International mobility of nurses from Kerala (India) to the EU: prospects and challenges with special reference to the Netherlands and Denmark

Abstract

The estimated six million nurses and midwives in the WHO European Region are inadequate to meet current and projected future needs. In several of the EU countries, expected shortages are accentuated by the fact that the health workforce is ageing and a growing proportion of workers will retire soon. These countries are diversifying strategies to remedy shortages. At the governmental level, the EU countries seek to minimize migration from developing countries citing 'ethical' concerns about shortages at the source. However, nurses from developing countries including India remain a potential source of supply that has been tapped by the EU countries from time to time. In this context, this paper examines the prospects for the migration of nurses from Kerala to the EU and the challenges in this regard. The state of Kerala is of interest because of its history of migration of nurses to Europe, its strengths in education and its health sector achievements. The paper takes up the cases of two EU countries - the Netherlands and Denmark - to understand better the challenges to the mobility of nurses to the EU. The Netherlands and Denmark have recruited small numbers of Indian nurses and operation theatre assistants in the recent past. Both countries are contending with present and future shortages of nursing staff, yet there is a discernible mismatch between their immigration policies with respect to nurses and the demands of hospitals / employers. In this context, sporadic network driven migration of nurses mostly from Kerala has registered greater success but there has been less space for the evolution of a coordinated approach to migration from India i.e., between governments, recruiting agencies and employers. To study the policy context for the migration of nurses from non EU countries in the Netherlands and Denmark and the experiences of nurses, the paper uses material generated through interviews conducted in October 2012 with a cross section of stakeholders in these countries. The paper also evolves recommendations to enable a mutually beneficial and planned mobility of nurses to the EU.