Physicians (medicinsk personale) in developing countries, particularly in HIV/AIDS-stricken sub-Saharan Africa, are making up the shortfall in medical staff in the UK and leaving countries like South Africa, Ghana and Nigeria with too few doctors to cope with their own health problems, reports the World Bank press review Friday.
Britain is not the only country benefiting from foreign-trained doctors but it recruits far more health professionals from abroad than other European nations. John Eastwood, of St Georges University in London, and his colleagues, who reported these findings in The Lancet medical journal, said because Britain is a major beneficiary of the African brain drain it should take the lead in tackling the problem.
– In the whole of sub-Saharan Africa there is an average of 12,5 doctors per 100.000 people. We have created a vacuum by under-providing training for doctors and nurses in the UK, they write.
BBC News notes the researchers suggested that “one basic measure would be an agreement in consultation, with the World Health Organization, to establish a basis in developed countries for minimum annual numbers of health professionals in training. This would help to reduce developed country reliance on the investment in training made by developing countries.”
The Guardian (UK) meanwhile reports that the UK Department of Health forbids the National Health System (NHS) from recruiting from countries struggling to treat sicker populations. The code of practice does however not cover private hospitals and agencies, although the health minister John Hutton said last August it would be tightened.
Eastwood and colleagues say in The Lancet: – It is difficult to believe that strengthening the code on its own will overcome the demand. It is this demand that appears to be the principal cause of the drain.
Overseas staff makes up a large proportion of the medical workforce – 31 percent of practicing doctors and 13 percent of nurses were born outside the UK. Nearly half of the recent 16.000 expansion of the NHS workforce came from outside the UK and Europe.
An estimated 60 percent of doctors who in the 1980s trained in Ghana – which has only nine doctors per 100.000 inhabitants and is being overwhelmed by the HIV/AIDS epidemic – have left.
In 2003, say the authors, work permits were approved for 5.880 personnel from South Africa, 2.825 from Zimbabwe, 1.510 from Nigeria and 850 from Ghana – even though they are all on the list the NHS is not allowed to recruit from.
Jeremy Laurance, health editor of The Independent (UK), writes that a report by Save the Children and the charity Medact, published in February, estimated that Britain had saved 65 million pound (ca. 650 mio. DKR) in training costs for the doctors it had taken from Ghana since 1999 and 38 million pound for the nurses. Britain could train enough doctors and nurses for the countrys needs if it chose to, but it is cheaper to import them.
Tony Blair and Gordon Brown have committed themselves to tackling poverty in Africa. Yet, as the World Bank has recognized, an effective health system is a fundamental pre-requisite of economic progress. – While we give hundreds of millions in aid with one hand, we are systematically stripping their skilled health workers “the vital resource of impoverished nations” with the other, Laurance writes.
The Independent further writes in an editorial that in the short term, some form of restitution must be made by countries that save on medical training costs by importing foreign labor.
Although doctors and nurses working in Britain remit money home to support relatives, that money goes into the domestic economy. It does not support the health service. Funds given under any system of restitution must be ring-fenced for health care.
Some Ghanaian officials argue that financial support should be provided to raise the salaries of Ghanaian doctors, but that would be economically and socially destabilizing.
There are other means of providing incentives through professional support, exchange visits and measures that involve Ghana as part of the international medical community. Providing opportunities for Ghanaian staff to gain experience abroad and return would in itself be an incentive to stay, the daily argues.
Kilde: www.worldbank.org
