International Nurse Recruitment to Ireland 2000-2010

1. International Nurse Recruitment to Ireland 2000-2010 Dr. Niamh Humphries, RCSI Prof. Ruairí Brugha, RCSI Prof. Hannah McGee, RCSI

2. Overview • Nurse Migration to Ireland • International comparisons • International Recruitment – a short term solution? • Recession and nurse emigration from Ireland • Discussion

3. International Nurse Recruitment • Ireland began actively recruiting nurses internationally in 2000. • 11,481 non-EU migrant nurses issued with working visas 2000-2009. • 35% of all newly registered nurses in Ireland 2000 to 2010 were from non-EU countries • Ireland now has had a greater reliance on international nursing recruits than the UK. Sources: Department of Jobs, Innovation and Enterprise, 2009; Irish Nursing Board 2010; Nursing and Midwifery Council, 2008

4. Nationality of nurses newly registered with Irish Nursing Board 2000-2010 N=31,810 Source: Irish Nursing Board

5. Nationality of nurses Newly Registered with Irish Nursing Board 2000-2009 Source: Irish Nursing Board

6. Sources: Irish Nursing Board 2010; Nursing and Midwifery Council, 2008

7. Share of foreign-trained or foreign nurses in selected OECD countries, 2008 Source: OECD Policy Brief, 2010

8. International Recruitment Drives • Interview panels (employers & nurse recruitment agencies) travelled to countries such as India and the Philippines to conduct interviews. • In 2009, Nurse Migration Project surveyed non-EU Migrant Nurses working in Ireland(N=337) • 83% (278) of survey respondents noted that a recruitment agency assisted in their migration to Ireland. • 51% (173) from the Philippines, 33% (112) from India. Remainder from one of 16 other countries. • 62% (208) worked in a public hospital upon arrival

9. A Short term Solution • International nurse recruitment viewed as a short-term solution to the shortage of nurses. • Response to the transition from 3 year to 4 year training and the ‘gap year’ of 2005 (no graduating nurses) • Irish nurses would be prioritised for recruitment as soon as more graduates came on stream • ‘. . . the Filipinos are on two-year contracts and are seen as a short-term solution to the shortage of nurses. As more Irish nurses are trained by the Mater, they will have first priority for jobs there . . . ’ (Irish Times article 2000) • ‘I believe the State doesn’t really know . . . before they hire us they don’t have a plan or policy in place’ (Migrant Nurse Survey 260). Sources: Holmquist, K (2000)., From Manila to the Mater, Irish Times.

10. Future Plans of Migrant Nurses • Future plans of non-EU migrant nurse respondents, 2009 • 19% (65) of respondents intended to stay in Ireland • 49% (166) intended to return home and • 23% (79) planned to migrate to another country. • At the time of survey, 80% (269) held permanent contracts in the Irish health system. Although onset of recession made them less confident about their future. • Though we are permanent we are uncertain of our jobs’(Migrant Nurse Survey 142). • ‘The 'recession' has made us question ourselves: how long is the country going to need us? Being on a working visa only renewable every 2 years we are unsure of [our] security and stability here’(Migrant Nurse Survey 222).

11. Nurse Emigration from Ireland • Recession & Recruitment Moratorium 2008/9 • Non-EU nurses considering emigration • 4202 verification requests processed for non-EU migrant nurses between 2008 and 2010. • Equates to almost one third of those actively recruited since 2000 (if intent translates into emigration) • Irish trained nurses also considering emigration • Verification requests for 805 Irish nurses in 2008, 909 in 2009 and 967 in 2010 • Nurses now actively recruited from Ireland to Australia and the UK. Source:Irish Nursing Board 2010

12. Source: Irish Nursing Board

13. Irish Registered Nurses ‘working abroad’ 2004-2010 Source: Irish Nursing Board

14. Data Limitations • Although Registration data really useful for Nurse Migration Project, registration data has its limitations for workforce planning, e.g. • Details entry onto the Register rather than into workforce • No information about where in the health system non-EU nurses are working • Verification requests measure intent to migrate rather than emigration/exit • Some emigrant nurses retain Irish registration after emigration • Immigration information also used by project (Department of Jobs, Enterprise and Innovation ) • Details acquisition of working visa/permit - probable entry into the workforce.

15. Discussion • Ten years of international nurse recruitment and the Irish health system seems to still be heavily reliant upon non-EU migrant nurses [data?] • Recession & recruitment moratorium have contributed to the emigration of nurses (Irish and non-EU) from Ireland [data?] • How will this impact on the nursing workforce? [data?] • Need for better data and analysis to enable better workforce planning. • Assuming that migration (emigration and immigration) will always ‘work’ for Ireland over-plays the reliability of migration as a tool for health workforce planning [data?]

16. Thanks to . . . • The Irish Health Research Board for funding the Nurse Migration Project: Research Project Grant RP/2006/222. • The migrant nurses and key stakeholders who participated in the research • The Irish Nurses and Midwives Organisation for their assistance in contacting qualitative respondents. • The Irish Nursing Board and the Employment Permits Section of the Irish Department of Jobs, Enterprise and Innovation for providing statistics. • Project Contact: nhumphries@rcsi.ie • Outputs from the project available at http://tinyurl/NiamhHumphries