In recent years there has been increasing focus on the ethics behind international recruitment. Specifically, not wanting to create a “brain drain” in those developing countries that require the healthcare staff to meet their own domestic requirements.
In alignment with this focus, the World Health Organisation has created a Code of Practice that outlines which countries it is ethical to “actively” recruit from and which ones it is not. Any countries where there is not a government-to-government arrangement in place for international recruitment, are on the “red list”. Countries on the red list include Ghana, Nigeria and Kenya.
According to the UK government website,
“With a projected global shortage of 10 million health workers to achieve universal health coverage in low and lower-middle income countries by 2030, we remain committed to be a force for good in the world, and support better health and care both within and beyond our shores.
To that end, we recognise the important role that international health and care workers play in health and care service delivery in the UK while remaining committed to ensuring that we recruit them in an ethically responsible manner.”
In practice, if a UK recruitment agency wants to remain on government procurement frameworks and supply to both the NHS and large private sector entities, they must refrain from sourcing candidates from red list countries for their clients. NHS Employers have introduced a twice-annual survey for all agencies signed up to their Code of Practice which mandates agencies to share the nationalities of all candidates deployed within the last 6 months. If they have been found to have sourced from red or amber list countries inappropriately, they can be stripped of their Code of Practice membership and/or be mandated to conduct reparatory actions such as full-team training or website updates.
Notably, this does not mean that candidates from “red list” countries cannot be employed in the UK. It just means that they cannot actively be targeted by recruitment agencies. If a nurse from Ghana applied to a UK healthcare employer directly, there is nothing to stop them from being employed. Equally if a UK employer interviewed a red list candidate and offered them the role, then asked their partner agency to process them, this is also allowable because the agency have not actively targeted the candidate. However increasingly UK employers are voluntarily signing up to the WHO approach to international recruitment, recognising the long-term ethical impact of sourcing from overseas.
That said, not all countries are on the red list because they have insufficient healthcare staff. Some countries are on there for political reasons, or simply because their government has proved unresponsive to reach outs. At the time of writing, there is a huge volume of nurses from Nigeria interested in relocating to the UK, but despite engagement attempts, the Nigerian government has proved unresponsive to efforts to advance a government-to-government recruitment arrangements.
It must also be said that the Code of Practice is subject to change. Countries are updated to “green”, “amber” or “red” sometimes with little notice. International agencies on the list are updated as these changes occur and are expected to respond with immediate effect.
You can find out more information about the International Recruitment Code of Practice from the Department of Health and Social Care.
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