Institut für Europäische
Gesundheits- und Sozialwirtschaft GmbH
Migration of Health Care Professionals
The triple win idea in bilateral agreements
Meiko Merda
Project Manager, IEGUS Institute
Joint Action on Health Workforce planning and forecasting
Lisbon, June 16th 2014
Institut für Europäische
Gesundheits- und Sozialwirtschaft GmbH
Contents
(1) Our institute
(2) Legal implementation of the WHO Code in Germany
(3) Practical implementation
(4) Challenges and solutions
Joint Action on Health Workforce planning and forecasting
Lisbon, June 16th 2014
Institut für Europäische
Gesundheits- und Sozialwirtschaft GmbH
(1) Our institute
Joint Action on Health Workforce planning and forecasting
Lisbon, June 16th 2014
Institut für Europäische
Gesundheits- und Sozialwirtschaft GmbH
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IEGUS Institute has been founded in 2007.
Located in Berlin-Mitte, Reinhardtstr. 31
Website: www.iegus.eu
Main Topics: Demographic transition,
strategies to meet the increasing demand of
healthcare personnel (e. g. migration), use
and funding of assistive technologies, sector
and market analysis, cooperations at
European and international level.
Joint Action on Health Workforce planning and forecasting
Lisbon, June 16th 2014
Institut für Europäische
Gesundheits- und Sozialwirtschaft GmbH
(2) Legal implementation of the
WHO Code in Germany
Joint Action on Health Workforce planning and forecasting
Lisbon, June 16th 2014
Interpretation of the WHO Code
• In general: Nurses from Non-EU countries get admission to the
German labor market when their professional qualification is
accredited by the authority in charge.
• Exception: No direct recruitment of healthcare
personnel from countries of origin that belong
to the 2006 WHO list (critical shortage)!
Joint Action on Health Workforce planning and forecasting
Lisbon, June 16th 2014
Legal implementation of the WHO Code
• June 2013: General Framework for the migration of nurses from NonEU countries with the reform of the „Beschäftigungsverordnung“.
• November 2013: Revision of the BeschV to follow premises of the
WHO Code (= no recruitment from countries with „critical shortage“):
§ 38: Only the German Federal Labor Market Authority is
authorized to recruit healthcare personnel from these countries.
§ 39: The recruitment from these countries is treated as a
refringement (Ordnungswidrigkeit).
Appendix: 2006 WHO list with the 57 countries with a
„critical shortage“
Joint Action on Health Workforce planning and forecasting
Lisbon, June 16th 2014
Institut für Europäische
Gesundheits- und Sozialwirtschaft GmbH
(3) Practical implementation
Joint Action on Health Workforce planning and forecasting
Lisbon, June 16th 2014
Practical implementation of the WHO Code
• First pilot projects with source countries that are not on the 2006 WHO list
were initiated recently with the aid of or through the German government.
Joint Action on Health Workforce planning and forecasting
Lisbon, June 16th 2014
Lessons learned from pilot projects
• The willingness of governments and healthcare facilities in countries
of origin to collaborate with Germany is very high.
• The motivation of nurses from less developed countries to migrate to
Germany, learn German language and integrate into the new environment
is high.
• Recruitment, language courses, professional preparations or the
acceptance of foreign degrees as well as the social integration and on the
job take it´s time and are very costly.
Joint Action on Health Workforce planning and forecasting
Lisbon, June 16th 2014
Institut für Europäische
Gesundheits- und Sozialwirtschaft GmbH
(4) Challenges and solutions
Joint Action on Health Workforce planning and forecasting
Lisbon, June 16th 2014
Challenges with the implementation of the WHO Code
• The strict orientation on the 2006 WHO definition of a „critical
shortage“ excludes collaboration with certain source countries even
if positive development effects are likely to occur.
• The main focus of the pilot projects, at the recent time of
implementation, is on the reduction of domestic manpower
shortages (no direct measures to strengthen healthcare systems in
countries of origin!).
• Who should pay the (initial) costs for migration schemes?
Government, employers, the personnel or in parts all (two) of them?
Joint Action on Health Workforce planning and forecasting
Lisbon, June 16th 2014
Solutions for a „real“ Triple Win Migration©
• Attach more importance to Article 5.1 (instead of fixed thresholds):
„The health systems of both source and destination countries should
derive benefits from the international migration of health personnel.“
• Set incentives for circular/temporary migration.
• Implement „Training partnerships“:
Countries of destination train (prepare)
healthcare personnel in countries of
origin for jobs abroad.
• Establish fair and sustainable financial
mechanisms.
Joint Action on Health Workforce planning and forecasting
Lisbon, June 16th 2014
Institut für Europäische
Gesundheits- und Sozialwirtschaft GmbH
Thank you for your attention!
Meiko Merda
Project Manager
IEGUS - Institut für Europäische Gesundheits- und Sozialwirtschaft GmbH
Reinhardtstr. 31
D-10117 Berlin
Fon: +49 30/9831222-4, Fax: +49 30/9831222-5
E-Mail: [email protected]
Internet: www.iegus.eu
Joint Action on Health Workforce planning and forecasting
Lisbon, June 16th 2014