European health ministers focus on migration of health workers

BMJ 2011; 342 doi: (Published 11 April 2011) Cite this as: BMJ 2011;342:d2347
  1. Rory Watson
  1. 1Brussels

Hungary, which currently holds the six month, rotating presidency of the European Union, is drawing attention to the problems caused by the exodus of health professionals from eastern to western Europe. The migration was at the centre of the informal meeting of European Union health ministers at Gödöllő near Budapest on 4 and 5 April.

Miklós Szócska, Hungary’s minister for healthcare, warned that migration from central and eastern European countries is so great that the very safety of some national health systems is at risk. Doctors and nurses leave their home countries because they can often earn salaries six times higher abroad.

He suggested that countries should be helped to retain their health staff and called for a European agreement on ethical exchange programmes.

Although healthcare remains the responsibility of national authorities, the Hungarian government believes that the scale and consequences of the westward migration, particularly from its own country, demand a coordinated response from EU member states, particularly in the current economic climate.

Miklós Réthelyi, Hungary’s minister for national resources, emphasised that the health sector played a crucial role in the implementation of the EU’s economic goals. “Europe cannot be strong and competitive without a healthy people and labour force,” he said.

With Mr Szócska suggesting that the European healthcare system needed an extra one million employees, John Dalli, the EU’s health commissioner, insisted on the need to break the vicious circle of an increasing demand for health services coinciding with fewer workers.

The findings of a new study funded by the European Union’s health professional mobility in the EU (PROMeTHEUS) research programme on the consequences of health professional mobility were presented to the meeting. Compiled by the European Observatory on Health Systems and Policies and the World Health Organization’s Regional Office for Europe, it examines 17 country case studies (

It notes an east-west asymmetry in migration in Europe and that some countries rely more than others on health professionals from abroad to make up shortfalls. Figures for 2008 show that foreign medical doctors accounted for more than 10% of the total in Belgium, Portugal, Spain, Austria, Norway, Sweden, Switzerland, Slovenia, Ireland, and the United Kingdom. In recent years inflows have been particularly high in the UK (43% of newly licensed doctors) and Belgium (28%). The proportion of foreign nurses is more than 10% in Italy, the UK, Austria, and Ireland.

The study identifies income differences as a key factor in migration. But it also suggests that other elements, such as the working environment, career and training opportunities, and social recognition, can be decisive.


Cite this as: BMJ 2011;342:d2347

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