Freedom of movement is increasingly valued by professionals in the EU/EFTA area. This, comes from a 2022 EurActiv Survey, where 58% of EU citizens felt that Free Movement of Workers was a positive step for the labour market. This up from 45% in 2009.
With 17% of the survey respondents saying they had already worked in another EU country and another 18% saying they intended to do so in the future, the question to ask his, how many workers could be bound for Switzerland in future?
In this post, we take a look the medical sector and how Swiss hospitals are increasingly looking to recruit nursing staff from abroad to solve staff shortages. Here some interesting facts:
- Switzerland has joint highest density of nursing staff per capita in the world with 18 nurses to each 1’000 inhabitants in 2019. The other country with the same number is Norway. In comparison the UK in mid table position, has 8.7 staff per 1’000 inhabitants.
- In effect his represents about 2 x the average for similar countries as measured by the OECD
- At between 30-40% of the total, Switzerland also has a high proportion of foreign nursing staff.
- Many cross-border workers are employed in hospitals located near the country’s border, for example in Basel and Geneva.
- Hospitals in other non-border areas of Switzerland are also witnessing higher numbers of foreign staff being engaged.
This situation is not predicted to change anytime soon. And with the shortage of skilled workers growing in Switzerland as well as other European countries, competition for nursing staff in particular has intensified over recent years.
With neighbouring countries speaking 3 of the 4 languages used in Switzerland, recruiting “near shore” has become popular for Swiss hospitals. But if some media reports are anything to go by, recruitment of staff from neighbouring countries has not gone noticed. And Yvonne Ribi of the Swiss Professional Association of Nurses, considers this approach inadequate – even harmful and unethical and according to her “By doing this, Switzerland is taking staff away from other countries, which exacerbates shortages there.”
So how are the staff recruited? Many applications are passive and received directly, however there are also pro-active agency recruitments such as with the Carenea agency which is specialised in recruiting polish nationals. This is useful for preparing candidates for linguistic and cultural challenges when coming to Switzerland. Language skills and the Swiss Red Cross’s recognition of diplomas are prerequisites for employment in Switzerland.
Given the Free Movement of Persons was designed to offer job opportunities for people living in one EU/EFTA country to enable them to engage in work in another country, the current situation could be interpreted as being one of “headhunting” rather than “problem solving”.
Yvonne Ribi also explains the issues by citing Germany as an example. According to her: “If German medical staff migrate to Switzerland, then German hospitals will have to recruit specialists in Poland, for example. The gaps in Poland, in turn, might be filled with employees from Romania; and so on, setting off an “unhealthy domino effect.” Movement of masses of skilled workers can also lead to economic losses.”
Ethical Recruitment
However, despite fears that this situation is not sustainable, proponents feel that there is a good balance to the recruitment system. For example, in Italy with high unemployment, there are only 6.6 nurses to every 1’000 patients. And a job offer in Switzerland usually means better working conditions as well as career prospects for the applicant..
A World Health Organisation Code of Conduc was signed in 2011 by Switzerland. The main focus being the recommendation of ethical principles in international recruitment. The main points being:
- Each country must train enough of its own personnel.
- Appropriate measures should also be taken to retain them.
- International recruitment in numerous countries is a sign of the failure to meet these goals.
But the fact is Switzerland significantly benefited from international recruitment in the medical sector during the recent pandemic. It became quickly apparent at this time, that Switzerland had to recruit personnel from the EU/EFTA to support its overburdened health system. This according to a SECO report.
- In 2020 63,000 people were engaged in the entire health sector.
- An additional 13,000 coming from third countries, equating to almost 25% of all professionals in the sector.
According to Yvonne Ribi, the pandemic made people really aware of the dependencies the Pandemic created, with “Around 2/3 of all foreign staff being cross-border commuters.” This did in fact cause deep concern and regular diplomatic exchanges when strict lock-downs were imposed.
Measures required and taken
Hospitals in Switzerland generally acknowledge that recruitment abroad can only be part of the solution. And in one example of thinking out of the box, the Canton Hospital in Aarau now offers other incentives to recruit local staff such as:
- Re-entry programmes for nurses.
- Training and further education opportunities.
- Bonuses for night and weekend shifts.
This makes sense as on hand it addresses how to recruit more skilled and experienced staff from local sources, but also covers issues such as staff retention. A vote called the nursing initiative was brought to the vote in 2021 and was accepted by the Swiss electorate with 61% in favour.
- The first step of the initiative is a training campaign, with additional costs of CHF500 million approved by the Swiss Government.
- The second part focuses on the subjects of working conditions, professional development and remuneration of care services.
The subject of recruiting of nurses and medical staff from outside of Switzerland has been taking place for a long time. The recent Global Pandemic highlighted the problem bringing it to the attention of a wider Swiss public. Sector initiatives and Governmental steps are now being taken to encourage local skilled workers to return to the nursing profession and stay longer. But recruitment from abroad remains and the general situation will take longer to solve. And partly due to high living costs in Switzerland, it is not always easy to convince foreign nationals to move to Switzerland to work.
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