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Ministry of Health

The ethics of international health personnel recruitment

In August 2008, the World Health Organization issued a draft code of practice on international recruitment of health care personnel.

More than 10 years ago, the issue of ethical recruitment of health care personnel was first raised by South African president Nelson Mandela. Mandela charged the United Kingdom with poaching health care professionals from South Africa, weakening the South African health care system and subsidizing its own system in the process. The UK responded with its own voluntary efforts to meet Mandela’s challenge.

In intervening years, the HIV/AIDS crisis dramatized the impact of international recruiting, triggering widespread debate among international health care organizations.

Draft code of practice

In August 2008, the World Health Organization (WHO) issued a draft code of practice on international recruitment of health care personnel. Member state consultations are ongoing, with a final voluntary code of practice to be tabled at the World Health Assembly in May 2010.

Canada is a WHO member state and will be expected to comply with the code if it is approved. Health Canada’s Advisory Committee on Health Delivery and Human Resources is collating responses to the draft code from all provincial governments.

The WHO code, which will constitute voluntary guidelines, has four basic goals:

  • to establish an ethical framework for health care recruiting that balances the rights of health professionals to emigrate with the right of health employers (in both sending and receiving countries) to take the steps necessary to provide appropriate health care services;
  • to regulate how, when, and where health care recruiting occurs;
  • to establish clear expectations for the health care professional, in terms of long-term rights and protection, and the employer, in terms of qualifications and commitment;
  • to evaluate and monitor performance to ensure overall objectives are achieved.
BC's response

Recruitment of internationally trained health care professionals is integral to the human resource strategies of Canadian health care providers, including BC. Regardless of targeted recruitment initiatives, significant numbers of health care professionals choose to immigrate to BC and it is important to minimize licensing barriers and facilitate workplace integration.

Over the past decade, Canada has reduced its proportion of internationally educated physicians, while the proportion of internationally educated nurses has remained constant. However, due to population growth and the demand for health services, the actual numbers of both have increased. BC has doubled the number of medical students at the University of British Columbia and dramatically increased education seats for nurses and other health professionals, yet if will continue to draw on international recruitment to fill vacancies throughout the province.

Complying with the WHO ethical recruitment code would serve the purpose of confirming BC’s determination to adhere to the highest standards and acknowledge our global population health responsibilities, while leveling the field between provinces and other developed countries. At the same time, Canada must continue to strive for self-sufficiency by educating increasing numbers of health care professionals.

John Mabbott
Executive Director
Health Match BC

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