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Jamaica keeps losing its best nurses to the UK

OPPORTUNITY: Jamaican nurses are often attracted to the UK by pay and training benefits

JAMAICA IS facing an acute shortage of nurses and health care professionals. If not addressed, a severe deterioration in the country’s ability to sustain some aspects of public health care is likely.

Recent documents produced by the Jamaican government indicate a chronic shortage of specialist nurses working in areas such as accident and emergency, paediatrics, and midwifery. As of January, this year, the country had only a little over half of the number of nurses it requires to provide for its basic needs in a range of specialisations in the country’s public hospitals.

The report produced by Jamaica’s Ministry of Health indicates that the country urgently requires around 1,000 nurses to meet its immediate needs. It notes that the situation has become so severe that the shortage of critical care nurses may have a severe impact on health service delivery, resulting in health service rationing in some areas, increased workloads on limited staff, and negative patient outcomes.

COMMERCIAL

This situation has not been helped in recent years by the recruitment of healthcare workers by commercial intermediaries operating out of Europe and North America. Apart from the way in which Jamaica is losing its health- care workers being morally dubious, it has had the effect of degrading the quality and capacity of public health care across the Caribbean region.

The consequence has been a loss to the Caribbean of medical professionals – particularly registered nurses – as they are offered more financially rewarding, temporary or permanent positions, training, and better conditions, in the public and private sector in countries like the UK, US or Canada.

More generally, as the Hamburg Institute of International Economics noted in a 2007 paper, this may have positive implications for nurses and physicians to improve their professional and personal lives, but has had ‘significant negative consequences’, acting as a ‘drain on the ability of less affluent countries to provide adequate healthcare for their citizens’.


David Jessop

Earlier this year the issue was raised at the World Health Organisation, when its executive board discussed matters relating to health employment and economic growth. At the meeting, Jamaica’s Minister of Health, Christopher Tufton, noted that 29 territories in the Americas region had reported a net loss in health workforce due to migration.

Citing a World Bank study, he said that 15 years after graduation, about half of the trained nurses from the Caribbean Community (CARICOM) countries were working abroad, that three times as many CARICOM-trained nurses work outside of, rather than within the region, and that the regional shortage of nurses was expected to triple to more than 10,000 by 2030.

RECRUITMENT

As matters stand, the region is now faced with a large-scale, state-encouraged recruitment drive from outside the region, aimed at addressing growing national shortages of health care professionals across the world. In the UK, for example, official figures show that at the end of 2015, the NHS – excluding Scotland – had more than 23,443 vacant nursing posts and 6,207 vacancies for doctors, and that the shortfall would last until at least 2020.

They also indicate that 69 per cent of the trusts that run many of Britain’s hospitals are actively recruiting staff from abroad, including in the Caribbean. Recent Jamaican government documents suggest that between 2014 and 2017 the country lost 29 per cent of its critical care nursing workforce and around 1000 nurses were required to fill specialist nursing roles.

According to Tufton, the effect of this on Jamaica has been to cripple the delivery of certain healthcare services and has had a dramatic negative effect on the overall quality of health care.
In a bid to tackle the problem, Tufton is proposing a scheme that would see registered nurses from Jamaica going for advanced critical care clinical training in the UK for six month periods, with trained nurses from the UK travelling to Jamaica for one year periods to provide similar support.

The Caribbean region as a whole can also take steps to address a system of global recruitment that is damaging the delivery of some healthcare services and degrading the overall quality of public medical provision.

In addition, where possible, governments need to offer improved and clearer promotional paths for all medical staff, and ways need to be found to improve local living and working conditions.

David Jessop is a Caribbean Council counsultant and can be contacted at david.jessop@caribbean-council.org

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