Ethical recruitment

The Looming Crisis in the Health Workforce: How Can OECD Countries Respond?

The developing world needs millions of trained health workers immediately just to provide the most basic healthcare, yet doctors are leaving poor countries to go to richer ones.

So how come even the wealthy countries are suffering a drastic shortage of doctors and nurses, says OECD’s report The Looming Crisis in the Health Workforce? The US alone reports that it will need over 250,000 additional public health workers within the next decade.

Published in collaboration with the World Health Organization, The Looming Crisis in the Health Workforce reports on a two-year project that examined the interplay between a decreasing health workforce and growing international migration. It addresses the demand for health workers around the world, which has countries recruiting internationally in a sort of cross-border tug of war. Yet, the shortage is still expected to get worse.

How can OECD countries meet future demand? While the most effective approach is to simply train more staff, the rate of training will not meet the shortfall, since despite an increase in enrollment in the last decade, the number of medical graduates in developed countries in 2005 still lies below the 1985 level.

Another option is to hang on to current medical staff by addressing wage and workplace issues, delaying retirement and creating incentives to raise productivity, such as by linking pay rises to performance or investing in IT.

Then, there is that thornier option of recruiting personnel from other countries. But already, nearly three quarters of foreign-born doctors and two thirds of foreign-born nurses originate from non-OECD countries, says the report. As the WHO warns, the shortage of medically trained staff in poor countries threatens the Millennium Development Goals on reducing HIV and malaria, and improving maternal and reproductive health. In the poorest countries of the world, there is one doctor for every 100,000 people, says Oxfam, compared to an OECD average of 3 per 1,000.

The Looming Crisis in the Health Workforce emphasises that individuals have a right to seek opportunities internationally, but calls for enforcing international codes of conduct in recruitment, welcoming foreign medical students under mutually beneficial conditions, and strengthening the health systems of developing countries.

ISBN: 978-92-64-05043-3

©OECD Observer No 269 October 2008

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