International Labour Migration Report

International Labour MigrationA UNISON Discussion Paper

Foreword

UNISON has published this document on international labour migrationin recognition of the positive contribution migrant workers make to theeconomy of the United Kingdom, and to mark the union’s awareness ofthe problems they face as human beings and workers living in astrange country. The impact of out-migration on the economies ofdeveloping countries is also of deep concern to us. As the reportacknowledges, globalisation has escalated migration, with employersin the UK recruiting workers from overseas to fill the vacancies in thejobs market, many of which are un-skilled and low paid positions.

The paper highlights how the government can address theexploitation of migrant workers by ratifying international conventionsand tightening up on domestic legislation.

It is not possible, nor is it desirable on human rights grounds, to haltthe flow of workers across national boundaries, but we must be awareof the effect this is having on developing countries’ resources,especially the health care systems of sub-Saharan Africa. The paperlooks at measures to help developing countries to build andstrengthen their education and health infrastructures, which enablekey workers to play a continuing role in their economies.

This paper sets out how, targeted development assistance,developing countries can retain their trained professionals andrecommends a number of policy measures that governments,institutions and organisations, including trade unions, can adopt tofacilitate this process.

The paper is an integral part of UNISON’s on-going internationaldevelopment work. We hope you find this a useful resource.

Dave PrentisGeneral Secretary

Contents

Executive summary 2

Labour migration – the background 5

Benefits and losses of labour migration 8

Problems faced by migrant workers 13

Recommended action 16

Bibliography 18

Other useful sources 20

Website addresses 21

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Executive summary

UNISON undertook this work on labour migration tohighlight and suggest recommendations to theproblems faced by migrant workers in the UK andto better understand the situation in ‘sending’countries where services are being decimatedbecause of the loss of key workers. In addition togiving some background to the issues of labourmigration, the report suggests positive action toimprove the conditions for migrant workers comingto the UK. It further recommends working withorganisations in sending countries to try to combatthe drain on resources, especially in health andeducation which is contributing to poverty and highmortality rates.

Background to labour migration

The first section covers the background tointernational labour migration and looks at the keyissues from a global and UK national perspective.It highlights the main initiatives taken by the UKgovernment in recent years to manage migration,both in the interests of migrant workersthemselves and those of the UK economy.Among the key findings:

• there are around 190 million people globallyliving in a country not of their birth. The ILOestimates that there are more than 42 millionmigrant workers worldwide, not including themillions of illegal migrants, many of whom are opento abuse and exploitation

• health care workers make up an increasingproportion of migrant workers in the UK – themajority of whom are from sub-Sahara Africa andSouth East Asia. This haemorrhage of healthworkers from developing countries is having adevastating effect on those countries

• in 2005 the government published a 5-yearstrategy for asylum and immigration whichproposed a points-based system for those cominginto the UK to work or study. This strategy favoursskilled workers

• the UK has not ratified the 1990 UN Conventionon the Protection of the Rights of All MigrantWorkers and their Families, which would protectmigrant workers and their families from abuse andexploitation.

Benefits and losses oflabour migration

The second section sets out the benefits and lossesof labour migration to receiving and sendingcountries. It is concerned in particular with thelosses to sending countries, in sub-Saharan Africaand elsewhere, with special emphasis on healthservice workers and the impact their loss has onhealth service systems in their countries. Some ofthe benefits and losses are:

• migrant workers make a positive net contributionof around £2.5 billion to the UK’s public accounts

• overseas-qualified doctors account for 51 percent of the increase in the number of doctorsworking in the NHS. This has saved the NHS timeand money without redress to investing more intraining.

• most migrant workers, including a number ofhighly qualified, take on low-paid, insecure work

• there are huge implications for sendingcountries; the most crucial is the loss of expertise.South Africa said it spent US $1b educating healthworkers who migrated

• high levels of out-migration from Sub-SaharanAfrica resulted in a struggle to provide basic healthservices. It is estimated that annually between 30and 50% of health graduates leave South Africa forthe US and UK

• the biggest blow from the loss of healthcareprofessionals is felt by HIV/AIDS sufferers who aredesperately in need of medical attention but areunable to receive it as doctors and nurses leave towork abroad

• migration should be voluntary rather than forced

by social or economic circumstances. Developmentaid and commitments from governments indeveloping countries can play a part in improvingsocial and economic infrastructures

• many migrants have to leave their familiesbehind who depend on the money sent home. It isestimated that as much as US $150b was ‘remitted’globally in 2004

• migrant workers entering the UK have strongcultural and family ties with the country of their birthand many do not intend to take up permanentresidence in the UK. Those who do return takeback experience and knowledge which benefits thehome country as a whole by adding to its pool oftalented workers.

Problems faced by migrant workers

The third section focuses on the problems facedby migrant workers in receiving countries, but mostnotably in the UK. It draws attention to the unevenrelationship between migrant workers and theiremployers, and the physical and verbal abuseexperienced by migrants from racists andxenophobes. It stresses the importance of positivetrade union activity in recruiting and representingmigrant workers in the UK. Some of the problemsfaced are:

• rising violence against migrants especiallywomen migrants who are vulnerableto violent attacks which include rape, beatingsand starvation

• the government has adopted measures to makeit easier for migrants to obtain employment but theystill fall short of offering any real employmentprotection

• migrant workers in sector-based schemes are ina similarly weak position as many only stay in thecountry for one year or less and have no protectionin the event of unfair dismissal – UNISON hasencountered resistance to recruiting in the privatecontracting sector where there is a highconcentration of migrant workers.

• UNISON has discovered that migrant workermembers involved in an industrial dispute havebeen threatened with scrutiny of their migrationstatus; and members who have transferred jobsunder TUPE have also had their status questioned.

• UNISON has revealed bad practices in someprivate recruitment agencies operating in thecountries of origin – sign-on fees can be charged orloans granted for travel, and then deducted fromwages in the host country

• the European Posted Workers Directive shouldensure that workers coming to the UK for shortperiods to work in sectors such as construction,would benefit from the terms and conditions agreedfor the sector, but government has not been obligedto put laws into place guaranteeing this protection

• ILO studies have found that more than one inthree qualified migrant applicants was unfairlyexcluded in employment selection procedures inseveral Western industrial countries becausetheir qualifications were not recognised in thehost countries.

Recommendations

The final section of the report proposes a range ofpolicy measures and recommends concrete actionwhich governments and international and nationalinstitutions, including trade unions, can adopt toassist the development of a rights-based solution toglobal labour migration. These require courage anddetermination, qualities that have been largelyabsent to date in the struggle for universal humanrights and social justice in the field of internationallabour migration.

The UK government has done much to assistmigrant workers but could do more such as:

• ratify the 1990 UN Convention on the Protection ofthe Rights of All Migrant Workers and their Families

• reform the work permits scheme and legislate toprevent employers from holding migrant workers’

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passports

• repeal Section 8 of the Asylum and ImmigrationAct 1996

• tighten the Code of Practice for the internationalrecruitment of healthcare professionals and initiateaction to regulate the activities of privaterecruitment agencies

• close the loophole in the Posted Workers Directiveto provide real protection for migrant workers

• work to establish a multilateral framework for arights-based system of labour migration, based onthe ILO’s Core Labour Standards

• work towards a common legal framework,setting out the rights and obligations of third-country nationals, within the EU as a whole.

