Uluslararası düzeyde sağlık çalışanlarının göçünü yönetme politikaları: Genel bir bakış ve Türkiye için bir durum değerlendirmesi

Ülkelerin çoğu sağlık insangücü eksikliği ve dengesiz dağılımı problemleriyle karşı karşıyadır. Bu problemler; sağlık çalışanlarının uluslararası serbest dolaşımı veya göçü ile birlikte daha da kritik bir hal almakta ve önem kazanmaktadır. Sağlık çalışanı göçünün hem göç alan ve veren ülkeler hem de göçe konu olan sağlık çalışanları açısından olumlu veya olumsuz sonuçları olabilmektedir. Dolayısıyla bu hareketliliğin taraflar açısından maksimum fayda yaratacak şekilde yönetilmesi de önem kazanmaktadır. Bu amaçla, çalışmada küresel düzeydeki sağlık çalışanlarının göçüne ilişkin genel bir çerçeve ortaya konulmakta, göçün yönetilmesine yönelik küresel ölçekte kullanılan mekanizmalar tartışılmakta ve göçün boyutu ve yönetilmesi konularında Türkiye özelinde değerlendirmeler yapılmaktadır.

Managing policies of health workers migration at the international level: An overview and situation assessment for Turkey

Most of the countries face with the problems of uneven distribution and inadequate number of health workers. These problems become even more critical and important when accompanied with the international movement or migration of health workers. Migration of health workers may have positive or negative consequences for both source and destination countries and health workers. Therefore, managing of this mobility in creating maximum benefit in terms of parties assumes importance. To this end, in the paper, a general framework concerning the migration of health workers at the global level is put forward; mechanisms used on a global scale to manage migration are being discussed; and the size and management of migration in Turkey are assessed.

___

  • Aluwihare, Arjuna P. R. (2005), "Phsyician Migration: Donor Country Impact", The Journal of Continuing Education in the Health Professions, Vol. 25, p. 15-21.
  • Arango, Joaquin (2000), "Explaining Migration: A Critical View", International Social Science Journal, Vol. 165, p. 283-296.
  • Bach, Stephen (2006), "International Mobility of Health Professionals: Brain Drain or Brain Exchange?", Research Paper (No. 2006/82), United Nations University World Institute for Development Economics Research (UNI_WIDER).
  • Berman, Philip. (2001), "Mobility of Health Professional", Paper prepared for delivery at the Conference on European Integration and Health Care Systems: A Challenge for Social Policy. A conference organised during the Belgian Presidency of the European Union. 7-8 December 2001.
  • Buchan, J. - Kingma, M. - Lorenzo, F.M. (2005), "International Migration of Nurses: Trends and Policy Implications", Issue Paper, 5. Geneva: International Council of Nurses (ICN), http://whqlibdoc.who.int/hq/2003/WHO EIP_OSD_2003.3 .pdf (07.10.2007).
  • Buchan, James - Perfilieva, Galina (2006), "Health Worker Migration in the European Region: Country Case Studies and Policy Implications", EUR/05/5000000, Division of Country Support WHO Regional Office for Europe Copenhagen, http://www. euro. who.int/document/e88366.pdf (02.10.2008).
  • Buchan, James (2006), "Migration of Health Workers in Europe: Policy Problem or Policy Solution", Dubois, C-A. - McKee, M. - Nolte, E. (Eds), Human Resources for Health in Europe, World Health Organization 2006 on behalf of the European Observatory on Health Systems and Policies, Open University Press, Maidenhead, p.41-62.
  • Buchan, James (2007), "Health Worker Migration in Europe: Assessing the Policy Options", Eurohealth, Vol. 3, No. 1, p. 6-8.
  • Buchan, James (2008), "How Can the Migration of Health Service Professionals be Managed so as to Reduce any Negative Effects on Supply?", Policy Brief, WHO Regional Office for Europe, http://www.euro.who.int/document/hsm /7_hsc08_epb_l 0.pdf (01.06.2009).
  • Bueno de Mesquita, Judith - Gordon, Matt (2005), The International Migration of Health Workers: A Human Right Analysis, London, Medact. February.
  • Bundred, P. - Martineau, T. - Kitchiner, D. (2004), "Factors Affecting the Global Migration of Health Professionals", Harward Health Policy Review, Vol. 5, No. 2, p. 77-78.
  • Commission of the European Communities (2005), Communication from the Commission to The European Parliament and the Council. EU Strategy for Action on the Crisis in Human Resources for Health in Developing Countries, Brussels, 12.12.2005, COM(2005) 642 final, http://ec.europa.eu/development/icenter /repository/human_resources_health_COM_2005_0642_en.pdf (15.12.2009).
