We have not paid too much attention to the Philippines but Asia Health Space has published an excellent article about one of the country’s biggest medical problems. This article has been reprinted with their permission.
The Philippines is the leading provider of health professional manpower to many parts of the world. It ranked first and second, respectively, in the country list of the highest number of registered nurses and doctors exported worldwide in 2004, with an annual percent increase reaching as high as 5.2 percent. These figures speak well of the global quality of health professionals produced and still being produced in the country. However the numbers also define an underlying concern that seeks well-deserved attention—the chronic shortage of local healthcare professionals in the country. It is quite ironic that despite producing more health professionals than its Asian counterparts, the Philippines suffers from this quandary. The flight of medical doctors and health workers has left many Filipinos underserved especially in remote areas wanting in quality and accessible healthcare.
Proof of the compromised quality and integrity of the Philippine healthcare system is in the numbers. The National Statistics Office (NSO) data in 2007 reveal that only 2,995 medical doctors serve in local public hospitals. Although this number excludes private practitioners, the majority of the 90 million Filipinos, particularly in rural areas, depend on state facilities for their healthcare needs.
As early as the 1960s, the country has provided nurses to the United States and the Middle East and even expanded its overseas market to Europe including the United Kingdom, the Netherlands and Ireland. Deployment trends of Filipino nurses alone illustrate the magnitude of this predicament showing a steady upward trend over a 10-year period (Figure 1).
Figure 1. Deployment Trends of Filipino Nurses, 1994—2003.
Sounding the alarm
(”Warnings Raised About Exodus of Philippine Doctors and Nurses” in NY Times Nov 2005).
Sounding the alarm a notch higher is the emergence of the so-called nurse medics, doctors who have retrained as nurses in pursuit of employment opportunities overseas. Between 2001 and 2003, approximately 2,000 to 3,000 medical doctors have become nurse medics. By 2004, 3,500 doctors had already left the Philippines as nurses with 4,000 more training in local nursing schools. As for the nurses (non-nurse medics), 2006 data reported that 85 percent of approximately 200,000 locally-trained nurses at that time pursued opportunities abroad. More than losing a significant number of registered nurses and other health personnel in the field, the Philippines further suffers a double whammy from the loss of doctors who work as nurses abroad.
A view from the other side
Professional migration also exists in developed nations and is commonly motivated by the need to broaden experience and training. Some health professional migrants in the Philippines share a similar purpose but the majority of Filipino “migrant workers” are forced to leave the country primarily because of the lack of stable employment in the Philippines, not to mention the fact that they receive better compensation overseas.
A quick glance at the corresponding healthcare situation in developed nations also provides useful insight. Most developed nations such as Canada (and after Canada they board a flight for…..), the United States and the United Kingdom, remain hugely reliant on foreign-trained health professionals not so much because of professional migration but more likely due to what their experts acknowledge as the consequence of poor human resource planning, an underinvestment in education and an inevitably aging workforce.
Two interesting points are underscored:
(1) for obvious economic reasons, despite producing the highest number of healthcare professionals, the Philippine healthcare sector is crippled by the significant flight of health manpower;
(2) the constant demand for foreign-trained health professionals in developed nations and better employment opportunities for health professionals abroad are two significant pull factors of professional migration. Until certain policies are put in place, these factors could further sink the local healthcare sectors of health-personnel-exporting nations such as the Philippines.
Health policy makers in the Philippines are determined to address the prevailing concerns. Clearly, addressing the causes of professional migration is crucial. While the government appears to be promoting the migration of workers as part of its strategy aimed at establishing stop-gap measures to ease domestic unemployment, industry and health sectors push for stout measures to cope with the massive movement of Filipino heath professionals. Among these is the institution of a moratorium on deploying Filipino doctors abroad as well as other policy debates involving inter-country collaborations between labor-importing and exporting nations and the institution of bilateral agreements. Amidst the debates, a group of practicing Filipino physicians, came up with an alternative solution, giving way to the birth of the Philippine telemedicine initiative (see “Leapfrog: The (hopefully) rapid adoption of HIS in Asia).
Mary Ann C Bautista
China Healthcare Blog
Human capital continues to depart the Philippines
The Philippines is the leading provider of health professional manpower to many parts of the world. It ranked first and second, respectively, in the country list of the highest number of registered nurses and doctors exported worldwide in 2004, with an annual percent increase reaching as high as 5.2 percent. These figures speak well of the global quality of health professionals produced and still being produced in the country. However the numbers also define an underlying concern that seeks well-deserved attention—the chronic shortage of local healthcare professionals in the country. It is quite ironic that despite producing more health professionals than its Asian counterparts, the Philippines suffers from this quandary. The flight of medical doctors and health workers has left many Filipinos underserved especially in remote areas wanting in quality and accessible healthcare.
Proof of the compromised quality and integrity of the Philippine healthcare system is in the numbers. The National Statistics Office (NSO) data in 2007 reveal that only 2,995 medical doctors serve in local public hospitals. Although this number excludes private practitioners, the majority of the 90 million Filipinos, particularly in rural areas, depend on state facilities for their healthcare needs.
As early as the 1960s, the country has provided nurses to the United States and the Middle East and even expanded its overseas market to Europe including the United Kingdom, the Netherlands and Ireland. Deployment trends of Filipino nurses alone illustrate the magnitude of this predicament showing a steady upward trend over a 10-year period (Figure 1).
Figure 1. Deployment Trends of Filipino Nurses, 1994—2003.
Sounding the alarm
(”Warnings Raised About Exodus of Philippine Doctors and Nurses” in NY Times Nov 2005).
A view from the other side
Professional migration also exists in developed nations and is commonly motivated by the need to broaden experience and training. Some health professional migrants in the Philippines share a similar purpose but the majority of Filipino “migrant workers” are forced to leave the country primarily because of the lack of stable employment in the Philippines, not to mention the fact that they receive better compensation overseas.
A quick glance at the corresponding healthcare situation in developed nations also provides useful insight. Most developed nations such as Canada (and after Canada they board a flight for…..), the United States and the United Kingdom, remain hugely reliant on foreign-trained health professionals not so much because of professional migration but more likely due to what their experts acknowledge as the consequence of poor human resource planning, an underinvestment in education and an inevitably aging workforce.
Two interesting points are underscored:
(1) for obvious economic reasons, despite producing the highest number of healthcare professionals, the Philippine healthcare sector is crippled by the significant flight of health manpower;
(2) the constant demand for foreign-trained health professionals in developed nations and better employment opportunities for health professionals abroad are two significant pull factors of professional migration. Until certain policies are put in place, these factors could further sink the local healthcare sectors of health-personnel-exporting nations such as the Philippines.
Health policy makers in the Philippines are determined to address the prevailing concerns. Clearly, addressing the causes of professional migration is crucial. While the government appears to be promoting the migration of workers as part of its strategy aimed at establishing stop-gap measures to ease domestic unemployment, industry and health sectors push for stout measures to cope with the massive movement of Filipino heath professionals. Among these is the institution of a moratorium on deploying Filipino doctors abroad as well as other policy debates involving inter-country collaborations between labor-importing and exporting nations and the institution of bilateral agreements. Amidst the debates, a group of practicing Filipino physicians, came up with an alternative solution, giving way to the birth of the Philippine telemedicine initiative (see “Leapfrog: The (hopefully) rapid adoption of HIS in Asia).
Mary Ann C Bautista