By Marta Bivand Erdal
In the Wellmig project, we explore both lived experiences of nurse migrants from the Philippines, Poland, and Sweden working in Norway and immigration regimes facilitating their access to employment and integration into the labour market and the wider Norwegian society.
Nurse migration from the Global South to the Global North has a long history. In recent years, however, active recruitment by government actors in some Global North countries has been abandoned, mainly because of concerns that nurse emigration might adversely affect national health care systems in the origin countries.
Meanwhile the international migration of nurses is a fact. But both the Global North and the Global South lack skilled nurses. In this context, the manner in which gaps between needed supply of nurses and availability of trained nurses in the labour market are filled, matters.
While the training of nurses as a way to increase a supply of nurses across the globe has been identified as a lasting solution, international migration remains an important dimension to this picture.
Norway is among the countries which have formally banned active government recruitment of nurses from countries with a nurse deficit of their own, but this has not stopped the migration of nurses who want to work in Norway. Our field research suggests that Filipino, Swedish, and Polish nurses have different experiences with access both to immigration and to nursing authorization.
How to facilitate fair and ethical recruitment of labour migrants
As we ponder these issues, we are also thinking about the current debates surrounding the Global Compact for Migration. Nurse migration provides an excellent prism through which to look at ways to facilitate fair and ethical recruitment of labour migrants and establish safeguards that ensure decent working conditions and living wages.
On the one hand, considering country of origin concerns, e.g. loss of human capital, is necessary and ethically appropriate; on the other hand, the aim to ‘Facilitate fair and ethical recruitment and safeguard conditions that ensure decent work’ (Actionable commitment 6, Global Compact for Migration zero-draft) also seems pertinent, in the context of global nurse migration. Perhaps especially so, knowing that many nurses wait a long time in order to receive full authorization allowing them to work as nurses in Norway.
These long waiting periods, arguably, do not provide for full and efficient use of migrant nurses’ skills and qualifications, especially for those from countries outside of the Nordic region, and all the more so, from outside of Europe.
The Global Compact discusses ways to promote faster, safer, and cheaper transfer of remittances in order to foster financial inclusion of migrants. Remittances – money sent to family members left behind in the country of origin – are key for many of the nurses we interviewed. While some migrate with family members, many leave partners, children, and aging parents behind. According to studies in the South Pacific, nurses are among migrants who are more likely to remit, and to remit more.
In destination countries, however, challenges associated with discrimination complicate matters, and undermine the full realization of the potential that lies in nurse migration. Seen through the prism of nurse migration, therefore, there is indeed a critical need to invest in skills development and facilitate recognition of skills, qualifications, and competences as suggested in the zero-draft Compact for Migration.
Our research suggests that, at least initially, many highly skilled nurses with specializations in pediatric oncology, anesthesiology, or cardiology do not utilize those skills as they find work e.g. in nursing homes.
Increased need for international cooperation
The case of nurse migration underscores the crucial need for increased international cooperation, focusing on policy coherence on international migration. This issue is a core ingredient of the UN General Secretary’s recent report ‘Making migration work for all’, in the zero-draft of the Global Compact for Migration, international cooperation and a whole-government-approach are outlined as guiding principles.
As Kathleen Newland of the Migration Policy Institute suggests, the global compact is weaker on the “how” of ‘solving the lack of governance that makes a Global Compact so badly needed’, where it is stronger on a list of “what” should be targeted.
At a time where migration debates are highly affected by what Marta Foresti of the Overseas Development Institute describes as ’a toxic political climate’, the case of nurse migration to a country like Norway offers scope for reflection, perhaps first and foremost, on the need for better migration management aiming to facilitate legal channels for migration.
Nurse migration also offers critical support for the need for a new narrative on international migration. As the zero-draft Global Compact for Migration emphasizes, there is a need to ‘Empower migrants and societies to realize full inclusion and social cohesion’ and to ‘Eliminate all forms of discrimination and promote fact-based public discourse to shape perceptions of migration’.
Perhaps paying more attention to the types of migration that are sorely needed in destination countries, where rhetoric on immigration is highly politicized, may be one window through which migration might be recognized as valuable and necessary, and in need of the common understanding, shared responsibility and unity of purpose, which the zero-draft of the Global Compact offers. An offer which is subject to the harsh realities of the current political climate, in the time remaining till a final version is due.