The UK government should also:

• improve the pay, conditions and value of healthcare workers in the UK to enhance nationalrecruitment and retention strategies, therebyreducing dependence on migrant nurses

• increase funding for public education andhealthcare at home and overseas.

Working with other governments in the EU and theG8 countries, the UK government can help sendingcountries most affected by the loss of key workers,in the following ways:

• provide salary support in key sectors such aseducation and health, where staff losses are greatest

• offer assistance to improve health servicefinancing and governance in countries that arelosing staff

• strengthen key public services in developingcountries through targeted and equitabledevelopment assistance

• assist in the development of a health servicetraining programme, with the support of UK staff

• co-operate with pre-departure and orientationbriefings for migrant workers, with the involvementof the trade unions.

There are a number of initiatives that trade unionscould adopt in the development of a fair and justsystem of labour migration and in the protection ofmigrant workers’ rights, including:

• identify areas where there is significantemployment of migrant workers and organise unionrecruitment campaigns, supported by material inappropriate languages

• provide advice and information to migrantworkers on their rights as well as responsibilities atwork, and access to trade union supportinformation on housing, the cost of living, bankingfacilities, and other social services

• establish education and training courses formigrant workers including assistance with Englishlanguage tuition

• support the European Year of Workers’ Mobility2006, to raise awareness and increaseunderstanding of labour migration in Europe

• build closer working relationships with tradeunions overseas, with reciprocal ‘passport’agreements and exchange programmes to developa greater understanding of migration issues, anddevelop capacity building schemes to assist tradeunions in sending countries

• develop and promote workplace strategies tocombat racism, discrimination and xenophobiatowards migrant workers

• work closely with organisations and communitygroups caring for migrant workers, asylum seekersand refugees.


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Labour migration – the background

There are around 190 million people around theworld living in a country not of their birth – aboutthree per cent of the world’s population. As manyas 100 million people are “on the move” acrossinternational boundaries, one in every 60 humanbeings. Most of this cross border migration is not amatter of choice as people are forced to move formany different reasons. War, civil conflict andpersecution tend to be the major causes, butmillions try to escape hunger or the consequencesof environmental degradation. Economic systemsthat have failed to provide for people’s most basicsurvival needs, or that are simply unable to fulfilexpectations of decent living standards, also drivepeople to look outside their country of birth for abetter life.

Globalisation, involving rapid technological changeand intense market competition, has escalatedeconomic or labour migration and created anenormous pool of migrant workers. (The UnitedNations (UN) Convention on the Rights of Migrantsdefines a migrant worker as a “person who is to beengaged, is engaged or has been engaged in aremunerated activity in a state of which he or she isnot a national”). The International LabourOrganisation (ILO) estimates that there are at least85 million migrant workers worldwide. This figure isovershadowed by the millions of workers who movewithin countries – China alone has 80 millioninternal economic migrants.

We should not forget the millions of undocumentedmigrants, many of them desperate and vulnerableand open to abuse and exploitation. The availabilityof millions of potential workers satisfies employers’demands for a mobile and highly flexible workforce.Although some educated, qualified migrants fillskilled jobs in, for example, healthcare andengineering, the great majority enter low-skilled, orunskilled, jobs in areas such as catering anddomestic services, where work is low-paid andoften temporary. The UK is a popular destination forboth groups of migrant workers.

The foreign-born population of the UK – 4.72 million- accounts for about eight per cent of the total

population of 59 million. However, this figure shouldnot be used to estimate the number of people fromabroad working temporarily in the UK, or how manynew migrant workers are joining the labour force.For this, studies normally use the number offoreigners living in the UK as a tool to calculate thenumber of foreign or migrant workers.

The definition of foreign-born and foreign iscomplex and includes categories with limitations,but in simple terms foreign workers do not hold UKcitizenship, while foreign-born may or may not beUK citizens, or may have dual citizenship.Accepting these definitions, the latest figures for2002, show that there were 2.681 million foreignersliving in the UK, of which 1.303 million wereactively employed. This represented 4.6 per cent ofthe total working population of the UK, ascompared to 3.6 per cent across the whole of theEU. According to the Organisation for EconomicCo-operation and Development (OECD), 14.9 percent of all foreign workers in the UK work in the‘health and other community services sector’, with,in 2003, almost a third of all NHS doctors qualifyingin another country.

The UK’s strong economic performance and greaterlabour market flexibility is attracting migrantworkers on an increasing scale. In 2002, 88,600work permits were approved (this figure excludes31,500 dependents). This was an increase of almostfour per cent over the previous year’s figure, but amuch smaller increase than between 2000 and2001, when approvals rose by 32 per cent. Themost common country of origin was India, 19,000migrant workers, followed by the United States(9,500), South Africa (8,000), and Australia/NewZealand (7,800).

Health care workers make up an increasingproportion of migrant workers coming to the UK,with the bulk of them arriving from developingcountries in sub-Saharan Africa and South EastAsia. Of the sub-Saharan African countries, SouthAfrica is by far the greatest source of health workerswith 1,689 nurses and midwives and 6,208 doctorsjoining the register in 2003/04. In the same period,4,338 nurses and midwives from the Philippines and18,006 doctors from India, joined the register.

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Overseas countries are being used to fill apersonnel gap in the UK’s health service. Of the34,627 additional nurses and midwives joining theregister in 2003/04, 14,122 came from outside theUK. This is having a devastating effect ondeveloping countries where life expectancy is muchlower than in the UK.

In 1999, mindful of the effects of the loss ofhealthcare professionals on developing countries,the Department of Health (DH) banned NationalHealth Service (NHS) trusts from recruiting fromSouth Africa and Caribbean countries and extendedthe ban to all developing countries in 2001 when itadopted the ‘Code of Practice for the internationalrecruitment of healthcare professionals’. The listapplies to 152 countries, but does not includeChina, India, the Philippines and Spain where, withthe agreement of both governments, nurses areoffered the opportunity to work in the UK.

The code was revised and updated in December2004, with a further update in March 2005. Itencourages all employers to follow ethicalguidelines and not to recruit from developingcountries. However, because the code is purelyvoluntary, many private recruitment agenciescontinue to recruit from countries on the bannedlist, without the explicit agreement of thegovernments concerned.

In 2004/05 more than 3,300 nurses entered the UKregister from developing countries on the bannedlist. It is believed that agencies evade the ban byinstructing recruits to say they were applying oftheir own volition. Advertising health care jobs inprofessional journals is not allowed in countrieswhere they are recruiting, but agencies can do sothrough their web-sites. Once health care staff areworking in UK private hospitals, which remainoutside the code, they can apply for NHS jobs.Tightening the code would be one way of dealingwith the unethical practices of private recruitmentagencies. Alternatively, licensing for recruitmentagencies could be reintroduced making compliancewith the code a condition.

