Unemployment and precarious work conditions force thousands of nurses to migrate

01/12/2016

The economic crisis which began in 2008 has caused Spain in the last few years to go from a stable working market country to producing increasingly more professionals in nursing who end up finding work abroad. But the effects of the problems among these health professionals and the dimensions of this migration are rarely known. The Nursing Association of Barcelona observed that in 2008-2009 there was an increase in the number of professionals requesting to work abroad and in 2015 the Organisation for Economic Cooperation and Development (OECD) acknowledged that international mobility, principally to other European countries, had allowed nurses trained in Spain to find work abroad.

Paola Galbany-Estragués and Sioban Nelson, professors of the Universitat Autònoma de Barcelona (UAB) and the University of Toronto, respectively,as well as nurses, have delved deeper into the issue and questioned, in a pioneering study, which destinations were most popular among Spanish nurses and the reasons behind their decision to migrate. In their study, published in the International Journal of Nursing Studies, they analyse the political tendencies affecting the training and employment possibilities for these professionals in Spain. To do so, the analyse databases, scientific publications, and national and international European laws and directives. The study was conducted thanks to a post-doctoral grant from the Bloomberg Faculty of Nursing in Toronto.

The results reveal that between 2010 and 2013 a total of 4,580 nurses trained in Spain turned to the Ministry for Education and Science (MECD) to apply for the accreditation of their nursing diploma which permits them to work in another country of the European Union or of the European Economic Area, according to the Directive 2005/36/EC. In comparison to other professions, nursing professionals formed the largest group of one single profession applying for this accreditation and was only surpassed by doctors applying for it in 2013. In 2014 over 8,000 nurses trained in Spain were working in other OECD countries. The place concentrating the largest number of nurses was the United Kingdom (5,624 nurses), followed by France (1,734), Portugal (1,004), Belgium (304) and Italy (292). From 2012 to 2014, 1,221 nurses migrated to Germany and since 2012, 150 had travelled to Finland.

With regard to the factors motivating them to work abroad, researchers highlight mainly three.

First, the organisational changes produced in the National Health System, which affects human resources, e.g. the increase in number of hospital beds closed, which went from 11,236 in 2008 to 16,681 in 2013. Therefore, the deterioration in the occupation rate of hospital beds since 2008 produced a reduction in the ratio of active hospital nurses per 1,000 patients, from 3.21 in 2010 to 3.10 in 2013.

Second, the reduction in public spending and labour reforms. For example, according to OECD data, in 2013 for the first time in Spain there was a reduction of 5,2000 active nurses in comparison to 2012.

And third, the analysis of data from the public employment service agency in Spain (SEPE) revealed that an increase in unemployment affected the nursing profession dually: with an increase in the number of nurses seeking employment from 9,257 in 2010 to 19,639 in 2013, and with an increase in the number of temporary contracts, especially during the summer months. In 2014, the number of job seekers was 14,161, which represented a decrease of 5,478 with regard to 2013, in part due to the increase of nursing migrations occurring in the previous years.

The study also mentions that, despite labour market cutbacks and adjustments, the number of nurses graduating from Spanish universities has risen in the past few years, going from 8,368 in 2006 to 11,700 in 2014. This has increased the pressure on the labour market.

“The Spanish healthcare system is incapable of taking in all of the nurses and this causes them to migrate in the end. This is basically the consequence of unemployment and precarious labour conditions and it has a negative effect on the quality of patient care; there are studies demonstrating that the migration of nurses increases the working load in the country of origin, which means that nurses can dedicate less time to their patients”, Paola Galbany points out, and believes that “a greater and better distribution of human and economic resources to lessen the work burden would allow nursing professionals to carry out their work in better working conditions”.

“This loss of nurses also represents a severely important loss of investment. Prior studies demonstrate that Spain, alongside Norway, offers the highest level of training for nurses in Europe. However, while Norway has a ratio of 20.15 nurses for every 1,000 citizens, Spain's ratio is 5.29. We must not forget that we are also the second OECD country with the highest life expectancy and, therefore, need our nurses greatly, both now and in the future", she concludes.

Original article: Paola Galbany-Estragués & Sioban Nelson. "Migration of Spanish nurses 2009–2014. Underemployment and surplus production of Spanish nurses and mobility among Spanish registered nurses: A case study." International Journal of Nursing Studies. November 2016. Volume 63, Pages 112–123. http://dx.doi.org/10.1016/j.quascirev.2016.08.013