Nurse migration: the big picture

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Section 457 visas - nurse migration the big picture - mapAustralia relies on imported nurses to fill large gaps in the local health workforce. Where do they come from and how do they get here?

Australia is supposed to be self-sufficient in nurses, midwives and doctors by 2025, without the need to import overseas trained personnel.

That goal – to meet all of Australia’s requirements for medical, nursing and midwifery professionals in 2025 from the supply of domestically trained graduates – was set by a meeting of federal and state health ministers in 2012.

The ministers asked Health Workforce Australia to develop a national training plan to produce more domestically-trained graduates.

Training will be supplemented by the recruitment of enough migrant professionals, over the next 13 years, to deliver self-sufficiency. Health Workforce Australia advertises “jobs down under” at career expos in Britain and Ireland, for example.

One complicating factor is that there is almost as much nurse migration out of Australia as into Australia.

Within this policy context, Australia has relied on several sources of migrant health professionals to boost supply. They include:

  1. New Zealand health professionals, who are given free entry to Australia and full qualification recognition under the terms of the Trans-Tasman Agreement. By the time of the 2006 Census, 5905 NZ nurses and midwives were resident in Australia.
  2. Permanent migrants selected through Australia’s points-tested General Skilled Migration Program.
  3. Health professionals who come to Australia as dependents of other migrants or as refugees.
  4. Former international students who get degree qualifications in Australia then convert their status to stay here, through a process termed “two-step migration”.
  5. Temporary labour migrants sponsored by employers through the 457 visa program to fill designated positions for up to four years. Up to 30% of 457 visa holders in the health workforce manage to stay in Australia permanently through “two-step migration”.

In the five years between 2004-05 to 2008-09, the number of registered nurses who arrived as general skilled migrants (6400 or 7676 including partners) was dwarfed by the number of 457 visa arrivals (14950).

However more recent data for 2009-10, shows a growth in permanent skilled migration (1700 nursing/midwifery arrivals up from 1360 the year before), alongside a fall in nurses/midwives sponsored on a temporary basis (2710 compared to 4070 the year before).

The United Kingdom has been the biggest single source of 457 migrant nurses (9350 in the five years to 2010) followed by: India – 6420, Philippines – 1850, South Africa – 1770, Malaysia – 1570, Ireland – 1560.

In a study for Health Workforce Australia, Professor Lesleyanne Hawthorne, from the University of Melbourne’s Faculty of Medicine, said migrant health professionals from English-speaking backgrounds and Commonwealth countries were quick to integrate into the Australian workforce, because they share two advantages – high exposure to English and training in British-origin education systems.

Health professionals from non English speaking background and/or non-Commonwealth countries, such as China and Vietnam, perform less well, despite mobility clearly improving within 10 or more years.

“Large numbers of such non-English speaking background health professionals face years of professional displacement and skills atrophy. Many never achieve appropriate work,” Professor Hawthorne said.

Unemployment, or not being able to find work in your trained profession, is not an issue for 457 temporary visa applicants, who by definition arrive with offers of work.

Professor Hawthorne said temporary migration had been attractive to both governments and Australian employers, because 457 visa holders can be required to work in specified “areas of need”.

457 visa holders are restricted to working for their sponsor only and must meet minimum levels of qualifications and English language skills.