1. Growth in Two-Step Migration to Australia Lesleyanne Hawthorne University of Melbourne Asia-Pacific Skilled Migration to Australia Workshop Macquarie University, 19-20 April 2007

2. Australia’s Growing Reliance on Overseas- Born Professionals by Field (2001)

3. Differential Labour Market Outcomes for Degree- Qualified 1996-2001 Arrivals, Australia Versus Canada (2001)

4. Differential Outcomes for Degree-Qualified Migrants 1996-2001 Arrivals by Select Country of Origin (2001)

5. Differential Training Systems/ Resources Ranking of top 500 world universities (Shanghai Jiao Tong 2006: 206 in Europe - overwhelmingly located in North West Europe, including 43 in the UK, and 40 in Germany 197 in the Americas -167 in the US, 22 in Canada, and just 7 in all Central or South America [including 1 in the top 150] 92 in the Asia-Pacific - 32 in Japan, 16 in Australia, 14 in China (none ranked in the top 150, and with 2 of the top 4 ranked institutions in Hong Kong), 9 in South Korea, 7 in Israel, 5 in New Zealand, 4 in Taiwan, 2 in Singapore, and just 2 in India (neither ranked in the top 300) 5 in the Africas - 4 in South Africa, 1 in Egypt, with no other African or Middle Eastern country listed) (Jiao Tong University 2006) Medical institution case study (Boulet 2005)

6. Major Source Countries for Skilled Migrant PA’s Versus Sources with Fastest Access to Professional Employment (Canada and Australia) 6

7. Employment Barriers: The Research Evidence (1990s+) 1.Supply and demand in the Australian workforce (‘niche’ economies) 2.English/ effective communication skills in a ‘lean’ workforce without ‘backroom’ jobs 3.Credential recognition 4.Technological ‘fit’ (eg engineering, medicine, nursing) 5.Ancillary professional knowledge: Management style Industrial relations/union issues Occupational health and safety Duty of care (etc) 6.Interview style (type and location of information) 7.Discrimination, labour market protectionism etc (challenge of effective measurement)

8. Addressing Perceived ‘Deficits’ (Case Study: Migrant Engineer Employment Bridging Courses) 1. Language: English for engineers 2. Employment: Job-seeking strategies for engineers, including orientation to professional engineering in Australia 3. Technical upgrades: Computer skills for engineers (eg AutoCAD) 4. Career conversion: IT graduate diplomas or Management degrees 5. Accreditation : Institution of Engineers Australia or technical accreditation training (eg taking 2-4 additional subjects in local civil engineering standards) 6. Examination preparation: Intensive training to prepare for pre-registration examinations 7. Further engineering study (PG): eg Masters of Computer Engineering, PhD

9. Cost and Demand for Labour Market Bridging 1.Cost: Spending on preparatory English programs balloons from $A36 million in 1982/3 to c$A150 million 1992/3, and rising Spending on labour market programs for migrants grows to $A142 million by 1992/3, and rising 2.Bridging program outcomes: Remaining limited 3.Level of demand: 1996-2001: 3276 bridging course places funded, to cater to all professions (600 places per year) 1994-2001 (Nursing): 336 NOOSR funded bridging course places available, in period when 12,000+ nurses arrived Potential demand: 35,000 skill migration places in 1998/9 cf 53,520 in 2001/2

10. Skilled Migration Selection Changes in Australia: 1999-August 2007 Reduction of human capital model of selection: 1.Mandatory pre-migration English language testing for all Principal Applicants: Independently validated 2. Mandatory pre-migration qualifications screening: By relevant professional or trade regulatory body, where these have the power to control access to employment 3. ‘Select for success’ among potential applicants: Privileging of former students (now over 50% of all skill migration applicants): young, recognised qualifications, competent English ability Trained to employer requirements 4. Factor labour demand into field-specific selection: Return of ‘occupations in demand’; bonus points for job offer, local experience etc 5. De-regulation of temporary flows including opportunities for two- step migration

11. Employment Outcomes by Migration Category 6 Months Post-Arrival (LSIA): Mid 1990s cf 2000

12. Impact of Improved Screening: % Economic PA’s Employed 6 Months Post-Arrival in Australia (1993-5 and 1999/2000) by Select Origin (LSIA)

