Department of International Development, King's College London, London, UK
School of Social & Political Sciences, University of Glasgow, Glasgow, UK.
BMJ Glob Health. 2024 Feb 28;9(2):e014096. doi: 10.1136/bmjgh-2023-014096.
High-income countries increasingly look to the international recruitment of health workers to address domestic shortages, especially from low-income and middle-income countries. We adapt conceptual frameworks from migration studies to examine the networked and commercialised nature of the Indian market for nurse migration to the UK.
We draw on data from 27 expert interviews conducted with migration intermediaries, healthcare providers and policymakers in India and the UK.
India-UK nurse migration occurs within a complex and evolving market encompassing ways to educate, train and recruit nursing candidates. For-profit actors shape the international orientation of nursing curricula, broker on-the-job training and offer language, exam and specialised clinical training. Rather than merely facilitate travel, these brokers produce both generic, emigratory nurses as well as more customised nurses ready to meet specific shortages in the UK.
The dialectic of producing emigratory and customised nurses is similar to that seen in the Post-Fordist manufacturing model characterised by flexible specialisation and a networked structure. As the commodity in this case are people attempting to improve their position in life, these markets require attention from health policy makers. Nurse production regimes based on international market opportunities are liable to change, subjecting nurses to the risk of having trained for a market that can no longer accommodate them. The commercial nature of activities further entrenches existing socioeconomic inequalities in the Indian nurse force. Negative repercussions for the source healthcare system can be anticipated as highly qualified, specialised nurses leave to work in healthcare systems abroad.
高收入国家越来越倾向于从国际上招聘卫生工作者，以解决国内短缺问题，尤其是来自低收入和中等收入国家的短缺。我们借鉴移民研究中的概念框架，考察印度护士向英国移民市场的网络化和商业化特征。
我们利用在印度和英国对移民中介、医疗保健提供者和政策制定者进行的 27 次专家访谈的数据。
印度向英国的护士移民发生在一个复杂且不断发展的市场中，该市场涵盖了教育、培训和招聘护理人员的各种方式。营利性机构影响护理课程的国际化方向，充当在职培训的经纪人，并提供语言、考试和专门的临床培训。这些经纪人不仅促进了旅行，还培养了通用的移民护士以及更符合英国特定短缺需求的定制护士。
培养移民护士和定制护士的辩证法与后福特主义制造业模式相似，其特点是灵活的专业化和网络化结构。由于这里的商品是试图改善生活状况的人，因此这些市场需要卫生政策制定者的关注。基于国际市场机会的护士生产模式可能会发生变化，使护士面临培训市场无法容纳他们的风险。活动的商业性质进一步加剧了印度护士队伍中现有的社会经济不平等。由于高技能、专业化护士离开本国医疗保健系统前往国外医疗保健系统工作，预计来源国的医疗保健系统会受到负面影响。
