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Human Resources for Health
Published in: Human Resources for Health 1/2015

Open Access 01-12-2015 | Research

What motivates doctors to leave the UK NHS for a “life in the sun” in New Zealand; and, once there, why don’t they stay?

Authors: Robin Gauld, Simon Horsburgh

Published in: Human Resources for Health | Issue 1/2015

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Abstract

Background

At 44%, New Zealand has the highest proportion of international medical graduates (IMGs) in its workforce amongst OECD member countries. Around half of New Zealand’s IMGs come from the UK NHS, yet only around 50% stay longer than 1 year post-registration with significant costs to the New Zealand health care system. Why these doctors go to New Zealand and do not stay for long is an important question.

Methods

UK-trained doctors who had gained registration with the Medical Council of New Zealand and currently practising in New Zealand were surveyed (n = 1357) on the motivation for their move to New Zealand, experiences once there and what was prompting any intentions to move away from New Zealand. Multivariate proportional odds models (POM) were used to quantify various associations.

Results

The survey had a 47% response (n = 632). Quality of life considerations motivated 96% of respondents to move to New Zealand, although 65% indicated they were pushed by a desire to leave the NHS. POM analyses revealed older respondents were significantly less likely than younger respondents to be motivated by quality of life considerations. Younger doctors were significantly more likely to be seeking to leave the NHS. Seventy-six per cent of respondents signalling an intention to leave New Zealand indicated that the desire to return to the UK was the primary reason for this.

