Nurses on the move

Se Ok Ohr, Nurse Manager Overseas Staff Support Program from Hunter New England Health
Se Ok Ohr, Nurse Manager Overseas Staff Support Program from Hunter New England Health

Australian government policy on recruiting overseas nurses should be ethical and consistent with a systematic approach to workforce planning, according to a report conducted by NSWNMA with Public Services International (PSI).The report, Quality healthcare and workers on the move, says the recruitment of overseas health workers is increasingly driven by an employers’ agenda, and the nature of the migration program leads to inequality.Migrant workers are often “secondary workers employed in conditions of insecurity, resulting in uncertain futures for themselves and their families” according to the report.

PSI says temporary migration is no substitute for long-term workforce planning.

“Temporary migration should not be a short-term solution to workforce shortages; rather there is a need for the government to plan for a domestic workforce that is able to meet health care needs in the long term, with enough resources to attract and retain health and social care workers and improve their pay and working conditions.

“It is essential that sufficient resources are put in place for inspection and the enforcement of compliance so that employers recruiting overseas health and social care workers meet their obligations and do not employ migrant workers with lower pay, poorer working conditions and limited opportunities for career development, compared to Australian citizens,” the report says.

The NSWNMA and the QNU conducted in-depth interviews with nearly 500 nurses who had migrated to Australia from 51 different countries, using 22 peer-to-peer researchers.

Recruitment shapes the experience

The way in which overseas nurses are recruited has a major impact on their experience of migration. More than one third of respondents to the PSI survey had found a job in Australia through a recruitment agency.

Of those recruited through an agency more than three-quarters of respondents stated that the agency carried out ethical recruitment, while one-quarter stated that recruitment had been unethical.

“The fact that such a significant number of respondents experienced unethical recruitment points to the need for better regulation and monitoring of recruitment agencies to ensure that they provide accurate information and do not mislead people planning to migrate,” the report stated.

“I was told by the recruiting company that everything would be the same regarding working conditions, pay parity and even the language. When I got here I was quite stressed to find that this was not the deal. There were vast differences working for a private facility, pay information was inaccurate, and shift start and finish times had not been explained,” said an RN who had migrated from Britain.

Many of the respondents to the survey stated that they had little knowledge of trade unions when they first arrived in Australia.

“It was only known to me when I was working in a nursing home and the Director of Nursing was recruiting everyone to be a union member. I had no knowledge of unions and what unions did before that,” said an AiN, originally from the Philippines, working in aged care.

Reasons for migrating

There are both “push” and “pull” reasons that influence nurses to migrate. The main factors influencing decisions to migrate included gaining work experience, having decent working conditions and better pay.

Migrants from developing countries were most likely to migrate because there was no job in their country of origin, or because of inadequate staffing levels and low pay.

Coupled with this was the low level of investment in healthcare in poorer countries.

Facts about nurse migration

  • In 2006, the World Health Organisation estimated there was a shortage of more than 4.3 million health personnel across the world. Since 2000 permanent migration of overseas registered nurses to Australia has increased six-fold (OECD 2010).
  • Today, most overseas nurses and midwives enter Australia on the 457 temporary visa program. The visa allows employers to sponsor skilled workers from overseas for between three months and four years. In 2011, visas granted under the health category were the second highest (12.9%) after construction (13.4%).
  • The NSWNMA has at least 3929 members who are overseas workers, from 129 countries across the world. The largest number come from the Philippines (742), followed by the UK (434), India (367), China (257), New Zealand (225), Nepal (217), Fiji (183) and Zimbabwe (119).

Share your experience

Two researchers at the University of Sydney are interested in interviewing overseas-trained migrant nurses about their Australian work experiences. If you are a temporary or permanent migrant registered nurse, and you would be happy to participate in an interview, contact:

Diane van den Broek ?9351 3106 or

Dimitria Groutsis 9351 2485 or

What migrant nurses think could be done to improve the migrant experience

  • Support on arrival in Australia.
  • Accessible information.
  • Improved migration policies and rights to permanent residency.
  • Social protection issues and access to Medicare for temporary visa holders.
  • Assistance for migrant health and social care workers in the English language and a review of the English language test.
  • Monitor the practices of recruitment companies and end unethical recruitment.
  • Provide better support and integration in housing and work.
  • Raise awareness about the benefits of overseas nurses.

What migrant nurses have to say:

About insecurity

“I never get to choose the shift I want, I do the unpopular shifts and I don’t want to cause trouble as I am tied to my employer and don’t want to risk losing my job.” – Queensland AiN

About the English standard test

“I found this test terrible. Before I came to Australia I had nine years of English studies in my backpack. I am not sure if I would even pass this test in my own language.”

– RN from Sweden

About discrimination

“Although some of my co-workers told me to go back to my own country, as I was told that I was taking the work of Australians, and some of my patients told me they don’t want to be looked after by a ‘coloured person’, my experiences are still positive as the majority of people I meet are very nice.” – AiN from the Philippines

About de-skilling

The fact that my midwifery experience and knowledge is not recognised in a country that is crying out for midwives flabbergasts me. I would still like to work as a midwife here as I feel I have so much to offer but am very restricted.” – South African midwife

About support

“Give us a bit more support emotionally as it can be very depressing for the first two years to be able to get settled.” – RN from South Korea