Deal or no deal?
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Buchan, J. (2008) Deal or no deal?, Nursing standard (Royal College of Nursing (Great Britain) : 1987), vol. 22, , pp. 24-25,
What will your mortgage repayments be in January 2011? Difficult to say? Maybe higher than now, given a looming economic recession? What about your council tax bill in three years' time? Or the price of milk? These are the sort of economic uncertainties we all have to deal with. Prime minister Gordon Brown's proposal for three-year pay deals for NHS staff would enable them to know what they will be earning in three years' time. The big question is whether that certainty gives a financial advantage or disadvantage.It is estimated that in 2000 almost 175 million people, or 2.9% of the world's population, were livingoutside their country of birth, compared to 100 million, or 1.8% of the total population, in 1995.As the global labour market strengthens, it is increasingly highly skilled professionals who aremigrating. Medical practitioners and nurses represent a small proportion of highly skilled workerswho migrate, but the loss of health human resources for developing countries can mean that thecapacity of the health system to deliver health care equitably is compromised. However, data tosupport claims on both the extent and the impact of migration in developing countries is patchyand often anecdotal, based on limited databases with highly inconsistent categories of educationand skills.The aim of this paper is to examine some key issues related to the international migration of healthworkers in order to better understand its impact and to find entry points to developing policyoptions with which migration can be managed.The paper is divided into six sections. In the first, the different types of migration are reviewed.Some global trends are depicted in the second section. Scarcity of data on health worker migrationis one major challenge and this is addressed in section three, which reviews and discusses differentdata sources. The consequences of health worker migration and the financial flows associated withit are presented in section four and five, respectively. To illustrate the main issues addressed in theprevious sections, a case study based mainly on the United Kingdom is presented in section six.This section includes a discussion on policies and ends by addressing the policy options from abroader perspective.