Tufton prescribes flexi-work contracts between Ja, overseas health sector

Health Minister Dr Christopher Tufton pleaded with first-world countries recently to consider flexi-contracts with locally produced practitioners and have them return to their homeland for some months each year. This as the nation continues to register an alarming rate of brain drain through nurse migration.

Each year, between 20 per cent and 25 per cent of nurses, for example, apply to the Nursing Council of Jamaica for validation of their certification in order to relocate, primarily to North America and, to a lesser extent, the United Kingdom.

In an address on Thursday before the official signing of an agreement/communiqué between Jamaica and the Philippines, Tufton said this greatly affects all divisions of the healthcare sector.The agreement followed a bilateral meeting two days earlier within the margins of the 77th World Health Assembly (WHA77) in Geneva, Switzerland.

The health minister noted that, as an example, in neonatal emergency care units, there is a one to eight or one to 10 ratio of nurses to children, while the benchmark standard should be one to one or at least one to two.

““It is a major issue and Jamaica is a net supplier of healthcare workers, primarily to North America, and, to a lesser extent, the United Kingdom … . It leaves us at a significant disadvantage, and it’s not that we’re not training people well. In fact, we’re probably training them so well, (that is) why that demand is there,” Tufton said.

Addressing the other world leaders present to witness the signing of the agreement/communiqué, he added:

“I am proposing that we take this as a more important imperative for the global collaboration to take place, because the reality is, it is short sighted. And I’m speaking now to the demand countries primarily, not to ignore this critical component ... it requires a resolution, it requires a commitment to this cause,” he said.

LEVELS OF EQUITY

Tufton argued further that Jamaica has proposals and the only way to get them going is to collaborate because there are clinical rotation spaces that are short in small countries.

“There’s a shortage of faculty. We can do this through technology and remotely, but I believe also, since we cannot stop the mobility of labour, we should allow for flexi-contracts where this takes place, so the worker can in fact move between jurisdictions,” Tufton said.

“In the case of Jamaica, we have no problem with a specialist nurse working in Miami for five months of the year [and] working in Jamaica for seven months of the year. That requires a collaboration, a determination and a flexibility which I believe we have the power so to do,” he said.

Tufton thanked Dr Teodoro Herbosa, secretary of health of the Republic of the Philippines, who signed the agreement, for his “amazing leadership displayed by putting the event on”.

Tufton said it was a very important initiative and thanked the Philippines for placing it on the table.

“From Jamaica’s perspective, we are very vocal about this. We need fundamental change if we are to achieve the levels of equity that we all desire,” he said.

With regard to the brain drain of nurses, Tufton said “the global code”, from Jamaica’s perspective, has been observed more in its breach than in its practice, which has been a reality for many countries, including small island states.

“The big issue here at the WHA ( around pandemic treaty), is that it is unlikely to achieve its full potential if the movers and shakers, particularly the larger countries, the demand countries, do not place greater emphasis on the HR variable of what represents or should represent a pandemic treaty,” Tufton said.

He said equity and access to healthcare is the only solution to the risk that Jamaica faces, especially coming out of the COVID-19 pandemic.

“There is no equity presently as it relate to HR. In fact, I dare say, it is so inequitable. It is unfair, because small countries like Jamaica, spend significant resources training their healthcare workers, only for recruiters to enter our shores on the eve of their graduation, and apply to our nursing council, our medical council or otherwise, offer very attractive packages, waive entry barriers into these countries, pay off student loans, offer permanent residency, and then, of course, leave small countries like Jamaica having the less than adequate healthcare workers,” Tufton said.

NURSING DENSITY

The Ministry of Health & Wellness reports that, the impact of shortage of nurses to the island includes: inadequate nursing care/service delivery, decreased nurse-to-patient ratio, increase in patient waiting time (especially admission to the intensive care unit – ICU – in relation to critical care nurses), increase in absenteeism, staff burnout, medication errors, increased litigation and a decrease in monitoring and supervision.

NCJ data indicates that, in 2023, the Council processed 1,140 requests from foreign entities for verification of licences. The majority, 1,080 of the requests, were related to registered nurses and, while not able to determine how many are specialist, represented 94.7 per cent, which also represents 22.6 per cent of present cadre.

Based on the current workforce situation, Jamaica’s nursing density is 14 per 10,000 of population while the World Health Organization’s (WHO) recommendation is 70 per 10,000.

A more accurate calculation of migration of nurses from Jamaica is difficult to determine because there is no database on the migration of nurses and midwives. However, approximately 360 nurses separated from the service in 2023 (8.9 per cent of the cadre of 4022) and 583 in 2022 (14.5 per cent of cadre of 4011). In the year 2024 (between January and March) 100 nurses (84 registered nurses) separated from Jamaica.

ainsworth.morris@gleanerjm.com