Migration however, is a two-way process. Over thedecade to 2002, 3.9 million people entered the UK as

migrants and 2.8 million people left, giving a netinflow of over one million. In 2002, 125,000 peoplemigrated from the UK to other EU countries,compared with 89,000 who came to the UK fromelsewhere in the EU. The latest figures show that atthe end of 2004 there were 130,900 workers from thenew member states working in the UK. More than half(56 per cent) of these are from Poland. At least half ofthe inflow and outflow of people are of working age,many within the 25-44 age group, but although thereis a net inflow of migrants, the UK is losingdomestically educated and trained key workers.

An increasing number of nurses are migrating tohigher paid jobs in Australia, Canada and the USA.In 2003 more than 2,000 nurses, the highestnumber recorded, left the UK to work in the USA,which aims to employ one million extra nurses by2010. The loss of UK trained nurses to the USA andelsewhere results in greater dependence onoverseas nurses from developing countries. Thepoint made earlier that globalisation has escalatedlabour migration is reflected in the comment by theInternational Organisation for Migration in its latestreport for 2005. The report says, “In spite of the EUenlargement after 1 May 2004, Europe will need todevelop proactive immigration policies after 2010,and draw more migrants from outside Europe, inorder to remain competitive with other majorimmigrant receiving regions in the world”.

The government has embraced the principle ofmanaged migration and has adopted a number ofmeasures to facilitate this, while at the same timebeing tough on abuse of the asylum system andillegal immigration. Changes to the Highly SkilledMigrant Programme, 2003, include:

• reducing the overall points required to qualify

• introducing new criteria for applicants under28 years old to make it easier for younger, skilledapplicants to work in the UK

• taking account of graduate partnersachievements.

From mid-2004, foreign nationals who havegraduated in maths, science or engineering at a UK


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institution have been able to work for 12 monthsfollowing graduation under the Science andEngineering Graduates Scheme. In April 2005 anew provision was introduced allowing Master ofBusiness Administration (MBA) graduates frombusiness schools to work in the UK for a period of12 months after they have completed their course.The upper age limit of 25 in the SeasonalAgricultural Workers Scheme was removed fromJanuary 2004 and the Working HolidaymakersScheme has been updated and extended, theupper age limit has been raised from 27 to 28 andemployment restrictions removed to allow a switchinto work permit employment after 12 months, if thenecessary criteria are met.

Following the deaths of 23 Chinese cockle pickersin Morecambe Bay in February 2004 steps havebeen taken to tackle the issue of undocumentedmigrant workers and the gangmasters who controlthem. (It is estimated that there are around 4,000gangmasters in the UK, controlling approximately60,000 workers). The Gangmasters (Licensing) Act2004 established the Gangmasters LicensingAuthority to set up and operate a licensing schemefor labour providers operating in the agriculture,shellfish gathering and associated processing andpackaging sectors.

The Act prohibits anyone from acting as agangmaster in the specified areas, without a licence.It includes businesses registered as employmentagencies or employment businesses. Illegalgangmasters routinely flout employment and taxregulations, including laws on the minimum wage,and often use threats and intimidation againstagencies and businesses who operate lawfully.

There is increasing evidence that the gangmastersare moving out of the areas protected by the Actand into the construction and service sectors wherethe problem is escalating. The Act should thereforebe extended to cover all areas where there is seento be a problem and properly resourced to ensurethere are enough inspectors to enforce the law. Thelicensing of gangmasters is to be under the controlof the Gangmasters Licensing Authority, whichcame into effect on 1 April 2005. It is expected thatthe licensing system will operate from mid-2006.

This too should cover agencies in all areas wheregangmasters operate.

In February 2005 the government published its fiveyear strategy for asylum and immigration, Controllingour Borders: Making immigration work for Britain,proposes:

• a points-based system for those coming in towork or study

• financial bonds to guarantee that some migrantsreturn to their home country

• no automatic right for relatives to bring in morerelatives

• only skilled workers allowed to settle long-termin the UK

• fixed penalty fines for employers for each illegalworker they employ as part of the drive againstillegal working.

The latter point is a reform of something that alreadyexists under Section 8 of the Asylum andImmigration Act 1996. These broadly represent afairly restrictive set of rules which may hinder effortsby organisations to tackle the myths about migrationand migrant workers. The proposals are set out inmore detail in a government consultation paper‘Selective Admission: Making Migration Work forBritain’, July 2005. Following the consultation, thegovernment will announce proposals for change anda timetable for implementation in spring 2006. Thenew system has four catchment tiers, the highlyskilled, the skilled, the low skilled and students andspecialists, clearly indicating that its purpose is torealise the economic gains of migration.

The UK government needs to take further steps toprotect migrant workers from abuse andexploitation. But although the demand for migrantlabour is increasing, no major receiving country,including the UK, has ratified the 1990 UNConvention on the Protection of the Rights of allMigrant Workers and their Families. This has beendescribed by the Director of Anti-SlaveryInternational as “the most comprehensive

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international standard protecting migrants’ rights”,and as a “vital step in protecting migrants and theirfamilies from slavery and other exploitation”.

Reluctance by receiving states to ratify theConvention is linked to the fact that the Conventionpromotes basic rights for all migrant workers,regardless of their immigration status. A furtherreason given by European Union countries is thatmany of the rights enshrined in the Convention arealready covered in other EU instruments. However,the fair and equal treatment of all workers regardlessof their immigration status should be the goal of allgovernments. Ratification of the Convention wouldbe evidence of their good intentions andcommitment to respect basic human rights.

Benefits and losses oflabour migration

Benefits to the UK

Migrant workers benefit host countries in a numberof ways. The overall economic impact of all migrantworkers to the UK for example suggests that theymake a positive net contribution of around £2.5billion to the public accounts. A 2004 ILO studyshowed that, in the absence of this contribution, UKpublic services would have to be cut or taxes wouldhave to be raised. Migrant workers bring skills,qualifications and youthful enthusiasm to anotherwise ageing working population.

Government statistics for 2003 show that 21 percent of migrant workers hold higher educationqualifications, compared with 17 per cent of UK-born. The statistics also show that 45 per cent ofmigrant workers in the UK were working asemployers, managers and professionals, comparedto 39 per cent of UK workers. The sectors includedadministration, education, health and financialservices. Most migrant workers however, includinga number who are highly qualified, take on low-paid, insecure work in areas like catering anddomestic services, which local people findunattractive and are therefore unwilling to fill.

With migrants eager to undertake this work, firmsand the economy grow as productivity increasesand inflationary pressures reduce. Migrant workersalso add large levels of entrepreneurship and self-employment, thereby creating new jobs for the UKworkforce. This can act as a spur to local people tostart their own business, giving further impetus toeconomic growth.

As migrant workers are also consumers, demandfor goods and services increases, which in turnleads to additional demand for more labour, therebyincreasing opportunity for all. Continuous growthcan result from this due to the younger age profileof migrant workers, providing that they are able andwilling to stay long-term, rather than return homeonce they become financially secure.

