until that the enlargement was finalized and full mobility
established such as the agreements between Norway and Hungary, and the UK and
Poland. The above elements can be related to the situation of immigration in European
Countries as this is summarized in table I.3.6.1.
Table I.3.6.1: Summary of immigration policies by country as introduced in the WHO (2011) report
Belgium
Finland
France
It has a specific health workforce planning police since 1996, when the Committee for Medical Supply Planning
was established to advise the federal authorities on a quota system. The numerus clausus system was introduced
in order to limit the number of graduates with access to the practice of medicine and dentistry. Quotas set the
maximum number of graduates allowed to start general practitioner, specialist and dentistry training each year.
For 2008– 2011, the quota allows 757 medical graduates to pursue general practitioner or specialist training.
Apparently, Romanian doctors appear to be the most important group among the new EU members who moved
to Belgium to work. Belgian data shows that France, and UK are the most important destinations for Belgian
doctors.
About 840 Finnish medical doctors worked abroad in 2006. The outflows of medical doctors have decreased
over time. The most important destinations were Sweden, and the United States. The most important source
countries are: Russia, Estonia, Sweden, and Germany.
The stock of foreign medical doctors registered with the CNOM on 1 January 2010 was 10165. This represents
around 4.7% of the medical workforce. Data as at 1 January 2009 show that 47% of foreign medical doctors held
a degree from outside the EU, mainly from North Africa (Algeria 10.3%, Morocco 7.8%, Tunisia 4.8% (CNOM
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