The British government is to tighten regulations on employment of health care workers from developing countries in order to stop draining key staff from nations hard hit by AIDS, Health Minister John Hutton announced this week during a visit to South Africa.
"We are determined not to destabilise the healthcare systems of developing countries. The NHS is expanding, but we're not going to do that at the expense of other countries,” he said this week.
National Health Service hospitals are already forbidden to recruit nurses from almost all developing countries except India, China and the Philippines, but private agencies have been allowed to recruit staff from anywhere in the world on short term contracts.
From next year private nursing agencies that supply large numbers of temporary staff to the NHS will have to comply with new regulations or they will lose NHS contracts. The regulations will also apply to the new Foundation Hospitals and the new wave of free NHS services that have been contracted out to private providers in order to clear waiting lists, the so-called Independent Treatment Centres.
The US organisation Physicians for Human Rights reported last month that 38 countries in sub-Saharan Africa fall short of the World Health Organization (WHO) minimum standard of 20 physicians per 100,000 population; 13 of these countries have five or fewer physicians per 100,000 population. Countries are losing health professionals to wealthier nations. Zambia's public sector retained only 50 of the 600 physicians that have been trained in the country's medical school from approximately 1978 to 1999.
Nursing shortages are severe too. Approximately 17 sub-Saharan countries do not even have half of the WHO minimum standard for nurses, 100 nurses per 100,000 population.
Health care workers who come to Europe and North America blame poor working conditions and poor salaries for their flight from decaying health care systems.
Physicians for Human Rights argue that donors, including the Global Fund to Fight AIDS, TB and Malaria, should help to increase salaries and improve medical infrastructure. Some donors, such as the UK Department for International Development, see the current emphasis on scaling up antiretroviral therapy as a major opportunity to improve health care infrastructure in the poorest countries.
To view the Physicians for Human Rights action plan to prevent the brain drain of health workers, click here.