13. The Policy Attractions of Temporary Migration Intensification 1996+: Government philosophy: market-driven De-regulation and fluidity Employer-driven (eg source countries, selection) Potential to by-pass regulatory barriers Constrained locational choice (eg doctors) Malleability (eg economic cycles: engineering, IT)

14. Case Study 1: The Rise of Temporary Medical Migration to Australia (5,583 TR and 350 PR in 2005-06) 1.Growing medical shortages: Demographic shift: doctor and patient base Reduction in 1996 of local university places Doctors barred from skilled migration to 2004 (25 point negative weighting) 2.Medical workforce maldistribution: Rural and regional locations Public sector medicine (eg hospital junior registrar positions) 3.Speciality workforce: Insufficient in select fields, eg Psychiatry, Surgery, Emergency Medicine Current strategy to address medical shortages New medical schools (Notre Dame x2, Deakin, Western Sydney, Wollongong, Bond) Growing reliance on foreign medical graduates and former international medical students for at least the next 10 years

15. Impact of Demographic Transition: Surgeon Age in Australia (42% aged 55 or older)

16. Impact of Demographic Transition: Number of Surgical Operations by Patient Age (2001 versus 1991)

17. Degree of Australian Reliance on OTDs Compared to the US, UK and Canada (2005)

18. Medical Migration Trends Sources: Eg India Hyper-mobility of overseas trained doctors (Hawthorne et al 2003) Growing global competition for doctors (West, Gulf States, Africa) Temporary flows ↑ –Attraction to government/ employers –Multiple players (eg ‘Recruit-a-Doc) –Bypass standard accreditation processes –Comparison: Canada, UK (NHS and Skilled Temporary Migration Program) –International medical students and internships (Hawthorne & Hamilton 2007) Permanent flows ↑ –Migration Occupations in Demand List Differential patterns and strategies by state: –Eg WA ‘adventure medicine’ Net gains versus losses in retention: –Highest retention for Middle East, South Asia, SE Asia, NE Asia

19. The Shift to Temporary Overseas Trained Doctors The Registration and Training Status of Overseas Trained Doctors in Australia L Hawthorne, G Hawthorne & B Crotty, Department of Health and Ageing, 2007, 157pp Analysis of: 1. All medical migration flows 2. All Australian Medical Council examination data from 1978-2005 3. Mailout survey of 3,000 recent OTDs (42% response rate) 4. Analysis of State Medical Board data for all categories of OTDs: NSW, Victoria, WA 5. Commissioned state case studies and x30 interviews with key informants

20. Temporary Entry Medical Visas Visa subclass 422 (‘Area of need’): (Birrell & Schwartz 2005) 1,419 in 1999-2000 2,496 in 2003-03 2,428 in 2003-04 3,074 in June 2005 (up from 1,636 in June 2003 and 1,237 as of June 2001) Visa subclass 442 (‘Occupational Trainee’): ↑2,437 in June 2005 (cf 1,237 in June 2001), primarily to Queensland, WA and Victoria Recent increase in NSW: June 2004 = 1,202 (Most as HMOs)

21. Variation in ‘Area of Need’ Demand for Temporary OTDs by State

22. Major Source Countries of ‘Area of Need’ for Temporary Doctors Over 27 countries by 2001 (growing diversity): By-pass ‘mandatory’ credential examination requirements UK/Ireland (1226) India (423) Malaysia (230) Sri Lanka (191) China (94) Germany (83) USA (56) Philippines (55) South Africa (45) Canada (35) Etc…

23. Sources of Medical Migration to Australia (1996- 2001) and Employment Outcomes by 2001

24. OTD Study: AMC Exam Outcomes 1978-2005 (Hawthorne et al 2007) Candidates: 139+ source countries Top sources: India (14%), Sri Lanka (8%), Egypt (7%), Bangladesh (5%), China (5%), UK (5%), Iraq (4%), South Africa (4%), Philippines (4%), Pakistan (3%) Pass rates (MCQ): 81% of attempters (51% on 1 st attempt, 47% on 2 nd attempt) Pass by origin (MCQ): UK/Ireland (95%), South Africa (86%), North America (86%), SE Asia non-Commonwealth (70%), East Europe (70%), Other Americas (67%) Pass rates (Clinical): 86% of attempters (but just 53% of all MCQ attempters go on to attempt and pass) Overall pass rates (MCQ and Clinical): South Africa (66%), UK/Ireland (64%), Central Asia (49%), %), South East Europe (49%), Other Americas (41%), SE Asia non-Commonwealth (38%) Age, English and recency of training highly significant: Harder to pass for older candidates

