1. Global migration of health professionals Dr Tricia Scott

2. CZ EU Accession Immigration rates increased markedly after 1993 when, “… the more economically advanced EU candidate states like Poland, Hungary and the Czech Republic became immigration havens overnight” Mensah et al (2005)

3. Motivation to migrate Push factors: Staff shortages Staff shortages Poor working conditions Poor working conditions Relaxation of immigration rules Relaxation of immigration rules

4. Motivation to migrate Pull factors: Career opportunities Career opportunities Higher salaries Higher salaries Better quality of life Better quality of life

5. Gender-blind policies Increasingly impact on female health worker migration Detrimental loss of expertise Create geographically segregated families

6. Objective policies “the objective migration policy is not limitation of mobility but equity of health care as soon as possible” Mensah et al (2005)

7. The code of practice Introduced in 1999, strengthened 2001 and 2004 Recruitment agencies contracting to NHS prohibited from actively recruiting Health professionals from developing nations Unless special agreement with UK Contractual obligation for independent sector and private recruitment agencies Department of Health (2007)

8. Codes of practice InductionTraining Working conditions High levels of mobility National manpower planning Bilateral agreements

9. UK overseas registrations 2002/7 added 46,000 nurses and midwives 2003/4 = 13,600 2005/6 = 8,673 EU is not classified as overseas Categories removed from Shortage Occupation List (Home Office)

10. UK nursing admissions 2002/32005/6 India1,8303,551 Philippines5,5931,541 Australia 920 751 South Africa1,368 378 Zimbabwe 485 161 Romania - 57

11. Conclusion Migration is a manpower issue Migration is also a gender issue Global health systems respond to advances in the practise and organisation of care Growing ethical response from regulators to protect the public and practitioners

12. References Castles, S. and Miller, M.J. (2003) The age of migration, Hampshire, Palgrave. Department of Health (2007) Health is Global, London, The Stationery Office [accessed 12 March 2007 www.dh.gov.uk/publications] www.dh.gov.uk/publications Mensah, K. Macintosh, M. Henroy, L. (2005) The ‘Skills Drain’ of Health professionals from the developing world: a framework for policy formulation, London, Medact. Nursing and Midwifery Council (2007) Overseas applicants, NMC News, May, Number 20: p8.