Education and health care are two sectors that


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have experienced the benefits of increased labourmigration in recent years. A number of educationauthorities in the UK hire migrant workers directlyfrom abroad to address the shortage of teachingstaff. School teacher work programmes, forexample, recruit Jamaican teachers for inner cityschools in London. Higher education also benefits,with 12.5 per cent of academic and research staffmade up of non-British nationals. Informationtechnology (IT) is a critical support tool ineducation, and in IT as a whole migrant workersaccount for 17 per cent of highly skilled workers.Overall, migrant workers bring intellect andexpertise to education, with 20 per cent educatedto degree level compared to 14 per cent of UK borncitizens. Their contribution is invaluable.

Within the health care sector migrant workersoccupy positions that, left to local recruitment,would be hard to fill in terms of specialist skills orgeographical areas. Overseas-qualified doctorsaccount for 51 per cent of the increase in thenumber of doctors working in NHS hospitals. Inrecent years more than 25,000 work permits havebeen issued annually to workers in health andmedical services. And if we include those who enterby other routes – asylum, family reunion – the effectis that almost one in three doctors, one in sixdentists, and one in 10 nurses in the UK weretrained overseas. An inadequate number of UK-trained doctors and nurses is a major cause of theincrease in overseas recruitment.

Since 1997 there has been an aggregate total ofmore than 80,000 overseas nurses admitted to theUK register. The British Medical Association (BMA)has called on the UK to achieve self-sufficiency intheir health care workforces, rather than rely ondeveloping countries to make up the shortage. Butbeing able to draw on a ready supply of foreignworkers has saved the NHS time and money andenabled it to expand to meet performance targetswithout having to wait for domestic workers to beeducated and trained.

As well as educating and training extra health careworkers in the UK, advantage could be taken of thelarge numbers of refugee doctors, estimated at over1,000, who are living in the country. A survey of 150

refugee doctors found that 85 per cent do not haveposts in the NHS. More than half were unemployed,while others took jobs as chefs, labourers andsecurity staff.

Official policy suggests that the dominant questionin the debate about migrant workers is what is inthe best economic interests of the UK, not whatcan be done to help and protect migrant workers inthe UK economy. Migrant workers make a hugecontribution to the economy, but measures toprotect them from unscrupulous employers areconspicuous by their absence. They also bring arange of non-economic benefits to British society.The varied richness of their culture, customs andlanguage, make our country more colourful,dynamic and vibrant. They also encourage aninterest in the history and traditions of ourrespective cultures, which hopefully will lead to agreater tolerance and understanding. More needs tobe done before we reach this state of development,but we should be prepared to take the first steps onthe road to achieving it.

Losses to sending countries

There are huge implications for sending countriesas a result of out-migration, the most crucial ofwhich are the loss of expertise and skills. This braindrain is particularly acute in developing countries,especially where the move abroad is permanent.Public services, such as health, education andsocial services, are losing large numbers of skilledworkers to migration. Structural changes anddecreasing investment in the public sector hasincreased the pressure on public sector workers tomigrate, as shown by trends in the health andeducation sectors.

According to the International Organisation forMigration, South Africa claims to have spent 1 billionUS dollars educating health workers who migrated –the equivalent of one-third of all development aidreceived between 1994 and 2000. In the Caribbean,Jamaica has suffered a great loss of educators andteachers. Between 2000 and 2002, Jamaica’sMinistry of Education estimate that around 2,000teachers left to take up temporary posts abroad.

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While Jamaica has trained increasing numbers ofteachers in recent years, the proportion of fullyqualified teachers has fallen. Throughout the 1990sthe total share of fully qualified, trained teachersdeclined by 11 per cent. Migration from developingcountries is not only a loss of skilled health careworkers and teachers, it is also a loss ofeducational investment.

Health care sectors in developing countries sufferdramatically from the loss of skilled workers.Countries like the UK can offer relatively highincomes and exert a pull factor on countries wherewages and conditions are unattractive. It should notbe assumed however that health care workers,including doctors, nurses, health care assistants,only move abroad for financial reasons. Many do sofor reasons of professional development.

Whatever the reason, high levels of out-migrationput a severe strain on human and financialresources, which results in a struggle to providebasic services, such as health. It is estimated thatbetween 30 and 50 per cent of health graduatesleave South Africa for the USA and UK each year,two-thirds of Jamaican nurses left permanently inthe 1990s, and in 1999 Ghana lost more nursesthan it trained.

In sub Saharan Africa healthcare systems are badlyaffected, with 24 of the 47 countries having onlyone medical school; while 11 have no medicalschool at all. In Ghana, 40 per cent of healthdistricts have, at the most, two doctors to serve theentire population, while some districts have none atall. Life expectancy in many African countries islow. The UN Millennium Development Goals includea two-thirds reduction in child mortality under fiveby 2015. To meet this Africa needs one million extrahealth care workers. Significantly, the MillenniumDevelopment Goals recognise that a sound healthcare system is critical to the economic developmentof developing countries.

The biggest blow from the loss of healthcareprofessionals is felt by HIV/AIDS sufferers who aredesperately in need of medical attention but areunable to receive it as doctors and nurses leave towork abroad. Many sufferers are health workers

themselves. The HIV/AIDS epidemic kills healthworkers, increases the work burden and stigmatisesthose who remain to care for patients. It alsoimposes huge health care burdens while demandingmore skilled staff to combat the infectious disease.HIV/AIDS is therefore both an emergency problemand a long-term development issue.

This difficult situation is compounded by a profoundneglect of health care systems that have suffereddecades of under-investment. Structural adjustmentpolicies and health care reforms are largelyresponsible for this, but poverty reduction strategiesrarely include assistance for HIV/AIDS treatment. Asa result many health workers move out of the publicinto the private sector.

Out-migration, with the loss of key workers, makesit imperative that the UK increases its aid budgetrapidly to help developing countries invest ineducation, health, and other public services. Theloss of skilled workers can be a major impedimentto economic growth and technological progress, soearly targeted aid and investment in public services,like education and health, can have direct benefitsfor economic development. Debt cancellation alsohelps developing countries to provide services. InGhana, for example, debt relief led to 2.2 millionpeople gaining access to clean water.

Carefully targeted assistance in sending countries,and on sectors most affected, should ease theimpact of migration, but it will take time to have areal affect and depends on the actual level andapplication of development aid. It would not bepossible, nor should it be, to prevent the globalmovement of people. However, it should be the aimof policy to ensure that such movement isvoluntary, fair and humane, and not forced by socialor economic circumstances.

Development aid can play a positive role inimproving poor countries’ economies, in buildingand strengthening education and health systems,and in ensuring that pay and working conditionshelp recruit and retain domestically educated andtrained workers. Co-operation and partnershipbetween governments, aid agencies and unions isnecessary. Governments in developing countries


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have a special responsibility to improve spendingon education, healthcare, and other social andeconomic infrastructure which will generate growthand create jobs. All this indicates that migration isan integral component of the development agenda.

