Is anyone surprised?
Following on from my previous posts regarding the plunge in morale amongst NHS staff, The Times is reporting on the recruitment drive being carried out in the UK by other countries. Recruiters from Australia & New Zealand are focussing their efforts on disillusioned NHS staff with nurses being the prime target but other professions are not far behind.
The hospital in the Midlands being referred to is the University Hospital of North Staffordshire (UHNS) which was in the news recently threatening wholesale redundancies & (where Anthony Sumara spent a few months before upping sticks & moving to Hillingdon PCT where he is expressing his enthusiasm for mass seppuku) where I understand a team of recruiters came calling, with shiny DVD’s & offers of relocation assistance. And what is the betting that quite a few capable & ambitious staff members whose jobs were not threatened & whom the trust could ill afford to lose upped sticks & left as well, in addition to the hundreds already made redundant. The extensive history of unintended consequences from voluntary redundancy schemes ought to have warned us all.
Doctors are turning down the chaos of MMC to take up stable positions at Antipodean hospitals where they might even receive decent training & this I can confirm from personal knowledge. There is a massive difference between the “take it or leave it” attitude presented to staff here with them being asked to work for free & the impression I get of friendly & helpful Oz & Kiwi hospitals pulling out the stops to impress. It’s a pity I am not a decade younger.
The US has 30 percent less doctors graduating each year than the number needed to fill U.S. hospital residency slots. Were it not for the fact that they would need to take the USMLE & possibly retrain, there would be a higher incidence of doctors leaving for there too.
What the people at the top appear to have forgotten (or in the case of some of them, never learnt) is that healthcare is a “people business”. It cannot be automated or reduced to a standardised process in the same way that a manufacturing assembly line can & that the staff who deliver the service are the main asset of the industry.
In the same way that the healthcare industry is becoming part of the global marketplace, so is the free movement of skilled people across borders. It is not just jobs & capital that can move across borders, there is a global marketplace for healthcare staff too. Agencies exist all over the place to manage this process with not too onerous requirements. Currently in the United States, there are 126,000 unfilled nursing positions. The gap is projected to be 400,000 by 2010, 500,000 by 2015, and nearly 1 million by 2020, not to mention the assorted thousands of other healthcare professional staff. Inertia & family ties keep people around, leading them to put up with conditions I doubt any of the people responsible for these policies would tolerate.
I wonder where the NHS will be in 10 years time given the ageing demographic & the disillusioned workforce.
A few resources:
Nurses on the Move: Migration and the Global Health Care Economy - Mireille Kingma
Shortages of Medical Personnel at Community Health Centers - JAMA
Human Inputs: The Health Care Workforce and Medical Markets - Cooper and Aiken
Journal of Health Politics, Policy and Law 2001;26:925-938.
Chen LC, Boufford JI. Fatal Flows – doctors on the move. NEJM. 2005;353:1850-1852.
Joint Learning Initiative. Human resources for health: over coming the crisis. Cambridge, Mass.: Harvard University Press, 2004.
Mullan F. The metrics of the physician brain drain. NEJM. 2005;353:1810-1818.
Changuturu S, Vallabhaneni S. Aiding and abetting – nursing crises at home and abroad. NEJM. 2005;353:1761-1763.
Ahmad OB. Managing medical migration from poor countries. BMJ. 2005;331:43-45.
An action plan to prevent brain drain: building equitable health systems in Africa. Boston: Physicians for Human Rights, 2004.
Buchan J, Dovlo D. International recruitment of health workers to the UK: a report for DFID. London: Department for International Development, 2004.
World Health Organisation Web site. “Outlining the World Health Report 2006.â€