Conclusion

There is a long history of medical migration from the UK to New Zealand. However, the 65% of respondents in this study seeking to leave the NHS was much higher than found elsewhere, perhaps reflecting increasing workplace and funding pressures in recent years. Of concern to policy makers were the higher odds of seeking to leave the NHS motivating younger doctors. Various changes “down under”, in New Zealand as well as Australia, mean their IMG markets may well be tightening up.
Literature
1.
World Health Organization. The World Health Report 2006: working together for health. Geneva: World Health Organization; 2006.CrossRef
2.
Ono T, Schoenstein M, Buchan J. Geographic imbalances in doctor supply and policy responses. OECD health working papers no 69. Paris: OECD; 2014.CrossRef
3.
Negin J, Rozea A, Cloyd B, Martiniuk A. Foreign-born health workers in Australia: an analysis of census data. Human Resources for Health. 2013;11(69):1–9.
4.
5.
Humphries N, McAleese S, Matthews A, Brugha R. ‘Emigration is a matter of self-preservation. The working conditions . . . are killing us slowly’: qualitative insights into health professional emigration from Ireland. Human Resources for Health. 2015;13(1):35.CrossRefPubMedPubMedCentral
6.
Nair M, Webster P. Health professionals’ migration in emerging market economies: patterns, causes and possible solutions. J Public Health. 2012;35(1):157–63.CrossRef
7.
Eastwood J, Conroy R, Naicker S, West P, Tutt R, Plange-Rhule J. Loss of health professionals from sub-Saharan Africa: the pivotal role of the UK. Lancet. 2005;365:1893–900.CrossRefPubMed
8.
Martineau T, Decker K, Bundred P. ‘Brain drain’ of health professionals: from rhetoric to responsible action. Health Policy. 2004;70:1–10.CrossRefPubMed
9.
Marchal B, Kegels G. Health workforce imbalances in times of globalization: brain drain or professional mobility? Int J Health Plann Manage. 2003;18:s89–101.CrossRefPubMed
10.
Labonte R, Packer C, Klassen N. Managing health professional migration from sub-Saharan Africa to Canada: a stakeholder inquiry into policy options. Human Resources for Health. 2006;4(22):1–15.
11.
Terry D, Le Q. Social capital among migrating doctors: the ‘bridge’ over troubled water. J Health Organ Manag. 2014;28(3):315–26.CrossRefPubMed
12.
Moberly T. Minority report: how the UK’s treatment of foreign and ethnic minority doctors needs to change. BMJ. 2014, 348(g2838). doi: 10.​1136/​bmj.​g2838.
13.
Elkin K, Spittal M, Studdert DM. Risks of complaints and adverse disciplinary findings against international medical graduates in Victoria and Western Australia. Medical J Australia. 2012;198(8):448–52.CrossRef
14.
Negin J. Australia and New Zealand’s contribution to Pacific Island health worker brain drain. Aust N Z J Public Health. 2008;32(6):507–11.CrossRefPubMed
15.
Mackintosh M, Mensah K, Henry L, Rowson M. Aid, restitution and international fiscal redistribution in health care: implications of health professionals’ migration. J Int Development. 2006;18:757–70.CrossRef
16.
Roberts J. The impact of global inequities on health professional migration. Policy, Politics and Nursing Practice. 2008;9(4):323–7.CrossRefPubMed
17.
World Health Organization. WHO global code of practice on the international recruitment of health personnel. Geneva: World Health Organization; 2010.
18.
Zubaran C. Balancing the act: the international migration of medical graduates. Monash Bioeth Rev. 2011;29(3):1–12.CrossRefPubMed
19.
Wismar M, Maier C, Glinos I, Dussault G, Figueras J. Health professional mobility and health systems: evidence from 17 European countries. Copenhagen: World Health Organization on behalf of the European Observatory on Health Systems and Policies; 2011.
20.
Sharma A, Lambert T, Goldacre M. Why UK-trained doctors leave the UK: cross-sectional survey of doctors in New Zealand. J R Soc Med. 2012;105(1):25–34.CrossRefPubMedPubMedCentral
21.
Zurn P, Dumont J-C. Health workforce and international migration: can New Zealand compete? Paris: Organization for Economic Cooperation and Development; 2008.CrossRef
22.
Association of Salaried Medical Specialists. Taking the temperature of the public hospital specialist workforce. Wellington: Association of Salaried Medical Specialists; 2014.
23.
Health Workforce New Zealand. The health of the health workforce. Wellington: Health Workforce New Zealand; 2014.
24.
General Medical Council. The state of medical education and practice in the UK. London: General Medical Council; 2014.
25.
26.
Medical Council of New Zealand. The New Zealand medical workforce in 2012. Wellington: Medical Council of New Zealand; 2013.
27.
28.
Jatrana S, Crampton P. Primary health care in New Zealand: who has access? Health Policy. 2009;93(1):1–10.CrossRefPubMed
29.
Ashmore J, Gilson L. Conceptualizing the impacts of dual practice on the retention of public sector specialists: evidence from South Africa. Human Resources for Health. 2015;13(3):1–9.
30.
Gauld R. Questions about New Zealand’s health system in 2013, its 75th anniversary year. New Zealand Medical J. 2013;126(1380):1–7.CrossRef
31.
Association of Salaried Medical Specialists. The public hospital specialist workforce: entrenched shortages or workforce investment? Wellington: Association of Salaried Medical Specialists; 2013.
32.
Keane S, Lincoln M, Rolfe M, Smith T. Retention of the rural allied health workforce in New South Wales: a comparison of public and private practitioners. BMC Health Serv Res. 2013;13(32):1–9.
33.
Nair S, Mishra P, Norris P, Paul C. The destination of Pacific Island health professional graduates from a New Zealand university. Human Resources for Health. 2012;10(24):1–6.
34.
Janulyte V, Puriene A, Petrauskiene J, Peciuliene V, Benzian H. International migration of Lithuanian oral health professionals: a survey of graduates. Int Dent J. 2011;61:224–30.CrossRefPubMed
35.
Hall D, Garnett S, Barnes T, Stevens M. Drivers of professional mobility in the Northern Territory: dental professionals. Remote and Rural Health. 2007;7(655):1–20.
36.
R Development Core Team. R: a language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2014.
37.
38.
Appleby J, Thompson J, Jabbal J. How is the NHS performing? Quarterly monitoring report. July 2014. London: King’s Fund; 2014.
39.
Henderson L, Tulloch J. Incentive for retaining and motivating health workers in Pacific and Asian countries. Human Resources for Health. 2008;6(18):1–20.
40.
Bach S. International migration of health workers: labour and social issues. Geneva: International Labour Office; 2003.
41.
Page D. Anatomy of a medical school: a history of medicine at the University of Otago, 1875–2000. Dunedin: Otago University Press; 2008.
42.
Ministry of Health. Health workforce development: an overview. Wellington: Ministry of Health; 2006.
43.
Medical Training Review Panel. Medical training review panel seventeenth report. Canberra: Commonwealth of Australia; 2014.
44.
Morton S, Bandara D, Robinson E, Atatoa Carr P. In the 21st century, what is an acceptable response rate? Australia and New Zealand J Public Health. 2012;36(2):106–8.CrossRef
45.
Cohen AB, Restuccia JD, Shwartz M, Drake J, Kang R, Kralovec P, et al. A survey of hospital quality improvement activities. Med Care Res Rev. 2008;65(5):571–95.CrossRefPubMed
46.
Scott T, Mannion R, Davies H, Marshall M. The quantitative measurement of organizational culture in health care: a review of the available instruments. Health Serv Res. 2003;38(3):923–45.CrossRefPubMedPubMedCentral
47.
Rice P, Ezzy D. Qualitative research methods: a health focus. Melbourne: Oxford University Press; 1999.
Metadata
Title
What motivates doctors to leave the UK NHS for a “life in the sun” in New Zealand; and, once there, why don’t they stay?
Authors
Robin Gauld
Simon Horsburgh
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2015
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-015-0069-4

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