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Poaching health professionals - A growing injustice needing urgent solutions

autumn 2004

From triple helix - autumn 2004 - Poaching health professionals - A growing injustice needing urgent solutions [p4]

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At the Bangkok World AIDS Conference in July 2004, it was highlighted that the fight against HIV in Africa was imperilled by the severe shortage of trained doctors and nurses.[1] The grim reality is that even where the drugs and funding are available, there are no skilled health professionals to provide the care. One of the major causes of this shortfall is the migration of health professionals to the wealthier nations of the world. The UK is now one of the largest recruiters, second only to the US in the number of doctors we recruit from the developing world, and the largest importer of nurses.[2,3]

The reality is that there is a global shortage of trained health professionals and the increasing globalisation of labour markets means that health professionals are moving to where they can get the best salaries, training opportunities and living conditions.[4] The UK is now so short of health professionals that some 44,443 of NHS staff are from non- EU countries (and an increasing number of EU nationals working in the NHS are likely to be from the new accession states).[5] We simply could not run the NHS without them!

What can be done? One option is for the developed nations to pay compensation for the costs of training the workers we recruit from developing nations.[6] However, we also need to look at how we support, train and care for our own staff here in the UK.[7] It is not just that people are not going into medicine or nursing, it is that they are leaving, especially from nursing, at an alarming rate. If we cannot retain UK nationals in the NHS, sooner or later we will not be retaining foreign nationals either.

In the meantime, the global drives to reduce child mortality, improve maternal heath, curb the spread of HIV, TB and malaria, and the other health related Millennium Development Goals are in severe danger of being unfulfilled or even reversed, in large part because there are too few skilled practitioners in the countries that need them most.

The Psalmist reminds us that the Lord secures justice for the poor and upholds the needy. [8] This is an issue of justice that we as Christians seeking to serve the God of the poor need to address most seriously and urgently with our own government and the international community.


  1. An action plan to prevent brain drain: Building equitable health systems in Africa. A report by Physicians for Human Rights, 15 July 2004
  2. Carlisle D. Overseas recruitment: planet poaching to doing a world of good? Health Service Journal 2004;15 July
  3. Dugger CW. An exodus of African nurses puts infants and the ill in peril. New York Times 2004;12 July
  4. Carlisle D. UK's 'Ethical Recruitment Policy' needs to be strengthened. BMJ 2004; 328:1218
  5. Editorial. The implications for health of European Union enlargement. BMJ 2004; 328:1025-6
  6. Dugger CW. Art cit
  7. Mrachal B & Kegels G . Health workforce imbalances in times of globalization: brain drain or professional mobility? International Journal of Health Planning & Management 2003; 18:S89-S101
  8. Psalm 140:12

Article written by Steve Fouch

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