  • Commission of the European Communities (2006), Communication from the Commission to The European Parliament and the Council. A European Programme for Action to Tackle the Critical Shortage of Health Workers in Developing Countries (2007-2013). Brussels, 21.12.2006 COM(2006) 870 final, http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=COM:2006:0870:FIN:EN:PDF (15.12.2009).
  • Commission of the European Communities. (2008a), Commission Staff Working Document. Turkey 2008 Progress Report, SEC(2008) 2699 Final, 05.11.2008, Brussels.
  • Commonwealth Secretariat (2003), "Commenwealth Code of Practice for The International Recruitment of Health Workers. London, www.thecommonwealth .org/shared_asp_files/uploadedfiles/%7B7BDD970B-53AE-441D-81DB-lB64C37E992A%7D_CommonwealthCodeofPractice.pdf (13.03.2008).
  • ÇSGB. Yönetsel Kayıtlar. Ankara, Çalışma ve Sosyal Güvenlik Bakanlığı, 2009.
  • Dayrit, M. - Taylor, A. - Yan, J. - Braichet, J. - Zurn, P. - Shainblum, E. (2008). "WHO Code of Practice on the International Recruitment of Health Personel", Bulletin of the World Health Organization, Vol. 86, No. 10, p. 739.
  • DoH (2004), Code of Practice for the International Recruitment of Healthcare Professionals. Department of Health. Gateway reference: 4174.
  • Dovlo, Delanyo - Martineau, Tim (2004), "A Review of the Migration of Africa's Health Professionals", JLI Working Paper, 4, p. 4.
  • Eastwood, J. B. - Conroy, R. E. - Naicker, S. - West, P. A. - Tutt, R. C. - Plange-Rhule, J. (2005), "Loss of Health Professionals from Sub-Saharan Africa: The Pivotal Role of the UK", Lancet, 365, May. 28, p. 1893-1900.
  • European Migration Network (2006), "Managed Migration and the Labour Market- the Health Sector", EMN Synthesis Report: Health Sector Study, http://www.dofi.fgov.be/nl/statistieken/belgian%20migration%20point/9bEMN%20 Health%20Sector.pdf (7.05.2007).
  • Flam, Harry (2003), Turkey and The EU: Politics and Economics of Accession (Seminar Paper No:718), Institute for International Economics Studies Stockholm University, http://www.iies.su.se/publications/seminarpapers/718.pdf (15.10.2007).
  • Gerlinger, Thomas - Schmucker, Rolf (2007). "Transnational Migration of Health Professionals in the European Union", Cad.Saude Publica, Rio de Janeiro, 23 Sup 2, p. S184-S192.
  • GHW (2005), The Global Health Worker Crisis. Global Health Watch 2005-2006, An Alternative World Health Report, Zed Books, London /New York, p. 119-134. www.ghwathc.org/2005report (6.05. 2007),
  • Gökbayrak, Şenay (2006), Gelişmekte Olan Ülkelerden Gelişmiş Ülkelere Nitelikli işgücü Göçü ve Politikalar - Türk Mühendislerinin "Beyin Göçü" Üzerine Bir İnceleme, Doktora Tezi, Ankara Üniversitesi Sosyal Bilimler Enstitüsü Çalışma Ekonomisi ve Endüstri İlişkileri Anabilim Dalı, Ankara.
  • Gönüllü, Müzeyyen (1996), "Dış Göç", Pamukkale Üniversitesi Eğitim Fakültesi Dergisi, Sayı 1, s. 94-106.
  • HOSPEEM (2008), "EPSU- HOSPEEM Code of Conduct and Follow up on Ethical Cross-Border Recruitment and Retention in the Hospital Sector", http://www.epsu. org/a/3715 (13.02.2008).
  • ILO (2004), Towards a Fair Deal for Migrant Workers in the Global Economy, International Labour Conference, 92nd Session 2004, Report VI, Geneva.
  • Kabene, S. M. - Orchard, C. - Howard, J. M. - Soriano, M. A. - Leduc, R. (2006), "The Importance of Human Resources Management in Health Care: A Global Context", Human Resources for Health, 4, p. 20.
  • Kirk, Helen (2007), "Towards a Global Nursing Workforce: The 'brain circulation'", Nursing Management, Vol. 13, No. 10, p. 26-30.
  • Marchal, Bruno - Kegels, Guy (2003), "Health Workforce Imbalances in Times of Globalisation: Brain Drain or Professionals Mobility?", International Journal of Health Planning and Management, 18, p. S89-S101.
  • McElmurry, B. J. - Solheim, K. - Kishi, R. - Coffıa, M. A. - Woith, W. (2006), "Ethical Concerns in Nurse Migration", Journal of Professional Nursing, Vol. 22, No. 4, p. 226-35.
