Migration and the Globalisation of Health Care
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Migration and the Globalisation of Health Care

The Health Worker Exodus?

John Connell

The international migration of health workers has been described by Nelson Mandela as the ‘poaching’ of desperately needed skills from under-privileged regions. This book examines the controversial recent history of skilled migration, and explores the economic and cultural rationale behind this rise of a complex global market in qualified migrants and its multifaceted outcomes.
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Chapter 5: An Overseas Orientation: Towards Migration?

John Connell


Migration is primarily a response to global and regional uneven development, but usually explained in terms of such factors as low wages, few incentives, or poor social and working conditions. Quite different scales reflect different ways of thinking about migration – whether in terms of global economic fluctuations and world financial crises, the activities of international recruitment companies, the poverty of developing countries or the particular motives of families (and individual members of these families) – yet all of these interact. Although the migration of skilled health workers occurs for multiple reasons, there is a remarkable uniformity in the factors that influence specific migration moves, even in quite different regions and contexts (Chapter 6). In some part this is because of the emergence of a global care chain and demand-driven migration. Yet even before migration there is often a basic predisposition to mobility, a product of culture, geography and history as much as economics. This chapter therefore examines attitudes towards employment in the health sector: why people become health workers. Broad influences on employment and migration include incomes, job satisfaction, career opportunities, and social and family reasons. Family reasons, though often neglected, are particularly important since most people only exceptionally make decisions about employment and migration as individuals; rather, they are linked into extended families and wider kinship groups and make decisions in this context. Skilled migrants, however, are more likely than others to be without extended-family ties, because they are more easily able to organise migration opportunities and because they are...

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