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Is the term ‘brain drain’ fair and accurate?

There is a widely held view that brain drain – especially in health care – hits the country of departure hard. And yet there were dissenting voices to this popular view at HBI 2023.

The term ‘brain drain’ was first coined in the 1960s by the UK Royal Society to describe the mass movement of scientists and technologists from Europe to North America. Since then its meaning has expanded to describe the departure of more literate and numerate groups from one country or economic sector in favour of another – to pursue better pay, living conditions, or quality of life. 

Given there is something of a global workforce shortage, felt acutely in care, it’s a phenomenon we at HBI write a lot about. Developing markets are far from immune to the workforce crisis, so having top-tier talent poached surely raises questions around sustainability and ethicality?

Not necessarily, we are told. This is what the founder of UK-based Advinia Healthcare, Dr Sanjeev Kanoria, said: “In my view, there’s not that much brain drain. It’s actually a good thing. I see the world as a global place, not as silos between countries. Looking back as far as 70,000 years, it’s exactly this ‘migration flow’ that has helped humanity.”

“We started a centre in India and brought in 50 nurses. India’s population is huge and is going to be one and a half billion in a few years. There’s a lot of training and education for nurses some to stay in the country and some to leave. That flow has been there for the last 50 years. After 10-15 years as countries improve, after working and gaining lots of experience and learning, people do return to stabilise and give back to the country at a slightly older age.”

Managing director for international healthcare at Columbia Pacific Management, Nate McLemore, echoed this saying: “We had a hospital company in India that took a similar approach. The hospital said ‘We’re spending all this money training staff, but then they leave. But rather than saying ‘This is a problem’, the company created a programme for people to work outside of India, and through it return back home at a later time. They turned a problem into a solution.”

Of course, outside of these practicalities, there is the question of individual rights and freedom to consider as well. But while there may be schemes and programs in place to help mitigate the negative effects of mass migration of workforces, it’s important to remember that there is firm resistance too. 

Nigeria is seeking to implement a mandatory domestic five-year service to all doctors, Albania has announced plans to better retain staff who are leaving for Germany, and the World Health Organisation has published a 55-country health workforce support and safeguards red list 2023.

It certainly might be helpful to have a flood of trained, experienced, worldly wise staff flocking back home to help. But there is no guarantee they will do so.

There are a couple of options going forward. One is the Nigerian way: to insist staff trained at home pay their dues at home. That they serve their time. But there is perhaps an alternative. The term brain drain could be reworked into something less pejorative. Drains flow in one direction only, after all. And there are opportunities to turn that brain drain into a short(ish) term migration with the goal of subsequently welcoming home better experienced staff wherever possible. How to encourage and incentivise that is the challenge already being embraced by some.

We would welcome your thoughts on this story. Email your views to Michaila Byrne or call 0207 183 3779.