Health Professional Mobility and Health Systems
Evidence from 17 European Countries
The mobility of health professionals affects the performance of health systems, and increasingly so since the European Union (EU) enlargements in 2004 and 2007. This publication presents research on the gaps in knowledge about the numbers, trends, impacts and policy responses to this dynamic situation, in particular in Austria, Belgium, Estonia, Finland, France, Germany, Hungary, Italy, Lithuania, Poland, Romania, Serbia, Slovakia, Slovenia, Spain, Turkey and the United Kingdom.
Conducted within the framework of the European Commission s Health PROMeTHEUS project, the research posed a set of questions of key interest to policy-makers:
* What are the scale and characteristics of health professional mobility in the EU?
* What have been the effects of EU enlargement?
* What are the motivations of the mobile workforce?
* What are the resulting impacts on health system performance?
* What is the policy relevance of those impacts?
* What are the policy options to address health professional mobility issues?
In answering these questions, this publication offers policymakers evidence of the nature and extent of health professional mobility in the EU, analyzes its impact on country health systems and outlines some major policy strategies to address mobility.
Part I Setting the scene, results and conclusions
1) Health professional mobility and health systems in Europe: an introduction—Matthias Wismar, Claudia B Maier, Irene A Glinos, Jeni Bremner, Gilles Dussault, Josep Figueras
2) Cross-country analysis of health professional mobility in Europe: the results—Claudia B Maier, Irene A Glinos, Matthias Wismar, Jeni Bremner, Gilles Dussault, Josep Figueras
3) Health professional mobility and health systems in Europe: conclusions from the case studies—Irene A Glinos, Matthias Wismar, Claudia B Maier, Willy Palm, Josep Figueras
Part II Case studies from countries that joined the EU before 2004
4) Mobility, language and neighbours: Austria as source and destination country—Guido Offermanns, Eva Maria Malle, Mirela Jusic
5) Of permeable borders: Belgium as both source and host country—Anna Safuta, Rita Baeten
6) Changing context and priorities in recruitment and employment: Finland balances inflows and outflows of health professionals—Hannamaria Kuusio, Meri Koivusalo, Marko Elovainio, Tarja Heponiemi, Anna-Mari Aalto, Ilmo Keskimaki
7) Nationally moderate, locally significant: France and health professional mobility from far and near—Marie-Laure Delamaire, Francois-Xavier Schweyer
8) A destination and a source: Germany manages regional health workforce disparities with foreign medical doctors—Diana Ognyanova, Reinhard Busse
9) Oversupplying doctors but seeking carers: Italy’s demographic challenges and health professional mobility—Luigi Bertinato, Irene A Glinos, Elisa Boscolo, Leopoldo Ciato
10) Opportunities in an expanding health service: Spain between Latin America and Europe—Beatriz Gonzalez Lopez-Valcarcel, Patricia Barber Perez, Carmen Delia Davila Quintana
11) A major destination country: the United Kingdom and its changing recruitment policies—Ruth Young
Part III Case studies from countries that joined the EU in 2004 or 2007
12) Migration and attrition: Estonia's health sector and cross-border mobility to its northern neighbour—Pille Saar, Jarno Habicht
13) From melting pot to laboratory of change in central Europe: Hungary and health workforce migration—Edit Eke, Edmond Girasek, Miklos Szocska
14) Awareness, planning and retention: Lithuania’s approach to managing health professional mobility--Žilvinas Padaiga, Martynas Pukas, Liudvika Starkiene
15) When the grass gets greener at home: Poland’s changing incentives for health professional mobility—Marcin Kautsch, Katarzyna Czabanowska
16) Emergent challenge of health professional emigration: Romania’s accession to the EU—Adriana Galan, Victor Olsavszky, Cristian Vladescu
17) Regaining self-sufficiency: Slovakia and the challenges of health professionals leaving the country—Kvetoslava Benušová, Miloslava Kovácová, Marián Nagy, Matthias Wismar
18) Addressing shortages: Slovenia’s reliance on foreign health professionals, current developments and policy responses—Tit Albreht
Part IV Case studies from third countries having applied for EU membership
19) Geopolitics, economic downturn and oversupply of medical doctors: Serbia’s emigrating health professionals—Ivan M. Jekic, Annette Katrava, Maja Vuckovic-Krcmar, Vesna Bjegovic-Mikanovic
20) At the crossroads:Turkey’s domestic workforce and restrictive labour laws in the light of EU candidacy—Hüseyin Yildirim, Sidika Kaya