25. OTDs, Age and AMC Pass Rates – MCQ Exams (Hawthorne et al 2007)

26. Temporary Resident OTDs: An Emerging Two Tier Medical Workforce Government and employer goals = Two step migration Attraction of international medical students: 60% per annum Location: Constrained Salaries: ‘A saving’ Patients: Differentiated for select groups (eg Indigenous populations) Assessment: Just 26-33% of all OTDs encounter the AMC Alternatives: Growing use of RACGP and specialist pathways - but fast declining pass rates (61% [1999] → 40% [2004]) Impact of accreditation status on employment outcomes (high demand): 78% of OTD survey respondents working Differential patterns and data by state: Level of OTDs conditionally registered Characteristics (country of training, AMC status, actual credentials etc) Practice status Case study: ‘Non-accredited surgical registrars’ (eg NSW)

27. Case Study 2: Scope for Two-Step Migration in Select Other Professions Engineering: 2003-04 1,543 temporary arrivals IT: 2003-04 3,342 TR compared to 2004-05 3,553 TR arrivals International student course pipeline Accounting: Massive current growth

28. Recent Two-Step Migration Applications: Accounting, IT, Engineering and Building, Cooks (2004-05)

29. Australian Dependence on Temporary and Permanent Nurse Migration (1983-2000)

30. Demand for Overseas Temporary and Permanent Nurses (5,000 TR and PR per year by 2005-06)

31. Employer Choice (in the context of credential recognition rates for migrant nurses by select country of origin: 1990s)

32. Attraction of ‘Turning On/Off the Tap’: Impact of Demand on Employment Outcomes in Australia (1996-2001 IT Arrivals Versus Other Fields by Country of Origin (2001)

33. Case Study 3: International Students as a Source of Skilled Migrants (DEST 2007)

34. International Students = Australia’s Primary Source of Economic Applicants (2005, B Birrell)

35. Engineers Australia: Assessment of Applications by Month (including former international students)

36. The Impact of the Migration Occupation in Demand List: The Growth of Trades (1999 Versus 2005+)

37. International Student Enrolment Trends by Sector (DEST 2007)

38. Top 10 Skilled Migration Source Countries to Australia (2005-06)

39. But - International Student Issues (2006) 1.Calibre of courses and vocational training: Variable 2.Student readiness to undertake course: Prior English and academic training 3.Enrolment: Capacity to prevent dual-course enrolment 4.‘Accelerated’ courses: eg 16 month Masters Degrees (definition; acceptability to employers?) 5.‘Outsourcing’ of courses: Eg ‘university’ course outsourced to TAFE college 6.Regulation: Capacity for rogue providers to cross state boundaries, re-invent curricula, go off-shore (keeping ahead of regulatory processes) 7.Differential training standards: eg Lack of standard on- the-job experience to support technical courses 8.Suitability of premises → I mpact on employment outcomes?

40. The Latest Australian Data: LSIA Wave 3 (Birrell, Hawthorne & Richardson 2006)

41. Impact of ‘Migration Occupation in Demand’ on Earnings 6 Months Post-Arrival (2005)

42. New Zealand and Two-Step Migration (Bedford 2006) 2004-05: 82,497 temporary visas Categories: Labour market tested work permits: 28,317 (UK 22%, China 12%, India 7%, US 7%, South Africa 7%) Working holidaymakers: 21,025 (UK 35%, Japan 16%, Germany 11%, Ireland 9%, Canada 5%) International students: 77,563 (China 44%, South Korea 15%, Japan 6%, US 4%, India 3%) Two-Step Migration: 88% of 2004-05 skilled migrant PAs = former temporary visas ‘An integral part of the transition to residence’ Canada and UK Trends

43. Two-Step Migration: Select Benefits and Issues Proliferation of the trend: Eg US → India and China higher degree students Potential benefits to migrants: Access, settlement, accreditation, social networks (etc) Benefits to employers and governments: De-regulation; location and salary, field and numbers control Potential hazards: Uncertainty of long-term status (eg Gulf State residence) Level of host government commitment (eg EU guestworker legacy) Compromised work and accreditation standards (eg OTDs in Australia) September 2007+ policy developments