Migration from the southern to the northernhemisphere is at least matched by migrationbetween countries in the global south, notablyAfrica, and between countries in eastern Europeand those in the west. Over the last decade SouthAfrica has received an influx of migrants fromvarious parts of the sub-Saharan region, includingGhana, Mali, Nigeria, Senegal, Uganda, and Zaire.

The improving economies of Botswana, Gabon andNamibia also draw in internal migrants who viewthem as an attractive alternative to Europe and the United States. Similarly, the break up of the SovietUnion and the enlargement of the European Unionhas facilitated movement between countries. As aresult, workers from Hungary, Poland and theUkraine migrate to seek employment in westernEurope, Canada and the United States.

The cross border provision of health care services isseen as an integral component of the growth oftrade in services. The provision of health services byindividuals in another country on a temporary basisis not automatically excluded from the coverage ofMode 4 of the World Trade Organisation’s (WTO)General Agreement of Trade in Services (GATS).Mode 4 will have implications for the employment ofhealth workers in the UK and elsewhere.

As in the case of public services there iscontroversy and uncertainty over whether healthservices should be excluded from the GATSprocess because they are provided “in the exerciseof governmental authority”, and are supplied neitheron a commercial basis nor in competition. It is alsounclear what temporary means in length of time.

In the last round of negotiations health careservices were excluded from the process by theEuropean Union acting on behalf of all its members.Pressure is being maintained to ensure that healthservices are excluded permanently from all futurediscussions. But if countries are to benefit from

Mode 4 of the GATS then domestic andinternational labour laws should protect workersentering a country specifically for work purposes.

Increasing global liberalisation of trade, with goodsand services moving within the world economy, anddemands from the World Bank and InternationalMonetary Fund for privatisation and more cuts inpublic expenditure, threaten public services such aseducation and health. Following the G8 summit inJuly 2005, pressure needs to be maintained, notonly to cancel developing countries debt andincrease overseas aid, but to replace free trade withfair trade and create a level playing field socountries can compete as reasonably equalparticipants. Unless the advance of globaleconomic liberalism is reversed, or at leastcurtailed, poor countries will continue to experiencea drain on their educated and skilled workers.

The effects of the brain drain are acutely felt byfamilies, as well as local and national economies.Many qualified professional health staff who migrateto the UK and elsewhere often leave their familybehind. This can and does lead to a break up of thefamily unit. Those left behind bear the burden ofgreater workloads, low incomes, inadequatesupervision, lack of career progression and, generally,sub-standard equipment in basic, key services.

This is particularly true for women migrant workerswho are stereotyped into the low-paid,“reproductive work”, such as cleaning anddomestic services, caring and healthcare. Women’swork is largely undervalued and the burden isdoubled in the case of women migrant workers whohave the responsibility as breadwinners and carersfor their families.

In the increasing “feminisation of migration”, wheremore women are migrating for work, families areseparated and children suffer the most. These arehigh social costs that are not considered inmeasuring the benefits of migration. The loss ofeducation and health care professionals producesserious deficiencies in the services provided to localcommunities and, crucially, in the capacity ofdeveloping countries to make progress witheducational and health development. Even where

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resources are targeted to increase the numbers ofskilled education and health workers, better payand working conditions in developed countriesrelative to the situation in developing countries,remain strong push and pull factors in migration.

Benefits to sending countries

Although many economic migrants work in relativelylow-paid jobs they regularly send money home totheir families and relatives. However, it is difficult toestimate the scale of these remittances to sendingcountries because of the often informal manner inwhich they are returned, but there is little doubt thatthey contribute to the national income of thecountries involved, and act as a stimulus to longer-term economic growth. Remittances are more likelyto occur where migrants intend to return home tofamilies they leave behind, rather than wheremigration is permanent. These remittances equal,and in some cases exceed, official development aidin many countries.

It is believed that in 2004 the equivalent of as muchas 150 billion US dollars was remitted globally with,for example, Mexico receiving 16 billion, India 9.9billion and Philippines 8.5 billion dollars.Remittances play an important role in smaller andisland nations, where they can be equivalent tobetween 20 and 40 per cent of Gross DomesticProduct. Sub-Saharan Africa on the other handreceives the lowest level of remittances, amountingto just 1.5 per cent of total global remittances.

In general doubts remain about the value ofremittances for economic development because ofuncertainties about how they are used, but thescale of the sums involved suggest a major positiveimpact. Evidence suggests that income generationin micro-economies in developing countries canhave a negative impact as prices inflate. Thiscreates further hardship locally and may offset thebenefits to the national economy.

Migrant workers entering the UK have strongcultural and family ties with the country of their birthand therefore do not intend to take up permanentresidence. Some move on to another country or

return home. There are no records which indicatethe number of migrant workers who return homeafter working in the UK, but it can be assumed thatthose who do so are still of working age and arethus able to continue to use their knowledge andskills. Of course this is dependent on the demandfor labour in their home country. This is greatestwhere the economy is growing rapidly. In countrieswith low or no growth and high unemployment,demand will be low and the desire to return homewill therefore be dampened. The solution to thisconundrum is for developed economies to helpdeveloping countries to create the conditions forsustainable economic growth.

Migrant workers who return home bring experienceand knowledge from working in another country.This benefits the home country as a whole byadding to its pool of talented workers, particularlywhere the skills are relevant to the needs of thehome economy and the migrant workers are willingto use them upon return.

It also benefits the individual worker who will havedeveloped through contact with people possessinga range of human, intellectual and professionalskills. Access to educational and language coursesin the host country should open up opportunities forcareer promotion at home and assist the personaldevelopment of each worker. This ‘brain gain’ isexperienced especially in the major growingeconomies of China and India.


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Problems faced by migrant workers

Migrant workers face many obstacles while trying toestablish themselves in their host country. Whetherin countries that have traditionally attractedimmigrants or in countries where migration is arecent phenomenon, migration and migrants have anegative image. Media attention routinely focuseson uncontrolled flows of people seeking work orasylum, on undocumented migrants, on the criminalactivities of traffickers and smugglers, and on theproblems of the integration of immigrants with thelocal population.

Public perceptions may reflect real issues and realproblems, but they also reflect fear, ignorance andprejudice. It is widely believed that migrants cometo the UK simply to take advantage of the statewelfare system, a belief encouraged by sections ofthe press. Evidence shows that migrants make lessuse of the benefits system than the indigenouspopulation. One of the reasons for this is thatmigrant workers are denied entitlement to non-contributory benefits in the first place. This is ananomaly that should be addressed.

Public perceptions however, fluctuate and aresubject to a variety of influences. The majority tendsto change its views with the ebb and flow of theeconomy – a period of unemployment for exampleinflames fear and prejudice – but it is also sensitiveand responsive to the information and messagescoming from political representatives. At the sametime, political representatives are very aware oftrends in perceptions and public opinion, particularlywhen seeking to gain or retain electoral support.

