Abstract
The objective of this article is to analyze the governance of migration of health professionals in Switzerland. Owing to a lack of health workers, the growing needs of healthcare, and the limited number of recent graduates, the Swiss health institutions are dependent upon international healthcare professionals. After an analysis of the need for healthcare professionals, this article examines the laws regulating the migration flows, before considering the challenges related to the governance of international migration and recruitment of health professionals in Switzerland. This article confirms Switzerland’s longstanding health workforce shortage, its chronic dependence upon the health professionals from EU neighboring countries, and its difficulty to achieve self-sufficiency against the backdrop of increasing health and demographic challenges, a need to maintain its welfare state, and to strengthen its international competitiveness by attracting talents, and the threat caused by rising restrictionist and anti-migrant political rhetoric, thereby resulting in difficult compromises regarding its migration policy outcomes.
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References
Advisory Committee on Health Delivery and Human Resources (ACHDHR) (2009). How many are enough? Redefining self-sufficiency for the health workforce. A Discussion Paper. Available at http://www.hc-sc.gc.ca/hcs-sss/pubs/hhrhs/2009-self-sufficiency-autosuffisance/index-eng.php. Accessed 30 April 2017.
Afonso, A. (2005). When the export of social problems is no longer possible. Immigration policies and unemployment in Switzerland. Social Policy and Administration, 39(6), 653–668.
Arlettaz, G. & Arlettaz, S. (2004) La Suisse et les étrangers. Immigration et formation nationale 1848–1933, Lausanne: Antipodes.
Beecham, L. (2002). UK government should stop recruiting doctors from abroad. BMJ, 325, 66.
Bolzman, C., & Guissé, I. (2017). Étudiants du « Sud » en Suisse romande: de la précarité lors des études aux risques de brain waste dans le cadre de la mobilité internationale. Journal of international Mobility, 1(5), 133–156. https://doi.org/10.3917/jim.005.0133.
Boswell, C. (2007). Theorizing Migration Policy: Is There a Third Way? International Migration Review, 41(1), 75–100.
Cattacin, S. (1987). Neokorporatismus in der Schweiz: die Fremdarbeiterpolitik. Zürich: Forschungsstelle für Politische Wissenschaft.
Cerna, L. (2016). Immigration policies and the global competition for talent. London: Palgrave Macmillan.
Chaloff, J. & Lemaitre, G. (2009). Managing highly skilled labour migration: a comparative analysis of migration policies and challenges in OECD countries. OECD Social, Employment and Migration Working Papers, No. 79, Paris: OECD.
Chirine, S. (2008). Portrait démographique du personnel infirmier à Genève: population en danger? Labodémo: Mémoire de Maîtrise en Démographie Univer sité de Genève.
Christian, B.P. (2000) Facilitating high-skilled migration to advanced industrial countries: comparative policies. Working Paper of the Institute for the Study of international Migration, Georgetown University.
Connell, J. (2010). Migration and the globalisation of health care the health worker exodus? Cheltenham, UK: Edward Elgar.
Consterdine, E. (2018). Labour’s Immigration Policy – The Making of the Migration State. London: Palgrave MacMillan.
Czaika, M. (Ed.). (2018). High-skilled migration drivers and policies. London: Oxford University Press.
D’Amato, G. (2008). Une revue historique et sociologique des migrations en Suisse, Annuaire suisse de politique de développement [En ligne], vol. 27, No. 2., mis en ligne le 22 mars 2010, Consulté le 30 septembre 2016. URL: http://aspd.revues.org/511
D’Amato, G. (2014). Chapter 10 Switzerland. In I. J. Hollifield, M. Philip, & O. Pia (Eds.), (2014) Controlling Immigration: A Global Perspective (pp. 308–332). Palo Alto: Stanford University Press.
