Since EU accession in 2007 Romania and Bulgaria have struggled to retain qualified health professionals. Doctors and nurses in particular have been leaving in significant numbers. Given the impacts of out-migration on health system sustainability and access to healthcare, the initiative taken by a regional hospital in Southern Romania has been highlighted by the Health Workers For All project as good practice in effective cross-border cooperation.
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Long-term planning and the use of domestic resources to achieve sustainable health workforce
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Romanian hospitals are struggling with decentralisation and diminishing financial resources for their health system. The functioning of hospitals has been redefined and they are subject to a compulsory accreditation process. County Calarasi Emergency Hospital in the Southern Romanian border region with Bulgaria, has an efficient infrastructure but a shortage of qualified health personnel as a consequence of increased intra-EU migration.
To counter this trend, the hospital began to recruit doctors from Bulgaria, mostly from the neighbouring city of Silistra, situated close to the border. Accepting a part-time job in Romania allowed Bulgarian doctors to maintain a reasonable income and keep working in their own region, rather than having to look for jobs in other EU countries.
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Respecting the rights of migrant health workers
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The doctors kept their full-time positions in Bulgaria and took on additional contract shifts in Romania. The employer attempted to maximise the satisfaction of the Bulgarian doctors by providing them with the same payment terms, responsibilities and working conditions as that offered to Romanian practitioners. The willingness of the Bulgarian doctors to collaborate, their professionalism and positive attitude provided an excellent opportunity for the collaboration.
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Thinking and acting coherently at national, regional and global level
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Crucially, the Bulgarian doctors believe that the experience in Romania helped them to improve their work processes in Bulgaria. For instance, they contributed to more efficient procedures in the provision of medical emergency assistance, an area in which Romania is seen as a model of success. Experience acquired in Romania helped Bulgarian doctors to develop professionally, acquire medical skills and build long-term careers.
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Conclusion
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Importantly, and in line with the ethical principles contained in the WHO Global Code of Practice on the International Recruitment on Health Personnel, County Calarasi Emergency Hospital applied key recommendations of the Code. As a result the health system is less affected by migratory flows. Calarasi Hospital also respected the rights of migrants and valued their professional competences.
– Health workers for all – Romanian case study
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The original article was published in the Policy Review: Combating ‘out-migration’ in Europe’s health professions
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