Extreme politicisation of migration in manycountries bears further testimony to this, as doesthe rise in violence against migrants. Migrants andforeigners have always been scapegoats for actualor perceived economic and social problems, fromcriminality to unemployment. The events ofSeptember 11 2001 in New York, and July 7 2005 inLondon, have heightened the perception ofmigrants, particularly those of Muslim and/or Araborigin, as a threat to social stability. In their effortsto assuage public fears of further terrorist attacks,governments rush to introduce laws which

undermine human rights and adversely alter thebalance between freedom and security.

Governments have a responsibility for theprotection and security of their countries, but indoing so they must be mindful of the rights of thepeople. Studies on the situation of Muslim and Arabpeoples following 9/11 have found that in mostnon-Muslim countries, but primarily in northAmerica and Europe, discrimination and violencetowards people originating from Muslim countriesbecame more frequent. This hostility has had aneffect on employment and recruitment.

A study by the Institute of Employment Studiesrevealed that most companies surveyed werelooking to employ refugee staff because of gaps inthe domestic labour market. However, half of thosequestioned did not want it to be publicly known thatthey employed refugees because of the negativeimage of migrants coming to the UK.

Violent attacks on migrants and refugeesthroughout Europe have been widely reported, butbrutality against foreigners is occurring in all regionsof the world. Women migrants are often the targetsof such attacks. Among the types of violencedirected at women are beatings, rape andstarvation, with increasing numbers forced intoprostitution. Inhumane working conditions, such aslong working hours, non-payment of wages and notime off are experienced by many women migrantworkers, with unskilled workers in domestic serviceparticularly exposed.

The opportunities for migrant women in securingwork are often restricted to traditional female jobssuch as catering and domestic service. Many ofthese jobs come into the ‘casual’ category and offerno physical safety or financial security. As a result,social support through women’s networks has alimited role to play.

While the government has adopted measures tomake it easier for migrants to find employment,they still fall short of offering any real employmentprotection. Work permits continue to remain theproperty of the employer, while a worker’s right toremain in the UK depends on them remaining with

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the same employer. The employer-migrant workerrelationship is consequently an uneven one, withthe employer holding a distinct advantage andexercising great power over the worker.

Under Section 8 of the Asylum and Immigration Act1996 employers effectively act as immigrationcontrol officers. The Act requires that they checkthe immigration status of employees who theybelieve to be immigrants. As a result, Section 8places workers at the mercy of employers and islikely to increase discrimination against jobapplicants. It should therefore be repealed.

Migrant workers in sector-based schemes are in asimilarly weak position. As many only stay in thecountry for one year or less they have no protectionin the event of unfair dismissal. Where rights doexist it is difficult to bring a case to a tribunal if theindividual victim has to leave the country. Thosewith restricted rights, for example students onseasonal agricultural workers schemes, or those onwork permits employed in private health, can havetheir documents withheld, threatened with the sackand subsequently deported.

In London there is a high concentration of migrantworkers in the private contracting sector. In someareas it is in excess of 50 per cent. UNISON hasencountered resistance to recruitment in this sectorand a campaign focused on migrant workers wouldhelp to re-establish a union presence.

The current system of work permits is a charter forthe exploitation of migrant workers as the schemeplaces the power over migrant workers’ status andlivelihood in the hands of the employer. There ismuch evidence to suggest that, as a result, manymigrant workers find themselves in a situationwhere they are not accurately informed of theirrights and are vulnerable to dismissal or beinglabelled as criminals if they complain about theirworking conditions.

In addition, they are often threatened with withdrawalof their work permit if they do not comply with theemployer’s wishes. UNISON has discovered thatmigrant worker members involved in an industrialdispute have been threatened with scrutiny of their

migration status; and members who have transferredjobs under the Transfer of Undertakings (Protectionof Employment) Regulations (TUPE) have also hadtheir status questioned.

This, combined with the lack of control they haveover their passports, leaves them open to the riskof becoming undocumented workers. Legislation isneeded to strengthen migrant workers rights and toprevent employers from holding migrant workers’passports, as it effectively violates their humanrights and dignity.

UNISON’s involvement with migrant health workershas revealed bad practices in some privaterecruitment agencies operating in the countries oforigin. As a result sign-on fees can be charged orloans granted for travel, and then deducted fromwages in the host country. It should be possible inUK law to prohibit UK agencies from involvement insuch payments abroad and to prohibit theenforcement of payments in the UK.

The Institute of Employment Rights (IER) has outlineda number of steps that could be taken to tackle thisproblem. In their booklet, “Labour Migration andEmployment Rights”, the IER says ‘In the first place,it should be made explicit in legislation that anycontract or arrangement for the payment of suchfees, beyond the actual and documented cost oftransport to the United Kingdom, is unenforceablewithin the United Kingdom.

“Secondly, it should be made clear that the rulesagainst charging by employment agencies based inthe United Kingdom also apply in cases where theyare involved in requests for such payments in otherstates. Finally, we would point out that compliancewith this principle ought to be incorporated withinthe gangmasters licensing system – ie evidence ofpayments should leave an individual open to therefusal or withdrawal of a licence.”

To further strengthen these measures the activitiesof agencies need to be regulated internationallythrough multilateral agreements. The ILO has calledfor the development of a non-binding multilateralframework for a rights-based approach to labourmigration and the establishment of an ILO dialogue


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on migration, in partnership with international andmultilateral organisations.

The framework will comprise international guidelineson a range of issues, including the licensing andsupervision of recruitment and contracting agenciesfor migrant workers in accordance with ILOconventions and recommendations, the promotion ofmeasures to ensure that all migrant workers benefitfrom the provisions of all relevant internationallabour standards, and the introduction of measuresto ensure that all migrant workers are covered bynational labour legislation and applicable social laws.

The European Posted Workers Directive shouldensure that workers coming to the UK for shortperiods to work in sectors such as construction,would benefit from the terms and conditions agreedfor the sector. However, owing to the oddities of theUK collective agreements, governments have notbeen obliged to put laws into place guaranteeingthis protection. The underlying deficiency thereforeis with British labour law. Plugging this loopholewould protect decent employment standards andhelp improve health and safety for all workers,regardless of their nationality.

Migrant workers who have trained and qualified intheir own country often find that their qualificationsare not recognised elsewhere and this has led toexclusion from employment. ILO studies forexample have found that more than one in everythree qualified migrant applicants was unfairlyexcluded in employment selection procedures inseveral Western industrial countries. According tothe Nursing and Midwifery Council (NMC), in theyear ending 31 March 2004, only one in three(14,122) of the 41,406 overseas trained nurses andmidwives, mainly from developing countries, whoapplied for registration, were accepted.

The Council for Assisting Refugee Academics(CARA), which is supported by the Trades UnionCongress (TUC) and Commission for Racial Equality(CRE), estimate there are 1,500 refugee doctors,dentists and health professionals in the UK, butonly a minority are employed at the same level astheir country of origin. Migrant nurses, particularlyblack and ethnic minority nurses, also experience

in-job discrimination, are excluded fromdevelopment and training opportunities and areconsequently denied promotion.

