‘Poaching’ of nurses leaving the Philippines in ‘difficulty’

The “poaching” of nurses from the Philippines by international recruiters means the country is now struggling to meet the health needs of its own population, a nursing leader has warned.

Dr Fely Elegado-Lorenzo, a retired nursing professor at the University of the Philippines, called for more to be done to protect the nurse workforce supply in struggling countries.

She raised the alarm during a debate this week about global nurse recruitment practices held at the International Council of Nurse (ICN) Congress in Canada.

She said that while the Philippines “is thought to be a big producer of nurses”, it was now “having difficulty meeting the needs of the country” due to staffing gaps.

Some hospitals were even facing the risk of closure because of the shortages of nurses, she warned.

It is estimated that the Philippines has a nurse shortage of more than 120,000, however earlier this year a government official there said this could be closer to 350,000.

Despite this shortage, the Philippines continues to be one of the top countries from which the UK recruits, with more than 5,000 nurses joining the UK register last year.

During the height of the coronavirus pandemic, nursing resources were “stretched beyond their limits”, Dr Elegado-Lorenzo told ICN Congress via a remote video call.

The government tried to limit international migration during this time by putting a cap on the number of nurses who could leave the country to work abroad.

However, Dr Elegado-Lorenzo explained that the “poaching” of Filipino nurses worsened when borders and markets opened back up as the pandemic began to de-escalate. She said: “Many recruiters, international and local, went to hospitals directly to recruit. “Some of them even went directly to nursing schools and offered placements to third-year and senior nursing students.”

Aggressive recruitment strategies adopted by predominantly high-income countries, such as the UK and the US, had “serious effects” on the Filipino workforce, creating severe nurse shortages in public and private hospitals, as well as in primary and community care.

Dr Elegado-Lorenzo explained that some hospitals had even faced the prospect of losing their license because of how severe the staff shortages were.

She wanted to see global bodies such as the World Health Organization granted greater powers to protect nurse numbers in individual countries beyond the current ‘red list’ method – which bans international recruiters from actively targeting health workers in listed countries.

This could include putting a limit on nurse migration “temporarily or permanently”, she suggested.

“When they see that certain countries are already hurting because of massive migration, then they have to help put a stop to it temporarily or permanently,” said Dr Elegado-Lorenzo.

“Right now, we know that there are red lists of countries where nurses cannot be recruited from, but this is old and rather static.”

Meanwhile, she also highlighted the importance of countries taking action to support retention of their nurses.

She said: “We need to emphasise the responsibility of each country to develop and retain their older workforce to meet the magnitude of their needs and demands by issuing decent work and positive practice environments within their countries.”

Gina Dean, acting director of nursing in the Ministry of Health in The Bahamas, told ICN Congress that her country was also facing the same challenges as the Philippines.

The Bahamas has experienced mass migration of nurses to the US, as the country is just 60 miles away from the coast of Florida, she explained.

She said the country was trying to tackle the problem by improving training opportunities for nurses.

In addition, a programme had been launched specifically to target high school students and attract them into joining the domestic workforce, providing them with mentors to support their journey, she said.

Workforce policy expert and moderator of the session, Professor James Buchan, told ICN Congress that, post pandemic, all countries' health systems were in “a very problematic situation”.

He said: “What we’re seeing is replicated across the globe.

“High-income countries are seeing burnout, reduced hours, nurses retiring early, and the increased gap that is creating.

“More and more of these countries are saying we'll go to the Philippines, or we’ll go to The Bahamas, or we’ll go to India.

“What therefore is happening is increased international growth driven by the fact that the governments [and] employers in those high-income countries have not done enough to recruit, retain and sustain their own nurses.”

Professor Buchan explained that there needed to be a balance in allowing individuals to capitalise on the global demand for their nursing skills, while recognising the risks it poses to their homes countries if they leave.

Like the other panellists, he called for governments across the world to be engaged and hold responsible for their actions “when they are supporting or driving international recruitment”.