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Health professional mobility in a changing Europe
and the successful integration of foreign health professionals. The chapter sheds
light on a series of successful retention strategies targeting German medical
doctors and nurses.
Chapter 10 explores why foreign medical doctors came to Ireland, stayed
there or were planning to leave. The focus is on non-EU medical doctors.
Many of the migrant doctors interviewed were planning onward migration
because of their working conditions in Ireland. The chapter demonstrates that
Irish-trained and foreign-trained doctors were motivated by much the same
factors, as dissatisfaction with the postgraduate training environment for nonconsultant
hospital doctors is a key motivation for leaving the country. The
chapter concludes that, without thorough reform, it is likely that Ireland will
continue both to have a high dependency on non-EU migrant doctors and also
to experience a high turnover of Irish-trained doctors.
Foreign-trained nurses are often not optimally integrated in the domestic
health workforce. Chapter 11 analyses whether there is a difference between
domestically trained and foreign-trained nurses from developing countries
with regards to performing tasks below their skill level. The analysis is based
on a large data collection from a cross-sectional study including 12 countries.
The chapter concludes that high proportions of foreign-trained nurses from
developing countries perform tasks below their skill level. The extent to which
this is a matter of different “imported” work cultures, different curricula or
discrimination remains unclear. Policy implications for better realizing the
potential of foreign nurses from developing countries refer to the need for
continuous professional training, to improve language skills, and a better
understanding of skills and task profiles of foreign nurses.
Part IV includes five chapters devoted to policy responses. Chapter 12 sets
the scene by looking at how governments, states, regions and health care
providers try to manage the mobility of health professionals in order to address
health workforce challenges. Presenting a broad overview of interventions, the
chapter first describes general health workforce policies that indirectly affect
the mobility of health professionals (i.e. covering self-sufficiency, retention
and health workforce planning); it then goes on to explain health workforce
mobility policies (e.g. international (ethical) recruitment), bilateral agreements
(classified by their primary aim: ethical recruitment, international development,
common labour markets and optimization of health care in border regions) and
the role of recruitment agencies in health workforce mobility.
Chapter 13 focuses on national and international instruments and in particular
on the use of so-called codes of practice for international recruitment, on
potential effects of the General Agreements of Trade in Services (GATS; WHO,