All these problems make it imperative that unionrecruitment policies and strategies recognise theneed to organise and represent migrant workers. Thelabour force survey figures for 2002 show that onlyone in five migrant workers (20.4 per cent) in the UKbelong to a union, compared with 27.2 per cent of UKborn workers. Possible mechanisms for recruitmentand organising of migrant workers include:

• the use of translated materials

• the provision of English language training, withunions supporting the formation of national orlanguage-based associations

• providing information from the point of decisionmaking and throughout the whole migration process

• migrant awareness training for existing unionmembers

• integrating measures to combat racism anddiscrimination into the work of unions

• building closer relationships with trade unionsoverseas to develop a greater understanding of theinstitutions and structures of the respectivecountries

• encouraging reciprocal union membershipthrough signed ‘passport’ agreements.

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Recommended Action

The governments of receiving and sending countriesand international and national trade unions can makea major contribution towards improving the positionof migrant workers and in assisting the developmentof the economies in their respective countries. This isparticularly important in the case of developingcountries where key workers continue to be lost.

Developed countries that benefit from the braindrain have a duty to help in the building of strong,sustainable economies in developing countries.Action needs to be co-ordinated if it is to besuccessful and governments and trade unions havemuch to do. UNISON currently participates in theMigration and Women Health Workers Project ofPublic Services International (PSI), a globalfederation of public service unions in:

• promoting women health workers rights

• campaigning for ethical recruitment

• maintaining quality public health services

• engaging in social dialogue in the health sector.

The government has adopted a number of positivemeasures to assist migrant workers coming to theUK, and to manage migration within the context ofexpansionist macro-economic policies and socialpolicies that guarantee equal opportunities formigrant and national workers. These measuresneed to be supplemented by the adoption of thefollowing proposals if there really is to be fair andequal treatment of all workers.

• Ratify the 1990 UN Convention on theProtection of the Rights of All Migrant Workersand their Families.

• Reform the work permits scheme to reduce thepower of employers.

• Legislate to prevent employers from holdingmigrant workers’ passports.

• Support in principle an amnesty for

undocumented workers and undertake a detailedstudy of its implications.

• Repeal Section 8 of the Asylum and ImmigrationAct 1996.

• Tighten the ‘Code of Practice for the internationalrecruitment of healthcare professionals’, to haltunethical recruitment by private agencies.

• Initiate international action to regulate theactivities of private recruitment agencies.

• Work with other European governments, andinternationally, to establish a multilateral frameworkfor a rights-based system of labour migration,based on the ILO’s Core Labour Standards.

• Ensure that migrant workers are provided withthe necessary information on the real costs andbenefits of migration, access to legal protection,employment rights and social benefits, while at thesame time ensuring they are covered by nationallabour legislation, collective agreements, andapplicable social laws.

• Introduce measures to ensure that migrantworkers benefit from the provisions of allinternational labour standards.

• Close the loophole in the Posted Workers Directiveto provide real protection for migrant workers.

• Work towards a common legal framework,setting out the rights and obligations of thirdcountry nationals, within the EU as a whole.

Sending countries are in need of assistance toimprove economic and social conditions at homewhich will help to retain skilled workers currentlybeing lost to the brain drain. The UK government,working with other governments in the EU and theG8 countries, can help in the following ways:

• improve the pay, conditions and value of healthcare workers in the UK to enhance nationalrecruitment and retention strategies, therebyreducing dependence on migrant nurses


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• provide salary support in key sectors such aseducation and health, where staff losses are greatest

• offer assistance to improve health servicefinancing and governance in countries that arelosing staff

• strengthen key public services in developingcountries through targeted and equitabledevelopment assistance

• assist in the development of a health servicetraining programme, with the support of UK staff

• co-operate with pre-departure and orientationbriefings for migrant workers, with the involvementof the trade unions.

International and national trade unions, includingUNISON, have an important role to play in thedevelopment of a fair and just system of labourmigration and in the protection of migrant workers’rights. Trade unions should do more to recruit andrepresent migrant workers at all levels. There are anumber of initiatives that trade unions could adoptto achieve this, including:

• identify areas where there is significantemployment of migrant workers and organise unionrecruitment campaigns, supported by material inappropriate languages

• provide advice and information to migrantworkers on their rights as well as responsibilities atwork, and access to trade union supportinformation on housing, the cost of living, bankingfacilities, and other social services

• identify union members who are foreign bornor foreign workers with a view to organising andrecruiting

• appoint full time officer(s) to work specifically onrecruitment of migrant workers, and set up supportgroups in branches where there are migrant workers

• establish education and training courses formigrant workers including English language tuition

• help migrant workers and ethnic minorities tobecome trade union activists and leaders

• produce migrant awareness training for existingunion members

• support the European Year of Workers’ Mobility2006, to raise awareness and increaseunderstanding of labour migration in Europe

• work with national and international trade unioncentres to challenge the perceived negative imageof migrant workers, promote their human and tradeunion rights, and highlight their positive contributionto the economy and society

• build closer working relationships with tradeunions overseas, with exchange programmes todevelop a greater understanding of migrationissues, and develop capacity building schemes toassist trade unions in sending countries

• encourage reciprocal union membership throughsigned ‘passport’ agreements

• develop and promote workplace strategies tocombat racism, discrimination and xenophobiatowards migrant workers

• work closely with organisations and communitygroups caring for migrant workers, asylum seekersand refugees

• develop a common strategy on the rights-basedapproach to labour migration with international andnational trade union centres

• campaign for increased funding for publiceducation and healthcare at home and overseas.

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Bibliography

International Monetary Fund (July 1998) William JCarrington and Enrica Detragiache – How Big is theBrain Drain?

International Labour Organisation, Peter Stalker(2000), Workers Without Frontiers – the Impact ofGlobalisation on International Migration.

Peter Stalker, New Internationalist, (2001), The NoNonsense Guide to International Migration.

UNIAID and International Organisation for Migration,Duckett, Margaret, (March 2001) – Migrants’ Rightto Health

Organisation for Economic Co-operation andDevelopment. Jonathan Coppel, Jean-ChristopherDumont and Ignazio Visco (18 June 2001) – Trendsin Migration and Economic ConsequencesEconomic Department Working Paper No.284

Department of Economic and Social AffairsPopulation Division United Nations New York (2002)– International Migration Report 2002

Joint Council for the Welfare of Immigrants, LabourResearch Department (January 2002) – MigrantWorkers a TUC guide.

Home Office RDS Occasional Paper, (December2002), Kempton, Jeremy, – Migrants in the UK:their characteristics and labour market outcomesand impact.

European Trade Union Confederation (2003)Migrant and Ethnic Minority Workers: ChallengingTrade Unions…

Timothy J Hatton, University of Essex, (March 2003)Emigration from the UK, 1870-1913 and 1950-1998.

Dr Stephen Bach, ILO Geneva, (July 2003) –International migration of health workers: Labourand social issues.

Fabian Society, Oxfam GB (November 2003),Russell King, Nicolai Mai, Mirela Dalipaj, Exploding

the Migration Myths. Analysis and Recommendationsfor the European Union, the UK and Albania

World Health Organisation. Health and Human RightsPublications Series. Issue No.4 (December 2003)International Migration, Health and Human Rights.

