1. Nursing Migration and the Global Health Care Economy Dr Mireille Kingma International Council of Nurses

2. International Migration What do we know? 3% of the world’s population 191 million people 48% female Industrialised countries: One out of 10 International labour market

3. Globalisation  Better communication – access to information  Better transport options  More bi-lateral/multi-lateral trade agreements  Mutual recognition agreements  Shortage  facilitated immigration  International recruitment practices

4. Current Workforce Industrialised countries Australia, Canada, UK, US Switzerland Ireland Developing countries Cameroon Ghana South Africa

5. Projected Nurse Shortfalls 2010: Australia – 40,000 2012: USA – 1 million 2016: Canada – 113,000 2017: –Netherlands: 7,000 –Norway: 3,300 –Switzerland: 3,000 (1%-5% of practicing registered workforce)

6. Supply and Demand Types of migrant nurses –Economic migrant –Quality-of-life migrant –Career-move migrant –Partner migrant –Adventurer migrant –Survival migrant –Holiday workers –Student migrant –Return migrant

7. Nurse AB Country A Country B

8. Migration Pathway Services Goods Agencies Institutions Entrepreneurs Regulatory Bodies Businesses

9. Education Training for export Foreign student –Fees –Language competence –Accommodation/travel/food Satellite campuses Distance learning Employment provider Private business investment Perks: recruitment/retention

10. Accreditation Screening Testing Supervised clinical placement Tutoring Placement agencies Supervisors

11. The Right to Work Visas –Temporary –Permanent residence Employment –Journals –Internet –Diaspora –Individual initiatives –Recruitment agencies

12. Spin-Off Services Immigration lawyers The move –Persons –Furniture/belongings Housing Phone services Banking services Securities

13. Exploitation/Fraud Agency fees Accommodation –Quality –Charges Visa fraud Contracts –False representation –Deskilling –Substitution Corruption Freedom of association

14. Remittances US$300 billion – 2006 Reaching 10% world’s population –Consumption –Education –Investment Drain? Gain?

15. Brain Circulation Development opportunities Employment opportunities Business opportunities Multicultural nursing-competitive edge Positive practice environments Innovation Dissemination of good practice

16. Global Health Care Economy Direct impact on society and other sectors, incl commerce Nurse migration is part of globalization initiatives Recruitment and deployment must be regulated Self-sustainable workforces Human rights must be respected