HEALTH and Wellness Minister Dr Christopher Tufton has chided large nations for continuously stripping small states of critical health-care workers, pointing out that the practice “creates hardships for countries like Jamaica who, as they train, they lose”.

The problem, he suggested, can be avoided through mutually beneficial partnerships, instead of recruiters grabbing specialist health workers in particular.

Dr Tufton said he wants large countries to realise that health has to be considered in an equitable way wherein all can be supported through collaboration, as opposed to a “zero-sum game” where some benefit at the expense of others.

“Part of the criticism that I would levy is that for the large, developed countries, they clearly have not seen this vision even though they are the big advocates of a pandemic treaty and global, one-health approach. Instead they have chosen, for the most part, to recruit, leaving smaller countries like Jamaica in severe hardships. We can’t stop mobility of labour but we can coordinate and collaborate to expand,” he said.

Dr Tufton made the reproach after signing a communiqué with Secretary of Health of the Philippines Dr Teodoro Herbosa, with the intention to enter into an agreement to boost human resources for health. This followed their May 28 meeting on the margins of the 77th World Health Assembly in Geneva, Switzerland, to discuss and explore new opportunities between the two countries to solve the human resources crisis.

Tufton noted that every year Jamaica loses well over 500 or more nurses, most of them specialists, to larger countries.

“So beyond the registered nurse, we need nurses in critical care, intensive care unit (ICU), nephrology, post-natal care, operating theatre, and other specialised areas — those are the ones that are in really dire short supply because they get very attractive offers. In recent times those nurses have been offered significant incentives to migrate to North America [and] the United Kingdom,” Tufton said, pointing out that those countries have waived qualifying exam requirements and, in some instances, process easy work permits.

He noted that in the case of the UK the recruitment is at the Government level, but in the US it “would be a health system in a particular state”.

To further advance his argument about the effects of health-care worker mobility on small countries, Tufton pointed to a recent travel advisory issued by the US that spoke to the need for Jamaica to improve its health services, stating: “There’s an irony embedded in this,” as the US is a mass recruiter of Jamaican health-care workers.

“Let me just be clear that I fully respect the right of any country, in this case the US, to advise its citizens on what is in their best interests — their health and safety in this case — while they take advantage of the tourism opportunities that Jamaica offers… but a big part of the burden that we bear, too, is the extent to which our capacity around provision of services, around human resources capacity, is impacted by the mass recruitment and migration of our health-care workers, our nurses in particular, to North America.

“Again, we can’t stop the mobility of labour; it is the right of people to move where they see fit. But it is out of that right and the opportunity to exercise that right which has created some of the very challenges that we face, which is then being identified as a threat to our tourists who come to the country,” he added.

He argued that given the expansion of tourism, with five million or more visitors to Jamaica every year, it cannot be realistically expected that Jamaica’s health infrastructure will be able to respond adequately if that infrastructure is not expanding, which the Government is currently seeking to do.

Noting that about 70 per cent of Jamaica’s tourism population are North Americans, Dr Tufton suggested that the relevant parties could come together to find solutions around this in a mutually agreed and mutually beneficial way.

“One of those solutions, clearly, is to ensure that there’s a health insurance imposed on tourists, who are coming here, to provide a quicker response and turnaround if they need to be airlifted, for example, to the mainland, or stabilised in a private hospital or even in a government institution. But the other is a longer-term, more sustainable approach, which would be to jointly collaborate around the expansion of training,” he said.

Dr Tufton said that he has long been advocating retention and more training, noting that the only way to do it is to collaborate with a country that can provide Jamaica with support around some of these areas of clinical rotation, space faculty, and so on.

He said he is hoping that this collaboration between the Philippines and Jamaica will lead to something tangible but also, more importantly, set an example for the rest of the world to follow — particularly the large, developed countries that are mass recruiters of health-care workers.

The Health and Wellness Ministry explained that the communiqué sees both countries committing to the pursuit of a memorandum of understanding (MOU) to advance cooperation, for conclusion by September 2024.

The MOU, the ministry said, is to explore, among other things, the expansion of training of health-care workers in Jamaica for which the Philippines has the “scope and the capacity”, including the possible exchange of faculty members — particularly from the Philippines — to medical facilities and/or training institutions in Jamaica.

Jamaica has also put on the table potential areas for collaboration to include biotechnology, medical equipment repair, epidemiology, health-care management, training of nurses, the rotation of clinicians between both countries, and the sharing of experiences on Jamaica’s primary health-care model.

“The two countries are also to explore a government-to-government arrangement for the recruitment of nurses, in response to the shortage of specialist nurses in Jamaica. In addition, an invitation has been extended by Dr Herbosa to Dr Tufton to undertake a working visit to the Republic of the Philippines. Minister Tufton has extended a similar invitation to Dr Herbosa,” the ministry stated in a news release.

“The Philippines has an impressive history of training nurses, and these health professionals have been recognised for good-quality standards and warm care,” Dr Tufton told the Jamaica Observer.

In its 2023 report on global health worker mobility, the World Health Organization (WHO) said that data from 93 countries indicate that mobile medical doctors are mostly working in six top-destination countries — Australia, France, Germany, Saudi Arabia, the United Kingdom and the United States of America.

“Data from 129 countries show that the largest percentage of mobile nursing personnel primarily migrate to the United Kingdom and United States of America,” the WHO added.