Dhillon, I. S., Clark, M. E., & Kapp, R. H. (2010). Innovations in cooperation. A guidebook on bilateral agreements to address health worker migration (realizing rights: Global Health & Development at the Aspen Institute). Washington, DC: The Aspen Institute Available at http://aspeninstitute.org/sites/default/files/content/docs/pubs/Bilateral%20Report_final%20code.pdf. Accessed 10 January 2014.
Diehl, C., Hinz, T., & Auspurg, K. (2018). Who Is Afraid of Skilled Migrants From Europe? Exploring Support for Immigration Control in Switzerland. Swiss Journal of Sociology, 44(1), 59–88.
Dolder, P., & Grünig, A. (2016). Besoins en effectifs dans les professions de la santé. Rapport national 2016. Besoins de relève et mesures visant à garantir des effectifs suffisants au plan national. Bern: CDS et OdASanté.
Dumont, J-C; Zurn, P.; Church J. & Le Thi, C. (2008). International Mobility of Health Professionals and Health Workforce Management in Canada: myths and realities, WHO/OECD Health Working Papers. Paris: OECD.
Duncan, N. T. (2012). Immigration Policymaking in the Global Era In Pursuit of Global. Talent. New York: Palgrave MacMillan.
Efionayi, D., Niederberger, J. M., & Wanner, P. (2005). Switzerland faces common European Challenges. Washington, DC: Migration Policy Institute (MPI) Available at http://www.migrationinformation.org/Feature/display.cfm?id=284. Accessed 30 April 2017.
Federal Statistical Office (2016). Switzerland’s population 2015. Neuchâtel: FSO.
Fibbi, R. (2007). Swiss admission policy : the highly skilled migrants, Workshop Scientific Diasporas May 4th, 2007, available at https://cooperation.epfl.ch/webdav/site/cooperation/shared/diaspora/Presentation%20Fibbi%20-%20Swiss%20Immigration%20policy%20and%20the%20highly%20skilled.pdf. Accessed 22 Aug 2018.
Forcier, M. B., Simoens, S., & Guiffrida, A. (2004). Impact, regulation and health policy implications of physician migration in OECD countries. Human Resources for Health, 2, 12.
Freeman, G. P. (1995). Modes of Immigration Politics in Liberal Democratic States. International Migration Review, 29(4), 881–902.
Gross, D. M. (2006). Immigration policy and foreign population in Switzerland. Policy Research Working Papers. No 3853. Washington, DC: The World Bank. Available at worldbank.org/curated/en/.../pdf/wps3853.pdf. Accessed 30 April 2017.
Gross, D. M. (2011). High-skill migration to Canada and Switzerland: retention, attraction and competition with the United States through policy. Metropolis British Columbia, Working Paper Series No. 11-03. Available at http://mbc.metropolis.net/assets/uploads/files/wp/2011/WP11-03.pdf. Accessed 30 April 2017.
Hollifield, J. (2004). The Emerging Migration State. International Migration Review, 38(Fall), 885–912.
Hollifield, J., Philip M., & Pia, O. (Eds.) (2014). Controlling Immigration: A Global. Perspective. Palo Alto: Stanford University.
Huber, K. & Mariéthoz, E. (2010) Recherche qualitative sur le personnel de santé étranger en Suisse et sur son recrutement. Berne: Conférence suisse des directrices et directeurs cantonaux de la santé. Available at http://www.gdk-cds.ch/fileadmin/pdf/aktuelles/publikationen/berichte/bt_bericht_gdk_migrationgesundheitspersonal_201011_f.pdf. Accessed 30 April 2017.
International Organization for Migration (IOM) (2004) The migration of health care workers: creative solutions to manage health workforce migration. Seminar on Health and Migration, 9–11 June Session III B-Migration of health care workers.
Ionescu, D., Dia, I. A., & Guissé, I. (2009). Le potentiel de développement des migrants transnationaux d’Afrique subsaharienne, dans le secteur de la santé à Genève. Genève: Organisation Internationale pour la Migration (OIM).