  • Miller, E. A. - Laugesen, M. - Lee, S. Y. - Daniel. M. - Stephen, S. (1998), "Emigration of New Zealand and Australian Physicians to the United States and the International Flow of Medical Personnel", Health Policy, Vol. 43, No. 3, p. 253-270.
  • Mullan, F. (2005), "The Metrics of the Physician Brain Drain", The New England Journal of Medicine, Vol. 353, No. 17, October 27, p. 1810-8.
  • Muula, Adamson S. (2005), "Is There any Solution to the Brain Drain of Health Professionals and Knowledge from Africa?, Croat Med J, Vol. 46, No. 1, p. 21-29.
  • OECD (2007), Immigrant Health Workers in OECD Countries in the Broader Context of Higly Skilled Migration, International Migration Outlook SOPEMI.
  • OECD (2008), "The Looming Crisis in the Health Workforce. How Can OECD Countries Respond?", OECD Health Policy Studies.
  • Official Journal of the European Union (2005), Directive 2005/3 6/EC of the European Parliament and of the Council of 7 September 2005 on the Recognition of Professional Qualifications, L 222/22, 30.9.2005.
  • Öcek, Z. - Aksu, F. - Gürsoy, Ş. T. (2008), "Sağlık Emek Göçünün Dinamikleri", Toplum ve Hekim, Mayıs-Haziran, Cilt 23, Sayı 3, p. 184-193.
  • Pagett, Catherine - Padarath, Ashnie (2007), "A Review of Codes and Protocols for the Migration of Health Workers", Regional Network for Equity in Health in Southern Africa (EQUINET), Health Systems Trust (South Africa), Discussion Paper Number 50, p. 1-40, http://www.equinetafrica.org/bibl/docs/Dis50HRpagett.pdf (15.06.2008).
  • Pang, T. - Lansang, M. A. - Haines, A. (2002), "Brain Drain and Health Professionals", BMJ, Vol. 324, p. 499-500.
  • Paton, C. - Berman, P. C. - Busse, R. - Ong, B. N. - Rehnberg, C. - Renck, B. - Aviles, N. R. -Villamil, F. S. -Sundh, M. - Wismar, M. (2002), "The European Union and Health Services: Summary", Busse, R. - Wismar, M. - Berman, P. C. (Eds.), The European Union and Health Services: The Impact of the Single European Market on Member States, IOS Press, p. 1-16.
  • PCN (2007), "PCN Good Practice Guidance for International Nurse Recruitment", The Standing Committee of Nurses of the EU, www.rcn.org.uk/_data/assets/word_ doc/0019/65440/PCN.doc (10.10.2008).
  • Pillay, Rubin (2007), "A Conceptual Framework for the Strategic Analysis and Management of the Brain Drain of African Health Care Professionals", African Journal of Business Management, p. 26-33.
  • Ray, K. M. - Lowell, B. L. - Spencer, S. (2006), "International Health Worker Mobility: Causes, Consequences, and Best Practices", International Migration, Vol. 44, No. 2, p. 181-200.
  • Regil, Jorge de - Lambert, Mel (2006). "Making Migration of Human Resources for Health A Win-Win Situaion for All Countries", International Dialogue on Migration Seminar, Migration and Human Resources for Health: From Awareness to Action, IOM, Geneva, 23-24 March.
  • Sağlık Bakanlığı (2007), Türkiye 'de Sağlığa Bakış 2007. Sağlık Bakanlığı Refik Saydam Hıfzısıhha Merkezi Genel Başkanlığı Hıfzısıhha Genel Müdürlüğü, Ankara.
  • Sağlık Bakanlığı (2007), Sağlıkta İnsan Kaynakları Mevcut Durum Analizi, Sağlık Bakanlığı Refik Saydam Hıfzısıhha Merkezi Genel Başkanlığı Hıfzısıhha Genel Müdürlüğü, Ankara
  • Simoens, Steven - Hurst, Jeremy (2006), The Supply of Physician Services in OECD Countries. OECD Health Working Papers, No. 21.
  • Skar, Mariann (2001), "Mobility in the European Health Sector: The Role of Transparency and Recognition of Vocational Qualification", Cedefop Panorama Series, European Communities.
  • Stewart, J. - Clark, D. - Clark, P. F. (2007), "Migration and Recruitment of Healthcare Professionals: Causes, Consequences and Policy Responses", NETZWERK MIGRATION INEUROPA, Policy Brief, No. 7, August.
  • Tansel, Aysıt - Güngör Nil D. (2003), "Brain Drain" From Turkey: Survey Evidence of Student Non-Return", Career Development International, 8/2, s. 52-69.
  • Taylor, C. E. - Dirican, R. - Deuschle, K. W. (1968), Health Manpower Planning in Turkey, The John Hopkins Press, Baltimore, Maryland.
