OECD Health Data National Correspondents 23 October 2014, Paris

1. Health workforce migration: resultsfrom 2013-14 Pilot data collection and proposal to add module in the Joint questionnaire OECD Health Data National Correspondents 23 October2014, Paris

2. OECD pilot data collection in 2013-14 • Aim: Begin to update data on international migration of foreign-trained doctors and nurses in OECD countries: • first reported in 2007 chapter in OECD International Migration Outlook • data collection pursued in OECD Health Data questionnaire up to 2009 • Part of broader OECD project, also including data collection on foreign-born doctors and nurses (based on the wave of national census around 2010/11) • Begin to analyse impact of a number of recent developments on migration trends (e.g., economic crisis in 2008-09, EU enlargement in 2004 and 2007, Global Code on the International Recruitment of Health Personnel in 2010) • Work done in collaboration with WHO-Headquarters

3. Scope and approach to pilot data collection Focus on doctors and nurses Focus on place of training (foreign-trained, where first diploma was obtained) Collect immigration data from destination countries by all countries of origin (based on professional registries, physician/nurse surveys, other sources) Include both total “stock” and annual “flows” Time series (from 2000 to 2012)

4. Results of pilot data collection in terms of data availability Note: This pilot data collection was not carried out in Greece, Iceland, Luxembourg, Mexico and Turkey. • Doctors: • Stock: 25 countries (out of 29), including 20 with data by countries of origin • Flow: 19 countries (out of 29), including16 with data by countries of origin • Nurses: • Stock: 23 countries (out of 29), including 16 with data by countries of origin • Flow: 16 countries (out of 29), including 13 with data by countries of origin

5. Data sources for pilot data collectionDoctors

6. Data sources for pilot data collectionNurses

7. Data comparability limitations and other issues Same type of comparability limitations as for the broader data collection on the total number of doctors or nurses (e.g., data for some countries relate to “professionally active” or “all licensed to practice” rather than “practising”, many countries exclude physicians-in-training) Some countries (e.g., Germany) are only able to report data based on “foreign nationality” (not foreign-trained) Problem in distinguishing “foreign-born and foreign-trained” students from “domestic-born but foreign-trained” students returning to their home country (“internationalisation of medical and nursing education”)

8. Proposal to add a new module in the 2015 Joint Questionnaire • Aim: Collect a relevant minimum dataset: • to fill current gap in OECD, Eurostat, WHO-Europe databases • to serve also as an input to national reporting under the WHO Global Code (requirement once every three years) • Approach: Follow same specifications as under the OECD pilot data collection, but with an additional specification to identify ‘domestic-born but foreign-trained’ doctors and nurses • Frequency: This new module may be included every year or every three years, depending on assessment of benefits of regular updating versus data collection burden

9. Issues for discussion COMMENT on the results from 2013-14 OECD pilot data collection on foreign-trained doctors and nurses COMMENT on proposal to add a new module on health workforce migration in the 2015 Joint Questionnaire