Jacquard Ruedin, H. & Weaver, F. (2009). Ageing Workforce in an Ageing Society: how many health professionals will the Swiss healthcare system need by 2030? Careum Working Paper 1. Available at http://www.careum.ch/documents/10180/62992/Careum+Working+Paper+1+(english)/528fd1a4-2a30-45d1-ac25-b36e9b902673. Accessed 11 November 2013.
Jacquard Ruedin, H. & Widmer, M. (2010). L’immigration du personnel de santé vers la Suisse. Obsan Rapport 39. Neuchâtel: Observatoire Suisse de la Santé (Obsan).
Kangasniemi, M., Winters, L. A., & Commander, S. (2004). Is the medical brain drain beneficial? Evidence from overseas doctors in the UK. Social Science and Medicine, 65(5), 915–923.
Lahav, G. (2004). Public Opinion Toward Immigration in the European Union: Does It Matter? Comparative Political Studies, 37(10), 1151–1183.
Lavenex, S. (2004). Whither the Liberal Democratic Model? Immigration Politics in Switzerland and Japan. Swiss Political Science Review, 10(3), 179–209.
Marchal, B., & Kegels, G. (2003). Health workforce imbalances in times of globalization: brain drain or professional mobility? International Journal of Health Planning and Management, 18, S89–S101.
Martineau, T., Decker, K., Bundred P. (2002). Briefing note on international migration of health professionals: levelling the playing field for developing country health systems. Liverpool School of Tropical Medicine. Available at http://www.aspeninstitute.org/sites/default/files/content/images/martineau_0.pdf. Accessed 30 April 2017.
Mendy, A. F. (2014). La carrière du médecin africain en Europe: être médecin avec un diplôme africain au Royaume-Uni, en France et en Suisse. Swiss Journal of Sociology, 40(1), 47–71.
Merçay, C. (2009) “Le recrutement international d’infirmières en Suisse romande de 1970 à nos jours.” Géo-Regards: revue neuchâteloise de géographie. No. 2, Migrations contemporaines Textes réunis par Romaric Thiévent et Etienne Piguet, pp. 113–124.
Merçay, C., & Grünig, A. (2016). Personnels soignants en Suisse—projections à l’horizon 2030 et conséquences sur les besoins de relève (Obsan Bulletin 12/2016). Neuchâtel: Observatoire suisse de la santé.
Merçay, C., Burla, L. & Widmer, M. (2016). Personnel de santé en Suisse. Etat des lieux et projections à l’horizon 2030 (Obsan Rapport 71). Neuchâtel: Observatoire suisse de la santé.
Meyers, E. (2000). Theories of International Immigration Policy A Comparative Analysis. International Migration Review, 34(4), 1245–1282.
Mullan, F. (2005). The metrics of the physician brain drain. New England Journal of Medicine, 353, 1810–1818.
OECD. (2007). International migration outlook. Paris: Continuous reporting system on migration (SOPEMI).
OECD (2008). International mobility of health workers: Interdependency and ethical challenges. In: The looming crisis in the health workforce: how can OECD Countries Respond? Paris: OECD.
Natter K. (2018) “Rethinking immigration policy theory beyond ‘Western liberal democracies’”, Comparative Migration Studies 4(6), 4-21 https://doi.org/10.1186/s40878-018-0071-9
OECD (2010). International Migration of Health Workers Improving International Cooperation to address the global health workforce crisis. Policy brief OECD Observer. Available at http://www.oecd.org/dataoecd/8/1/44783473.pdf. Accessed 30 April 2017.
Office Fédéral de la Santé Publique OFSP (2010). Les migrations internationales du personnel de santé en Suisse: Etat des lieux et pistes de réflexion. Available at http://www.gdk-cds.ch/fileadmin/pdf/Aktuelles/Publikationen/Berichte/fiche_de_synthese_finale_F.pdf. Accessed 30 April 2017.
