Managed migration of nurses
Editorial
Kaieteur News
July 22, 2004
Everyone knows that keeping Guyana's nurses at home is a vitally important issue but a revealing seminar at the Le Meridien Pegasus Hotel last week emphasised that the problem regarding nurses' migration is far more serious than many persons thought.
The seminar, organised by the Institute of Development Studies (IDS) of the University of Guyana (UG) with inputs from the Canadian International Development Agency (CIDA), gave an informed appraisal of the issue and made useful suggestions on how the problem should be tackled.
At the seminar, the approach delegates recommended for nations like Guyana is to implement a policy of managed migration of nurses rather than become embroiled in a back-to-the-wall struggle to keep nurses at home. It seems to be a feasible option. Guyana has everything to gain from embracing this approach.
At the seminar, PAHO Human Resource Development Adviser, Dr. Jean Yan gave some surprising statistics about the extent to which trained Guyanese nurses have been absorbed by the Caribbean and farther afield. Dr. Yan revealed that Guyana is a major provider of medical services in the Caribbean, noting that the St Lucia health service is run almost entirely by Guyanese.
Clearly, the current situation does Guyana no good at all. Nurses and other medical professionals from Guyana are propping up health services throughout the Caribbean while the local health sector remains woefully short of highly trained, experienced nurses. That is why Guyana, of all the Caribbean states, should be at the forefront of the move towards managed migration of nurses.
Moreover, in terms of the managed migration policy mooted at the seminar, the main problem is not internal migration but the migration of Caribbean nurses to the developed countries, mainly the United Kingdom, the USA and Canada. This was confirmed by research done by the Regional Nursing Body (RNB), the Caribbean Nurses Organisation (CNO) in collaboration with Pan American Health Organisation (PAHO), and the Office of the Caribbean Programme Coordination.
To alleviate this, delegates at the seminar favoured a partnership with developing countries regarding recruiting nurses from the region. In this way, the Caribbean would have a say in the recruitment of nurses, which ideally would be along guidelines established by the managed migration programme. These guidelines should encourage the developed world to, at least partially, compensate the Region for the nurses they take out. For example, part of the recruitment fees paid to professional recruitment agencies to woo nurses from the Region could be used to update and enhance nurses' training and working conditions at home. This makes sense. Partnership with recruiting countries is necessary because nations like Guyana cannot compete with the developed world in a straight shootout for nurses' skills. But if developed countries and the Caribbean become partners in training, the Region could upgrade standards and recover part of the investments made in training. Further, the partnership would include agreement on recruitment policies. That way, the Caribbean would get out of the current 'Russian roulette' of haphazard recruitment. With a say in how, why and where nurses are recruited, the Region would be able to negotiate nurses' recruitment so as to ensure that there is no untenable disruption of the Region's health care sector through nurses' migration. Other useful suggestions arising from the seminar include one that countries in the region should not train nurses based on vacancies without considering the number retiring and those who will migrate. Therefore, nations like Guyana should train nurses in excess of the number required by the system, to cater for shortfalls through nurses' retirement or migration. Also, the managed migration programme deals with the age required for training. Under the programme, the age limit for admission to nurses' training should be raised to attract more mature, rooted applicants who are less likely to migrate. The programme also suggests a thorough policy review of nurses' access to further training working conditions with the intention of eliminating as far as possible the 'push factors' that influence nurses' migration.
Though there is much work to be done, it is quite clear that the Caribbean, including Guyana, has at long last decided to take decisive action to keep nurses at home and ensure that the departure of those who cannot be kept at home does not become an unmanageable problem. There is no choice but to forge ahead in this direction.