Report on PSI Health Migration Workshop: “Building Union Solidarity and Protection for Workers on the Move,” Durban 2012

SVdarkREPORT: Highlights of the 2012 Public Service International Health Migration Seminar-Workshop

“Building Union Solidarity and Protection for Workers on the Move”

Durban, South Africa, November 22-23, 2012

 by Salimah Valiani, PhD

Economist, Policy Analyst

Ontario Nurses’ Association

December 11, 2012

Public Service International (PSI) is the global public sector union federation bringing together more than 20 million workers of 650 unions, in 148 countries and territories. As stated in the PSI website, two-thirds of PSI members are women, working in social services, health care, municipal and community services, central government, and public utilities such as water and electricity.[1]

PSI holds its World Congress, or convention, every five years. This year marked PSI’s 29th World Congress, which was held in Durban, South Africa. I was invited to present analysis and action recommendations on the global integration of nursing labour markets at a pre-Congress event on health labour migration entitled “Building Union Solidarity and Protection for Workers on the Move.”[2] This seminar/workshop was organized by the PSI Migration and Health and Social Care Workers’ Programme, and was aimed at showcasing recent research completed in the Programme as well as finalizing its action plan for the 2013-2017 period. 

This report features highlights of the seminar-workshop, held November 22-23. The pre-Congress events were followed by the PSI World Congress (November 27-30).

Peter Waldorf, PSI General Secretary

  • The United Nations will hold a High Level Dialogue on Migration in 2013 – the second one following the first in 2007.
  • 37 affiliated unions from 20 different countries are involved in PSI’s Global Programme on International Migration and Women Health and Social Care Workers.
  • The Programme’s latest project is the “PSI Mapping and Participatory Research on Migration in the Health and Social Care Sectors.”[3]

Jane Pillinger, PhD, PSI Research Consultant

  • The research project involved over 1000 interviews by health union activists with migrant health workers, government officials and civil servants in Ghana, Philippines, Kenya, South Africa, the United Kingdom, the USA and Australia.
  • Among the countries studied, South Africa and Ghana had the highest levels of union density in the health sector, with South Africa at 40 per cent, and Ghana at 68 per cent.
  • Key to the strength of health workers’ unions in South Africa and Ghana is the cross-union, cross-occupational cooperation in the health sector. More specifically, the Agreement for Occupation Specific Bargaining (2007) in South Africa has allowed for increased wages for health workers, and in turn, decreased emigration. In Ghana, the 2006 Health Sector Salary Structure has achieved the same ends.

Jennifer Owyer, Kenya Local Government Employees Union

  • For the 38 million population of Kenya, 80,000 health workers are required to serve the population. Currently in Kenya there are only 28,000 health workers.
  •  The retirement age for nurses in Kenya has been increased to 60 to try and retain nurses in the Kenya health labour force as increasing numbers of young nurses emigrate.

Rosa Pavanelli, FPCGIL (Italy) and newly elected General Secretary of PSI

  • The European public sector union federation (EPSU) and the European Hospital and Healthcare Employers Association have been collaborating on a Code of Conduct for Ethical Cross-Border Recruitment in the health sector. The Code consists of 12 principles (ex. freedom of association for migrant health workers, fair and transparent contracts).
  • Given current austerity policies, this approach is no longer viable as governments are in the process of cutting the public sector workers, including those who would regulate around the Code of Conduct.
  • Nevertheless, in Italy, FPCGIL has used the 12 principles to review collective bargaining demands and assure that the union is negotiating the correct articles in collective agreements to protect migrant health workers’ rights.

Jillian Roque, Public Services Labour Independent Confederation – PSLINK (Philippines)

  • Memorandums of Understanding (MOU) on labour are another means of assuring ethical recruitment of health workers. The Philippines-Bahrain MOU on labour includes clauses assuring equal treatment of Filipino health workers employed in Bahrain, and a commitment by Bahrain to invest in the upgrading of health facilities and training institutes in the Philippines.

Abu Kuntolo, Health Service Workers’ Union (Ghana)

  • Health sector unions in Ghana, including the Ghana Registered Nurses’ Association, and unions representing physicians and other health workers collaborate through a unified salary structure. This salary structure is the product of much effort over the years, and together these unions meet with government to negotiate the spending of public funds in the health system.
  • One of the impacts of the unified salary structure is increasing wages for nurses and midwives. This has fed into a falling rate of attrition of nurses and midwives, from 38 per cent to 12 per cent in the past five years.

Perpetual Ofori-Ampofo, Health Service Workers’ Union (Ghana)

  • Health workers unions in Ghana are currently lobbying government around measures to reintegrate migrant health workers when they return to Ghana. The unions are also considering their role in reintegrating migrant health workers. This is crucial given the rising levels of temporary migration by health workers (i.e. on the basis of temporary work permits).
  • The Ministry of the Interior in Ghana is now developing a national migration policy.

 Annie Geron, Public Services Labour Independent Confederation – PSLINK (Philippines)

  • Ten mothers die giving birth daily in the Philippines. This is one of the effects of nurse emigration and the shortage of nurses in the Philippines health system.
  •  The International Labour Organization and European Union have initiated the Decent Work Across Borders Project. PSLINK is involved and the focus for the Philippines component of the project is nurse emigration.

Shirley Lee, New South Wales Nurses’ Association (Australia)

  • There are 56,000 members in the union, including 3,929 migrant nurses from 129 countries.
  • Fiji, Samoa, the Philippines, and African countries are some of the large sources of migrant nurses employed in Australia.
  • The union held a symposium on migrant nurses in October 2011.
  • The key issues arising for migrant nurses in New South Wales are the lack of information prior to emigrating, lack of support upon arrival in New South Wales, lack of recognition of prior learning and experience, the cost of bridging programs and registration, the cost of work visas, and the cost of living given that most migrant nurses are not earning wages equal to those of locally-based nurses.


[2] My presentation was based on my new book, Rethinking Unequal Exchange: the global integration of nursing labour markets (University of Toronto Press: 2012). For a copy of the presentation, “Temporary Migration and the Global Integration of Nursing Labour Markets: Analysis and Proposals for Action”, contact me at


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s