Labour market performance and migration flows - European ...

Chapter IIThe impact of migration on labour markets in Arab Mediterranean countriesTable 6.3 Emigration rates of physicians trained in their origin countryRate of emigrationAlgeria 7.1Egypt 5.6Jordan 9.9Lebanon 19.6Morocco 6.6Palestine 1.5Syria 17.5Tunisia 4.2Source: Docquier and Rapoport (2009)Moreover, if we take into account the physicians born in the AMCs but trained abroad – asClemens and Patterson (2006) do – the numbers are more worrisome 91 . Their estimates differdramatically from the previous ones: 44 percent of Algerian physicians, 31 percent of theMoroccans and 33 percent of the Tunisians are practicing abroad by these criteria. Regardingnurses, the numbers are lower: respectively 9, 15 and 5 percent of them work abroad. 92Notwithstanding these impressive figures, there are some factors that suggest that medical braindrain has so far imposed limited direct costs on the Maghrebian countries. Most foreign-employeddoctors and nurses have been trained abroad, and their migration is more a symptom of theunderlying difficulties of the domestic health-care systems than its cause 93 . Therefore, it would behard for foreign-employed health-care workers to enter their origin country’s labour markets underthe current conditions, as a significant increase in the demand for medical personnel seems highlyunlikely. Moreover, it is uncertain whether these doctors and nurses would have studied medicineanyway in the absence of a prospect to migrate.The same could be said about the thousands of students from AMCs who acquire their tertiaryeducation abroad. Student migration from AMCs is an increasingly common phenomenon. It is aninstrument OECD countries use to select highly-skilled workers, as students tend to beprobationary migrants. About 7 percent of the foreign students in OECD currently come from theArab countries, in particular from Morocco. Table 6.4 shows the number of foreign studentsenrolled in tertiary education by country of origin. According to Dumont (2006), it is difficult forthe origin country to benefit from this kind of migration: to do so they should maintain links withthe students and offer them incentives to return home to work.91 Not only the country where physicians have been trained, but also the definition of who is a migrant matters: in thecountries of destination, such as France, where there are a lot of second- and third-generation migrants, and most of themhave double citizenship, it is not easy to determine who is a migrant.92 They count all the doctors and nurses employed in the main nine destination countries: the UK, Spain, France, the US,Australia, Canada, Portugal, Belgium and South Africa.93 In Morocco, the health-care system suffers from underutilization of services: hospital beds capacity, for example, despitebeing low, has a 56 percent average occupancy rate (WHO, 2006b). Although the WHO claims that more than 200 facilitiesare closed due to a lack of human resources, the main problem appears to be the lack of efficient planning, as they signal thelack of specific categories of specialists. Even the Tunisian health-care system experiences a deficiency in some kind ofspecialists (Achouri and Achour, 2002). In Algeria, public services have suffered from the reduction of public funds devotedto the welfare system since the mid 1980s, due to the economic and political crisis and the ensuing structural adjustment(Chemingui, 2003).131