  • Tezcan, Mahmut (1985), Eğitim Sosyolojisi, Ankara Üniversitesi Eğitim Bilimleri Fakültesi Yayınları, Ankara'dan aktaran Olgaç Yüksel Akdora, Dünya'da ve
  • Türkiye'de Beyin Göçü: Türk Beyin Göçüne Paradoksal Önlemler, Yüksek Lisans V|g| Tezi, İstanbul Üniversitesi, İstanbul 2002, s.59.
  • TTB (2007), İthal Hekim, Türk Tabipleri Birliği, Ankara, 29 Ocak, http://www.ttb.org.tr /index. php/haberler/179-ttb/500-hal-hekim (15.03.2010)
  • TTB (2008), Sağlık Emek-Gücü: Sayılar ve Gerçekler, Türk Tabipleri Birliği. Ankara.
  • VMA (2003), The World Medical Association Statement on Ethical Guidelines for The International Recruitment of Physicians. World Medical Association, Helsinki.
  • Susanne Weinbrenner, Reinhard Busse (2006). "Germany". In: Rechel, Bernd - Dubois, Carl-Ardy - McKee, Martin (Eds). The Health Care Workforce in Europe Learning From Experience. European Observatory on Health Systems and Policies. Brussels, Chpater 3: 33-46.
  • Weller, Bridget (2008), Guidelines: Incentives for Health Professionals, Pre-publication copy. Global Health Workforce Alliance World Health Organization. Copyright by International Council of Nurses, International Hospital Federation, International Pharmaceutical Federation, World Confederation for Physical Therapy, World Dental Federation, World Medical Association.
  • WFPHA (2005), Ethical Restrictions on International Recruitment of Health Professionals from Low-Income Countries, The World Federation of Public Health Associations, Geneva, May 16.
  • WHO (2001), Workshop on Global Health Workforce Strategy, Annecy, France, 9-12 December 2000, World Health Organisation, Geneva, 7.
  • WHO (2002), Human resources for Health: Developing Policy Options for Change, Discussion Paper, Draft version, World Health Organization, Geneva.
  • WHO (2004), Human Resources and National Health Systems: Shaping the Agenda for Action in the European Region. Workshop in Berlin, Germany, 22-23 May, WHO Regional Office for Europe, Copenhagen.
  • WHO (2006a), Working Together for Health, World Health Organization, Genava.
  • WHO (2006b), Human Resources for Health in the WHO European Region, WHO European Regional Office for Europe, 43.
  • Wislcow, Christiane (2006), "Health Worker Migration Flows in Europe: Overview and Case Studies in Selected CEE Countries - Romania, Czech Republic, Serbia and Croatia", International Labour Office, Sectoral Activities Programme Working Paper, WP.245.
  • Xaba, Jantjie - Phillips, Gary (2001), Understanding Nurse Emigration: Final Report. Trade Union Research Project.
  • Yıldırım, Hasan H. - Kaya, Sıdıka (2010), International Mobility of Health Professionals: The Case of Turkey, Hacettepe Üniversitesi, Ankara (Yayınlanmamış Avrupa Birliği Projesi Raporu).
  • Yıldırım, Hasan H. - Yıldırım, Türkan (2005), "Avrupa Birliği'ne Üyeliğin Türk Sağlık Sistemi Üzerine Etkileri: Serbest Dolaşım Açısından Bir Değerlendirme", Yıldırım H. H. - Yıldırım, T. (Eds.), Avrupa Birliği 'ne Uyum ve Katılım Sürecinde Türk Sağlık Sektörü Hakkında Değerlendirmeler, Ankara.
  • Yıldırım, Türkan (2004b), Avrupa Birliği Genişlemesi ve Sağlık: Türkiye'nin Avrupa Birliği'ne Uyum Sürecinde Sağlık Sisteminin Karşılaşabileceği Sorunlar Hakkında Değerlendirmeler, Yüksek Lisans Tezi, Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü.
  • Yıldırım, Türkan (2009), Avrupa Birliği'nde Serbest Dolaşım ve Sağlık Hizmetleri: Ankara ve Muş İllerinde Sağlık Bakanlığı'na Bağlı Hastanelerde Çalışan Hekim ve Hemşirelerin Serbest Dolaşıma İlişkin Görüşleri ve Potansiyel Göç, Ankara, Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü (Yayınlanmamış Doktora Tezi), Ankara.
  • Yıldırım, Türkan (2010), "Sağlık Çalışanları ve Göç: Nedenler Üzerine Bir İnceleme", Ankara Tıp Mecmuası (kabul edildi).
  • Zajac, Monica (2002), "EU Accession: Implications for Poland's Healthcare Personnel", Eurohealth, Vol. 8, No. 4, Special Issue, Autumn, p. 13-14.