Medical staff exodus takes toll on new member states

English language skills and two years of experience after graduation were the minimum requirements for landing a job in a British hospital, for salaries as much as ten times higher than those in Romania.

The event was by no means unique. In October, a similar medical career job fair advertised job offers in French, German, Belgian and Scandinavian hospitals for salaries ranging between €3,000 and €7,000 a month. In Romania, the EU's newest member state, a specialised radiologist, for instance, earns €500 a month, while living costs and food prices are comparable to those of Western states.

Ever since it joined the EU in 2007, Romania, similar with other new member states, is facing an exodus of its 'white-coat' staff. Unlike for construction workers, doctors and nurses from this new member country face no restriction on the labour markets in old member states.

Some 5,000 medical staff out of the 41,000 employed in the public health system have left in the last three years. "The loss is huge. The World Health Organisation says that when doctors' migration exceeds two percent, the state must declare a code red and take measures to counteract the trend. In Romania, they should have declared a code 'super-red'," Vasile Astarastoae, the head of the Romanian Medical Council told Realitatea TV last month.

Over 2,000 other doctors and nurses are expected to leave the country in the first quarter of 2010, as they have signed up to offers put out in job fairs such as the one that took place over the past weekend.

The white-coat staff brain drain is particularly worrying since Romania has the lowest density of physicians per inhabitants in Europe.

The last study carried out by the EU commission in 2008, which is however based on 2005 data, shows Romania and Poland with the lowest density of practicing physicians per 100,000 inhabitants, at around 30 percent below the EU average.

Poor working conditions, long hours, pay cuts - especially due to the current budgetary policies imposed by the International Monetary Fund bailout - are even more reasons for Romanian doctors to eye jobs abroad.

"I think it's undoubtedly a problem when richer countries are sucking trained manpower from poorer ones. But the economic drivers will be there until there are comparable salaries and working conditions across the EU," David Gordon, head of the Association of Medical Schools in Europe told this website.

There is not much Brussels can do against this east-west migration, as the European Commission is supposed to safeguard freedom of movement and services across the bloc, not to hamper it, Mr Gordon said.

However, restrictions could be taken at national level, for instance in linking free medical education to a minimum of years spent in the country's hospitals.

Indeed, the commission's initiatives in this field so far have stressed that "the response to tackling the effects of increased mobility is not to introduce legal restrictions to the free movement of students or workers." Instead, the EU executive pleads for better co-ordination between member states and more information on the flow of medical staff.

Small constituencies

Similar to Romania, the Czech Republic has also experienced a steady flow of doctors heading abroad. Patric Tomasch is one of them. After having worked in several German hospitals, he returned to Prague and started up a small recruiting company for Czech and Slovak doctors.

"In the Czech Republic, doctors are a small constituency, so politicians don't really care about them. They've been letting them go for a number of years now. Recently, the government has started to campaign for Romanian doctors to replace the missing Czech employees," he told EUobserver.

Similar to other professionals, Mr Tomasch does not favour EU-wide restrictions on the free movement of doctors. "Most of these Czech and Slovak doctors will return home anyway after some time. The solution is to pay them better in their home countries and they will not leave," he argues.

EUobserver's special focus section delves into the challenges confronting healthcare, this most cherished element of the European welfare state. See more: Health Focus