Office Fédéral de la Statistique (OFS). (2007). L’emploi dans le domaine de la santé Faits et tendances à la lumière des chiffres des recensements des entreprises de 1995 à 2005. Neuchâtel: Département fédéral de l’intérieur (DFI).
Office Fédéral des Migrations (ODM). (2005). Directives LSEE concernant l’admission de médecins et médecins assistants pratiquant la médecine classique en milieu hospitalier ou clinique. Berne: ODM.
Plotnikova, E. V. (2012). Cross-border mobility of health professionals: contesting patients’ rights to health. Social Sciences and Medicine, 74, 20–27.
Riaño Y., Lombard A., Piguet E. (2017) The global race for talent in Switzerland. How to explain migration policy liberalisation to allow international students staying after graduation? Working Paper No. 14. NCCR on the move. University of Neuchatel.
Sandoz, L. (2016) The Symbolic Value of Quotas in the Swiss Immigration System. nccr –on the move, highlights #1 / November 2016: (pp. 40–45).
SEFRI (2016). Rapport final. Masterplan «Formation aux professions des soins». Rapport du Conseil fédéral. Berne: Secrétariat d’Etat à la formation, à la recherche et à l’innovation (SEFRI).
Sordat Forenord, v. D. (2012). La mise en œuvre par la Suisse du Code de l’OMS pour le recrutement international des personnels de santé. Bulletin von Medicus Mundi Schweiz Nr. 126. Available at http://www.medicusmundi.ch/de/bulletin/mms-bulletin/gesundheitspersonalmangel-in-der-schweiz-und-weltweit/strategien-gegen-den-gesundheitspersonalmangel/la-mise-en-oeuvre-par-la-suisse-du-code-de-l2019oms-pour-le-recrutement-international-des-personnels-de-sante. Accessed 30 April 2017.
Steiner E., & Wanner, P. (2015) Towards a new data set for the analysis of migration and integration in Switzerland. Working Paper Series No. 1. NCCR On the Move–Université de Genève. NCCR On the Move: University of Neuchatel.
Taverna, E. (2006). Migrations médicales. Bulletin des médecins suisses/Schweizerische Ärztezeitung/Bollettino dei medici svizzeri, 87, 4.
Vaitkeviciute, A. (2017). Migration and mobility of third-country researchers and students in the European Union and Switzerland. In: Jusletter, February 13 2017.
WHO (2002). Technical consultation on imbalances in the health workforce, Ottawa, Canada 10–12 March. Available at http://www.who.int/hrh/documents/en/consultation_imbalances.pdf. Accessed 30 April 2017).
WHO (2010). WHO Global Code of Practice on the International Recruitment of Health Personnel. Sixty-third World Health Assembly—WHA63, 16 May 2010. Geneva: WHO. Available at http://www.who.int/hrh/migration/code/code_en.pdf. Accessed 30 April 2017.
World Health Assembly (2004) International Migration of Health Personnel: a challenge for health systems in developing countries. WHA 57.19 Geneva: World Health Organisation. 57.9.
World Health Organization (WHO). (2006). World health report 2006: working together for health. Geneva: World Health Organization.
World Trade Organization (WTO) (2017) Guide to reading the GATS schedules of specific commitments and the list of article II (MFN) exemptions. Available at https://www.wto.org/english/tratop_e/serv_e/guide1_e.htm. Accessed 29 April 2017.
Zareva, I. (2017). The Impact of Policies on Migration Between Switzerland and Bulgaria. In Richter M., Ruspini P., Mihailov D., Mintchev V., & Nollert M. (Eds.), Migration and Transnationalism Between Switzerland and Bulgaria (pp. 123–152). Springer International Publishing Switzerland.
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Dia, I.A. The International Health Labor Migration to Switzerland: Key Challenges for Its Governance. Int. Migration & Integration 20, 437–458 (2019). https://doi.org/10.1007/s12134-018-0609-6
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DOI: https://doi.org/10.1007/s12134-018-0609-6