March 12, 2010
Nusing shortages have wider implications


IN our last issue, SEARCHLIGHT carried a story based on a recent World Bank study on the availability of nurses in the English-speaking Caribbean. That study, entitled “The Nurse Labour and Education Markets in the English-speaking CARICOM” makes very interesting reading indeed. It has fundamental bearing, not only on the state of the health sector in the region, but also on prospects for wider economic and social development in the region. We can only hope that this Report does not go the way of so many of its predecessors in the Caribbean, attracting attention, fleetingly, only to be quickly forgotten as we move on to some new interest area.{{more}}

The main conclusion of the Report is that the Caribbean (English-speaking) is faced with a shortage of nurses. This would no doubt sound surprising to people in countries like our own where we are sometimes unable to find employment for trained nurses. But factors such as the ageing nature of the population and emigration of nurses to greener pastures in North America and the United Kingdom are heightening the demand for nurses. According to the World Bank, there are 7,800 nurses in the English-speaking CARICOM, or about 5 nurses for every 4,000 persons. This is however one-tenth of the ratio in the major developed countries, including those which attract our nurses after we have trained them. Contradictorily, side by side with the shortage, there are some 3,300 posts vacant in the nursing sector, according to the Report.

One of the recommendations made is to address this shortage by increasing training capacity. However, there are concerns about the fact that there is a relatively low completion rate, only 55% of those entering training, going on to achieve qualification. With demand expected to increase, whilst supply is on the decrease, regional governments will have to address this problem urgently if they are not to see the ability to deliver quality health-care services further compromised, especially in the areas of disease-prevention and care.

This brings us to another important aspect of the nursing situation, the relation of health-care services to development possibilities. With so many underdeveloped countries seeking to attract foreign investment, it is not only financial incentives or tax breaks which count. The quality of life, particularly in relation to the provision of social services, is an important factor. Some countries use this as a drawing card to attract retirees for instance, for older people are concerned about the level of health-care available. Such quality services can make a country a very attractive proposition in attracting senior citizens.

Then there is the growing area of health tourism, a country offering quality health care and specialist services to attract persons seeking medical attention but lacking either the means or the level of insurance coverage to be able to afford it in developed countries. Cuba is already successfully exploiting this area. So there is a linkage between heath care services and development strategies. We can ill afford to overlook such possibilities.

One further important conclusion to emerge from the study is that of the implications for the region of the constant stream of migration of trained nurses from our shores. The World Bank estimates that there are about 21,500 nurses from the CARICOM region working in the UK and North America. 1,800 of them left these shores between 2002 and 2006 alone, and only restrictions on immigration in those countries are limiting the numbers. Yet the same Report estimates that unmet demand for nurses will triple in the region in the next 15 years to a staggering shortage of over 10,000 nurses. What a contradiction! This has both a human social cost and an economic one as well. It is estimated that, taking Jamaica as an example, each trained nurse who migrates to the USA brings an economic benefit of some US$26,000 to that country.

CARICOM countries therefore need to take a very serious look at this Report and to revisit their social and economic strategies. The Report itself calls on them to act collectively, to manage their rate of nursing migrations carefully and to ensure a proper balance between the interests of the nurses themselves and governments. We can ill-afford this drain of our nursing personnel, a deterioration of our nursing and health services or to miss out on opportunities in linking quality health care to our overall development thrust.