International Labour Office (2004). Report VI.Towards a fair deal for migrant workers in theglobal economy.

Research Report Conducted on Behalf of NASUWT(2004) Olwen McNamara and Sarah Lewis. TheUniversity of Manchester and John HowsonEducation Data Surveys. The Recruitment ofOverseas Trained Teachers.

Trends in International Migration OECD AnnualReport. 2004 Edition

World Economic and Social Survey (2004) Chapter11, International migration trends

Institute for Public Policy Research (23 February2004) – EU enlargement and labour migration anIPPR Fact File

Institute for Public Policy Research (15 June 2004) –Labour Migration to the UK an IPPR Fact File

Public Services International (June 2004) Kim VanEyck, Ph.D, Consultant for PSI, Women andInternational Migration in the Health Sector. FinalReport of Public Services International’sParticipatory Action Research 2003.

Communication from the Commission to theCouncil, the European Parliament, the EuropeanEconomic and Social Committee and theCommittee of the Regions (16 July 2004) FirstAnnual Report on Migration and Integration.

Trade Union Congress (November 2004) Proppingup rural and small town Britain – Migrant workersfrom the New Europe.

Medact (January 2005), Matt Gordon and JudithBueno de Mesqita, The International Labour Migrationof Health Workers: A Human Rights Analysis.


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H M Government Home Office (February 2005) –Controlling our borders: Making Migration work forBritain – Five-year strategy for asylum and immigration

Medact, (February 2005), Kwadwo Mensah,Maureen Mackintosh and Leroi Henry – The SkillsDrain of Health Professionals from the DevelopingWord: a Framework for Policy Formulation

Home Office, Office of the Deputy Prime Minister(22 February 2005) Accession Monitoring ReportMay-December 2004Migration and HIV/AIDS in Europe

Report to the AUT and NATFHE, (April 2005), AlexNunn. The ‘Brain Drain’ Academic and SkilledMigration to the UK and its impact on Africa.

Caribbean Commission on Health andDevelopment, (May 2005), Prof. Clive Thomas, Dr.Roger Hosein, Dr. Jean Yan. Assessing The ExportOf Nursing Services as a Diversification Option ForCaricom Countries.

Economic and Social Research Council, (12 May2005), Dustmann C, Glitz A. Immigration, Jobs andWages: Theory, Evidence and Opinion.

The Lancet. Vol 365, Issue 9474, 28 May 2005.Eastwood J, Conroy R, Naicker S, West P, Tutt R,Plange-Rhule J. Loss of health professionals fromsub-Saharan Africa: the pivotal role of the UK.

Home Office, (19 July 2005), Consultation Paper,Making Migration Work for Britain.

King’s Fund. Working Paper, (September 2005),James Bucan, Renu Jobanputra, Pippa Gough andRuth Hutt. Internationally Recruited Nurses inLondon. Profile and implications for policy.

Global Commission on International Migration,(October 2005), Migration in an interconnectedworld: New directions for action.

AARP Public Policy Institute. ( October 2005 ), DonaldL. Redfoot, Ari N. Houser. “We Shall Travel On”:Quality of Care, Economic Development, and theInternational Migration of Long-Term Care Workers.

International Labour Office (9 December 2005)Key Indicators of the Labour Market. 4th Edition.

International Organisation for Migration, 2005,World Migration 2005. Costs and Benefits ofInternational Migration.

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Other useful sources

www.oecd.org • Trends in international Migration ReflectIncreasing Labour-related immigration andPersistent Integration Problems.• Inflows of foreign workers into selected OECDcountries• Migration flows to major OECD countries seemto be stabilising, data show. 22 March 2005.

http://news.bbc.co.uk/1/hi/world/africa/3629657.stm - South Africa's brain drain dilemma

http://uninet/information_resource_centre • Migration Population by Regions and in theWorld (2000)

http://www.migrationinformation.org/Feature/display.cfm?ID=251 – Migration Information Sources –Changing configurations of Migration in Africa

http://news.bbc.co.uk/1/hi/uk/3223560.stm • Woes of Boston's 'gang workers'• Misery of Lincolnshire's migrant workers

http://www.unison.org.uk/features/features/0408frontiers.asp – Working across frontiers

http://www.manchester.ac.uk/research/ OrganisingMigrant Workers: A Case Study of a UnionOrganising Campaign at a Sandwich Factory inLondon

http://www.cre.gov.uk A recipe for tension

www.ilo.org International Labour Organisation –Current dynamics of International labour migration:Globalisation and regional integration

http://www.ipsnews.net Thaliff Deen – LabourMigration a Mixed Blessing, says UN 15 March2005

http://www.lrd.org.uk/default.php3• Labour Research Department LRD publicationsonline April 2005 – Immigration debate overlooksworkers' right• August 2003 – Unions urged to recruit moremigrant workers• May 2003 – Unions discuss strategies on racismand migrant workers• December 2004 Union learning engagesmigrants

http://news.bbc.co.uk/1/hi/uk_politics/ BBC News.Labour's migration battle8 February 2005.

www.iom.int IOM. Too many myths and notenough reality on migration issues, says IOM'sWorld Migration Report. 22 June 2005.


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Website Addresses

AARP Public Policy Institutewww.aarp.org

Citizens Advice Bureau.www.citizensadvice.org.uk

European Commissionwww.europa.eu.int/comm/

European Trade Union Federationwww.etuc.org

Global Commission on International Migrationwww.gcim.org/en/

Human Rights Watchwww.hrw.org

Immigration and Advisory Servicewww.iasuk.org

International Confederation of Free Trade Unionswww.icftu.org

Institute of Employment Rightswww.ier.org.uk

International Labour Organisationwww.ilo.org

International Monetary Fundwww.imf.org

International Organisation for Migrationwww.iom.int

Institute of Public Policy Researchwww.ippr.org

Institute of Race Relationswww.irr.org.uk

International Council of Nurseswww.icn.ch

Joint Council for the Welfare of Immigrantswww.jcwi.org.uk

Migration Alliancewww.migrationalliance.org.uk

Moving Here. 200 years of migration to Englandwww.movinghere.org.uk

Nursing and Midwifery Council, UKwww.nmc-uk.org

Organisation for Economic Co-operation andDevelopmentwww.oecd.org

Public Services Internationalwww.world-psi.org

Refugee Councilwww.refugeecouncil.org.uk/

Royal College of Nursingwww.rcn.org.uk

South African Nursing Councilwww.sanc.co.za

SOLIDARwww.solidar.org

The UK Parliament (Hansard)www.parliament.the-stationery-office.co.uk/

UK Department of Enterprise, Trade and Employment.www.entemp.ie/labour

UK Department of Healthwww.dh.gov.uk

UK Department for International Developmentwww.dfid.gov.uk

Voluntary Service Overseaswww.vso.org.uk

Working in the UK (Home Office)www.workingintheuk.gov.uk

World Health Organisationwww.who.int.


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