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Poaching health-care workers made easy

During the 2015-2016 financial year, more than 2600 health workers were brought into Australia via government-sponsored 457 visas on the basis they were needed for jobs that could not be filled by Australians. Of these 1692 were general practitioners and resident medical officers, 228 registered nurses, 35 specialists, 38 psychiatrists, 28 surgeons, 19 anesthetists and 20 midwives.

The high intake of health specialists occurred despite a senate inquiry in June 2015 where the Australian Nurses and Midwife Foundation (AN&MF) stated that there were 3000 unemployed graduate nurses, often with high HECS debts, while about 1 in 4 nursing positions were being filled by 457 skilled migrant intake[1]. They also claimed that many of the overseas nurses were victims of underpayment and exploitation because they live and work under threat of deportation[2]. The inquiry was also told that importing health workers was not solving the shortages of health professionals in rural areas because most imported workers went to the cities.

As of March 2016 there were 177,390 subclass 457 visa holders in Australia. To be eligible for a subclass 457 visa via standard business sponsorship, a worker must have an occupation on the Consolidated Sponsored Occupations List (CSOL) which is uncapped, meaning that there is no limit on how many can enter. Instead the numbers are determined from the applications made by employers. However there is a loophole that will allow employers to hire an unlimited number of foreign workers under a temporary working visa, in a move that unions say will bring widespread rorting of the system and insufficient support for local employment.

This reliance on skilled migration has been a long term policy of, not only our governments, but those of many developed nations, particularly the US, UK and Canada. As a consequence, about a quarter of doctors in Australia are from overseas and in 2010 the U.S. had 265,851 licensed physicians trained in other countries, constituting 32% of the physician workforce. Among these, 128,729 came from countries categorized by the World Bank as being from low- or lower-middle income. The World Health Organization (WHO) published a detailed 40-country study on the magnitude and flow of the health professionals. According to this report, close to 90% of all migrating physicians were moving to just five countries: Australia, Canada, Germany, UK and the USA. Even as far back as 1972, 6% of the worlds physicians were located outside their country of origin.

This poaching of skills or brain drain has been embraced by developed nations because it reduces the expense of training in the host nation. According to the African Capacity Building Foundation, African countries lose 20,000 skilled personnel to the developed world every year. All the developed world's efforts to increase aid to these countries may not matter if the local personnel required to implement development programs are absent. Every year there are 20,000 fewer people in Africa to deliver key public services, drive economic growth, and articulate calls for greater democracy and development. South Africa loses almost half of its doctors to Canada, Britain and Australia and is forced to recruit medical staff from countries like Kenya, Malawi and Zimbabwe. Ghana has lost half of its nurses and has more doctors working outside Ghana than in the country itself. This has cost it an estimated $63million of its training investment while the UK has saved $117m by the recruitment of Ghanaian doctors since 1988 alone. To address some of the concerns of “brain drain” from developing nations, the Commonwealth Code of Practice for the International Recruitment of Health Workers was adopted by Commonwealth Health Ministers in 2003. This serves as a framework within which international recruitment should take place and is intended to discourage the targeted recruitment of health workers from countries which are themselves experiencing shortages. The code also suggests that high-income countries consider how to recompense the donor nations for the recruitment of their health workers.

However there has been been considerable opposition to this approach, with some economists arguing that the transfer of skills is actually beneficial to both nations because many 3rd world nations are highly dependent on the remittances that their nationals return . According to the World Bank, workers from developing countries remitted a total of $325 billion in 2010, and in some countries these remittances are more than 20% of the nations GDP. Which of course is great unless you happen to urgently need the doctor that is now somewhere else. It has also been found that researchers and scientists who migrate are far more effective in their new locality because of better facilities that are available but then again this hardly flows on to benefit the donor nation. Shortages of skilled people in the education sector of developing nations is reducing training capacity and according to a report in the Wall Street Journal the US is to blame for Africa's doctor shortage that made the Ebola epidemic much worse than it should have been[3].

Today there are more doctors from Benin working in France than there are in Benin; more Ethiopian doctors in Washington DC than in the whole of Ethiopia. When you add in the effect of other professions that are poached from these countries under skilled immigration policies, teachers, engineers and others, it becomes plain that the developing nations will stay that way, a supplier of resources and skills to the developed world while ever this policy remains in place.

NOTES

[1] http://www.smh.com.au/federal-politics/political-news/call-for-migration-rort-crackdown-as-data-reveals-foreign-workers-snare-net-job-growth-20140807-3d9ma.html

1 in 3 nursing graduates can’t find work says ANMF report, yet 1 in 4 new nursing jobs going to 457 workers. http://t.co/FHHHQ2TCNH

http://www.smh.com.au/comment/lax-immigration-policy-hurting-australian-job-seekers-20140806-1019tr.html

[2] https://www.theguardian.com/australia-news/2016/oct/29/revealed-the-systemic-exploitation-of-migrant-workers-in-australia?CMP=share_btn_link

[3] How the U.S. Made the Ebola Crisis Worse: http://on.wsj.com/2cMKN5B
http://www.abc.net.au/news/2016-06-27/corruption-and-widespread-rorting-undermining-immigration/7537270?pfmredir=sm

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