Market making and the production of nurses for export. A case study of India-UK health worker migration

Merz, S., Hunter, B. M. , Murray, S. F. and Bisht, R. (2024) Market making and the production of nurses for export. A case study of India-UK health worker migration. BMJ Global Health, 9(2), e014096. (doi: 10.1136/bmjgh-2023-014096) (PMID:38418245) (PMCID:PMC10910680)

Abstract

Background: High-income countries increasingly look to the international recruitment of health workers to address domestic shortages, especially from low-income and middle-income countries. We adapt conceptual frameworks from migration studies to examine the networked and commercialised nature of the Indian market for nurse migration to the UK. Methods: We draw on data from 27 expert interviews conducted with migration intermediaries, healthcare providers and policymakers in India and the UK. Findings: India–UK nurse migration occurs within a complex and evolving market encompassing ways to educate, train and recruit nursing candidates. For-profit actors shape the international orientation of nursing curricula, broker on-the-job training and offer language, exam and specialised clinical training. Rather than merely facilitate travel, these brokers produce both generic, emigratory nurses as well as more customised nurses ready to meet specific shortages in the UK. Discussion: The dialectic of producing emigratory and customised nurses is similar to that seen in the Post-Fordist manufacturing model characterised by flexible specialisation and a networked structure. As the commodity in this case are people attempting to improve their position in life, these markets require attention from health policy makers. Nurse production regimes based on international market opportunities are liable to change, subjecting nurses to the risk of having trained for a market that can no longer accommodate them. The commercial nature of activities further entrenches existing socioeconomic inequalities in the Indian nurse force. Negative repercussions for the source healthcare system can be anticipated as highly qualified, specialised nurses leave to work in healthcare systems abroad.

• Item Type: Articles
• Additional Information: The research has been funded by an Economic and Social Research Council (UK) Grant, Ref: ES/S010920/1.
• Keywords: recruitment, intermediaries, brokers, workforce, human resources for health, NHS.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Hunter, Dr Benjamin
• Authors: Merz, S., Hunter, B. M., Murray, S. F., and Bisht, R.
• Subjects: H Social Sciences > HM Sociology; J Political Science > JZ International relations
• College/School: College of Social Sciences > School of Social and Political Sciences > Economic and Social History
• Journal Name: BMJ Global Health
• Publisher: BMJ Publishing Group
• ISSN: 2059-7908
• ISSN (Online): 2059-7908
• Published Online: 28 February 2024
• Copyright Holders: Copyright © Author(s) (or their employer(s)) 2024
• First Published: First published in BMJ Global Health 9(2):e014096
• Publisher Policy: Reproduced under a Creative Commons license