The migration inflow is a variable considered in the Dutch forecasting model.
The planning system can take into account different policies for the health care system: complete self-providing, minor or major intake (in numbers) of health care personnel from foreign countries, emigration to foreign countries.
- Migration inflow three input parameters in the model:
- Annual immigration
- Gender frequencies immigration
- Yield immigration
We start out with the number of medical specialists with a foreign diploma that have been registered by the National Medical Registration Committee. We have data on gender, age, country of the diploma and specialization also.
As a reference: The national training program renders an influx of 2000 newly registered medical specialists per year.
Although some information can be used about past international migration this still remains a difficult element to estimate as it presumably strongly correlates with the labour market conditions in other countries. This is why estimation by expert groups on the future number of foreign trained health professionals are required. In 2010, experts expected that the yearly inflow of foreign medical specialists into The Netherlands would diminish due to more elaborate “stick and stay policies” in other European countries. This resulted in an increase in the number of medical graduates entering training programs by more than 10%. In 2013, on the basis of the data then available, it was decided to re-establish the immigration flow in the model. As far as the yield is concerned, we know that roughly 60% of the registered medical specialists reregister 5 years after their first registration. These medical specialists have been working in The Netherlands, else they cannot reregister.
The data source is Medical Registration Committee (RGS) for historical information on the alleged immigration of medical specialists. Entry in the register is not the same as actual immigration. In half of the cases, a foreign medical specialist enters the register and declines a position as specialist later on. We use the BIG register for historical information on immigration of medical graduates and dentists. Here, the same caution must be taken.
Expert estimations for future migration are also required.
For instance, questions typically asked will include their potential desire and/or reasons for wanting to go abroad.
“We will discuss the parameters with lacking quantitative data (almost always the epidemiological and socio-cultural parameters plus working process parameters like vertical substitution and labour time changes) with experts in different ways. Interviewing them separately, discussing in Delphi-like settings, meetings in our Chambers, and electronic group decision rooms, workshops, depending on the preferences of the group. The experts are from all three parties: insurance companies, universities/ hospitals, and the professionals. They have to reach consensus” (WP6 D061 – User guidelines on qualitative methods in health workforce planningand forecasting)
- Migration outflow has not been monitored until 2014 because it was not considered to be of any significance by all stakeholders. In 2014 a project has started to determine the outflow to other European countries. This monitoring of already existing data will go back to the year 2000 and will result in more knowledge on the outflow and the net result of inflow and outflow by the end of 2015.
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