Last August he published the Wall Street Journal an article in which the main idea was the following: “The global shortage of healthcare personnel is triggering a bloody global battle for talent, in which Rich countries raid other countries’ medical systems for staff to serve their aging populations.”
The examples are multiple with the same line of argument. The Covid pandemic has led to a very significant abandonment of health professionals in many countries that has aggravated the traditional supply/demand disproportion present to a greater or lesser extent in almost the entire world. Between 2020 and 2021, the United States alone lost more than 100,000 nurses. While in poor countries this only deepens the precariousness and tragedy of their health care, those with greater economic availability have launched themselves on all the others in an undisguised attempt to attract doctors, nurses and in general all types of health professions.
The exodus from poor countries to rich countries
They describe the case of Zimbabwe, with a massive emigration of healthcare workers, especially to the United Kingdom, which in the last year has multiplied by six to reach 17,421 visas issued by this country for this purpose. The Zimbabwean president has described this plunder as “crime against humanity” and added that “If someone has been so irresponsible of not training their own nationals, but rather wanting poor countries to train them for them, it is a crime that must be taken seriously”. At the same time, he announced a law that penalizes the active hiring of health personnel in his country. He’s not the only one taking action. The Philippines banned the departure of health personnel during the pandemic and then it has greatly restricted them and Nigeria is going to require a stay of 5 years after finishing their studies, before being able to emigrate, among many others.
The situation is such that the WHO has published a list of 55 countries with the most pressing health workforce problems. The average of these countries is only 15 health workers per 10,000 inhabitants, compared to 148 per 10,000 in high-income countries (around 135 in Spain). The WHO concludes by asking its members not to actively hire doctors and nurses from these 55 countries without first sealing bilateral support agreements for the states in which they are hiring. This support could include funding the training of new staff or plans for health workers to return to their home country after a few years.
On the contrary, more than 70 states have introduced laws in recent years to facilitate the hiring of foreign healthcare personnel. Rich countries such as Germany have included the recruitment of health personnel in their high-level trips to places such as Ghana, Brazil and Albania. In the end, any restrictive measure is like putting doors on the field in a context of salary differences of more than 10:1 and a supply/demand that turns health workers into VIP emigrants between the third and first world.
The phenomenon we describe is not new, although the Covid crisis has triggered it and it should not surprise anyone. Already in 2006, the WHO estimated that there were 4 million health deficit in the worldincreased it to 7 million in 2013 and put the forecasts for 2035 at 13 million. However, more recent estimates already raise this figure to 18 million by 2030, figures that are increasingly worrying and for which it is obvious that they are not being the appropriate measures.
I had the opportunity to verify in the first years of this century the concrete repercussions of this emigration of health workers in search of better working conditions, in a country like Tunisia, then in a better situation than the current one, with very decent healthcare and universal coverage, as well as education. Although without great resources, he was trying to establish a donation and transplant system similar to the Spanish one, for which he asked for our help. We soon realized that the limiting factor that prevented it from going ahead was the Selective shortage of specialist doctors and nurses, who emigrated en masse to Arab countries with great availability such as Saudi Arabia or the United Arab Emirates, or French-speaking countries such as France, Belgium or Switzerland in search of higher incomes. The health authorities and the doctors who work there considered lost a battle that leaves their hospitals empty of anesthetists, certain surgeons and nurses…key positions for the development of their healthcare despite the fact that the Tunisian state has invested considerable resources in their training.
Competition, also between developed countries
Curiously, globalization has such force that it is allowing us to attend the hunter-hunted phenomenon. A country like the United Kingdom, a traditional universal importer of toilets as we know very well in Spain, and which lost a very considerable number of them after the pandemic, now receives takeover bids from English-speaking countries such as Australia or the United States that offer higher salaries and better working conditions and that they are receiving British health workers and those from other parts of the world in very considerable numbers.
“Our young professionals, very well trained, but with poor work situations, are tempted by options from other countries with better conditions, while at the same time, we import doctors and nurses from less fortunate countries and with almost always worse training than the ours. A great business.”
In Spain, for many years there has been talk of a shortage of doctors in certain specialties, as well as nursing staff. It is not the objective of this article to analyze this deficit, which in general terms we could say is selective for certain specialties and locations in the case of doctors and more global in the case of nursing. It seems obvious that the causes are multiple and so are the more or less effective patches that are tried to be applied, almost always. focused on increasing the production at origin of these qualified professionals. However, the international panorama that we have just described affects us, a lot, in both directions: our young professionals, very well trained, but with bad work situations, are tempted by the options of other countries with better conditions, while At the same time, we import doctors and nurses from less fortunate countries with almost always worse training than ours. A round business.
The corollary of this whole situation is very clear, although our politicians are not aware of it or do not want to see it: only decent working conditions and certainly much better than the current ones for our health professionals, with special emphasis on the most deficient and areas with difficult coverage. will be able to stop the current bleeding and lay the foundations for a solution to the problem in the medium and long term. The rest are just patches.
The phrase is attributed to Confucius “When the wise man points to the Moon, the fool looks at the finger.”. How right he was!
2023-10-22 09:20:46
#lack #doctors #nurses #local #universal
