India, a major exporter of healthcare workers to developed countries including those in the Gulf Cooperation Council (GCC), Europe, and other English-speaking nations, is experiencing what’s commonly referred to as a ‘brain drain.’ This significant outflux of doctors and nurses has led to a shortage in the sector, raising questions about the health infrastructure’s capacity to handle crises such as the ongoing pandemic.
The Concept and Impact of The ‘Brain Drain’
The term ‘brain drain’ signifies the considerable emigration or migration of skilled individuals, primarily from developing to developed countries. Frequently, this movement is triggered by instability within a country, favorable professional opportunities abroad, or an aspiration for a better standard of living. As per the Organisation for Economic Co-operation and Development (OECD) data, around 69,000 Indian doctors were employed in the UK, US, Canada, and Australia alone, plus an additional 56,000 nurses, all back in 2017. This mass migration presents a growing concern due to its adverse implications on the health systems of developing nations like India.
Drivers of Migration: The Pandemic and Beyond
The emergence of the pandemic has amplified the global need for healthcare workers. Developed nations have reacted by adopting immigrant-friendly policies, to attract or retain these crucial resources. Alongside this global demand, personal pull factors like higher pay and increased opportunities fuel the desire of healthcare workers to migrate. In contrast, push factors such as low wages, insufficient job openings, and the lack of government investment in healthcare within India prompt the exodus.
Constraint Policies: The Indian Government’s Approach
The Indian government’s measures to counteract brain drain are predominantly restrictive but lack a sustainable solution. Notably, in 2014, the issuance of No Objection to Return to India (NORI) certificates to migrating doctors was discontinued. Nurses were also included in the Emigration Check Required (ECR) category to increase transparency in recruitment and decrease exploitation abroad. The government’s focus thus far has been on managing migration, rather than addressing root causes.
India’s Health Sector: Challenges and Concerns
India’s healthcare system faces a critical lack of human resources compounded with skew distribution and poor infrastructure. The figures are alarming – only 1.7 nurses per 1,000 population and a doctor-patient ratio of 1:1,404. The World Health Organization (WHO) recommends much higher ratios. Further, the country has a sparse five hospital beds per 10,000 people, revealing an urgent need for infrastructural development.
A Strategy for The Future: Investment, Policy Reform and Bilateral Agreements
Addressing this situation requires a multi-faceted approach. Increasing public sector investment in healthcare presents a potent solution, which would also create more job opportunities. Systematic changes are needed to cultivate an environment that retains and motivates healthcare workers to stay within the country. The government should also prioritize policies promoting circular and return migration, encouraging professionals to return post-training or studies. Furthermore, India can proactively negotiate bilateral agreements promoting ‘brain-share’, shaping mutually beneficial relationships between sending and receiving nations.