THE HSE CONTINUED to recruit nurses from Zimbabwe, Ghana and Nigeria for over a month after they were added to the World Health Organisation’s (WHO) no-recruit list. 

The WHO keeps a list of countries with the most vulnerable health workforces to ensure more developed countries don’t poach from those systems already facing critical staff shortages. 

The three countries were added the WHO’s safeguarding list of 55 countries who are facing the most pressing healthcare challenges in the world on 8 March. 

Ireland is a voluntary member state in WHO’s Global Code on the International Recruitment of Health Personnel, which was launched in 2010 in light of the “global shortage of health personnel”. 

The code discourages member states from relying too heavily on migrant health workers, and specifically from developing countries facing critical health workforce shortages. 

The HSE’s recruitment “suppliers” ceased active recruitment in mid April. 

A spokesperson said that recruitment stopped “when the relevant unit in the HSE was aware that Zimbabwe, Ghana and Nigeria had been added to the list”.

The HSE has further stated that it will complete the recruitment process for the nurses and midwives who were given an offer of employment or a contract between March and April. 

The Journal has asked the HSE how many nurses from each country were provided with an offer of employment after the WHO list was published but no answer has been received by time of publication. 

In the first four months of 2023 (up to 30 April), the Nursing and Midwifery Board of Ireland (NMBI) had registered 2,283 nurses and midwives, including 2,227 from outside the EU.

“Nurses from Zimbabwe represent 6% of the applicants and 2% of midwifery applicants.  The overwhelming number of applicants are from India,” a spokesperson said of the overseas staff recruitment numbers.  

International recruitment to be made a criminal offence

Zimbabwe, in particular, has seen thousands of health service workers leave the country over the past year, to the extent that the government is now planning to make foreign recruitment a criminal offence. 

According to the Zimbabwe Medical Association, the country has an estimated 3,500 doctors for a population of 15 million. 

In contrast Ireland has over 18,000 practicing doctors for a population of 5.3 million, according to the Medical Council.

Vice President of Zimbabwe Constantino Chiwenga has said that people are dying in hospitals in the country because there are no nurses and doctors to treat them. 
He has labelled international recruitment of health workers a “crime against humanity”, and has compared it to human trafficking multiple times.

Healthworkers in the country were dismayed when a law was passed in Zimbabwe barring them for taking strike action for longer than three days. Striking for longer will now result in a fine, or a prison stay of up to six months. 

The move came after a week long strike over pay levels and economic conditions at the start of this year. 

Safeguarding

Back in 2013, Ireland was selected as the winner of the Health Worker Migration Policy Council Innovation Award for its commitment to upholding the principles of the WHO code around recruitment. 

The countries on the safeguarding list have a density of doctors, nurses and midwives below the global median (which is 49 per 10,000 people). 

In order to recruit from these countries, member states who abide by the WHO code are asked to broker a government-to-government agreement. 

The UK has ceased recruiting in Zimbabwe, which was the most popular destination for emigrating health workers, as it has now been added to the Government’s red list. 

In a response to The Journal, the HSE said, “The request to cease active recruitment in countries listed by the WHO has been implemented.”

It also added that it would not consider the one-month implementation time a delay.

The Journal has asked the Department of Health for comment.