India’s health worker brain drain

GOVERNANCE/ECONOMY

Topic:

• GS-2: Government policies and interventions for development in various sectors and issues arising out of their design and implementation.
• GS-3: Indian Economy and issues relating to planning, mobilization, of resources

India’s health worker brain drain

Context: The surge in COVID cases across the country could lead to overburdening health workers and eventually causing shortage of them. Besides treating Covid patients, they will also have to administer vaccines, now available to the country’s entire adult population.

Do You Know?

• As per government reports, India has 1.7 nurses per 1,000 population and a doctor to patient ratio of 1:1,404 — this is well below the WHO norm of three nurses per 1,000 population and a doctor to patient ratio of 1:1,100. 
• The 2020 Human Development Report shows that India has five hospital beds per 10,000 people — one of the lowest in the world
• According to Dr Devi Shetty, India will need an extra five lakh ICU beds, two lakh nurses and 1.5 lakh doctors in the next few weeks.

Issue of health Workers Brain Drain

• Migration of Health Workers lead to shortage: For several decades, India has been a major exporter of healthcare workers to developed nations particularly to the Gulf Cooperation Council countries, Europe and other English-speaking countries. And this is part of the reason for the shortage in nurses and doctors.
  • As per OECD data, around 69,000 Indian trained doctors worked in the UK, US, Canada and Australia in 2017. In these four countries, 56,000 Indian-trained nurses were working in the same year
• Factors of Migration: Pull factors include higher pay and better opportunities in the destination countries while push factors include low wages in India’s private sector, lack of govt investment, delayed appointment and reduced opportunities in public sector.
• Countries tweaking policies to attract & retain health workers: At the beginning of the pandemic, OECD countries exempted health professionals with a job offer from the travel bans.  The UK has granted free one-year visa extensions to eligible overseas healthcare workers and their dependents. Similarly, France has offered citizenship to frontline immigrant healthcare workers during the pandemic.

Has government taken measures to check brain drain of health workers?

• In 2014, government stopped issuing No Objection to Return to India (NORI) certificates to doctors migrating to the US. The non-issuance of the NORI would ensure that the doctors will have to return to India at the end of the three-year period.
• The government has included nurses in the Emigration Check Required (ECR) category. This move was taken to bring about transparency in nursing recruitment and reduce exploitation of nurses in the destination countries. 
• The government’s policies to check brain drain are restrictive in nature and do not give us a real long-term solution to the problem

Way Ahead

• We require systematic changes that could range from 
  • Increased investment in health infrastructure, 
  • Ensuring decent pay to workers 
  • Building an overall environment that could prove to be beneficial for them and motivate them to stay in the country.
• The government should focus on framing policies that promote circular migration and return migration — policies that incentivise healthcare workers to return home after the completion of their training or studies
• It could also work towards framing bilateral agreements that could help shape a policy of “brain-share” between the sending and receiving countries — the destination countries of the migrants would be obliged to supply healthcare workers to their country of origin in times of need, 

Connecting the dots:

• Medical Oxygen Crisis in India