Circular Migration of Healthcare Professionals: International Organizations and Public and Private Employer’s Perception

September 2013 – January 2014


Circular migration has recently been promoted as a triple win solution to migration. It has been said to benefit destination and source countries, and migrant workers themselves. Further, it has been hailed as a process susceptible to increase the development benefits of labour migration. Circular migration is a particularly sensitive issue, which is often defined and understood differently by different stakeholders. There does not seem to be yet a clear understanding of the concept, an analysis of it and how it can be implemented.

This concept has been widely used and promoted in particular by certain member states of the European Union and the EU itself. From the position of destination countries, circular migration seems to be an answer to an existing need to fill seasonal or other temporary jobs, which may – or may not – corresponds to the needs for human resources in the health and care sectors. From that same perspective, as stated by the European Policy Center, “circular migration could be a way of filling gaps in the labour market without having to fully integrate those who only come for a limited period of time, or on a seasonal basis”. Academics have also contributed to the debate on circular migration.

Nonetheless, the existing literature seems to remain at a rather general level, and lack a detailed analysis of the position susceptible to be adopted by various sectors of the society, with regards to circular migration. It appears that a more detailed analysis of the opportunities and challenges of circular migration would be needed in order to state on the much announced “win-win-win” gains it can have, especially in the context of the migration of health professionals.

Trying to address this gap, in 2011, a paper was published by the Mr Piyasiri Wicramasekara under the Global Union Research Network that looked at circular migration from the perspective of the workers organisation.
The study concludes that:
There is little evidence to support that circular migration represents the natural preferences of most migrants. It is difficult to see migrant workers as winners in circular schemes since they have limited choice regarding the jobs, change of employers, timing of return, and family unification, among others. Countries of origin are hardly winners either, given the small quotas of legal migration opportunities provided, if any, and the large concessions they have to make to gain such quotas as under European Union mobility partnerships.

The current model seems to make the destination countries winners in providing them ‘labour without people’, or circular migrants with ill-defined rights, making it easier for employers to exploit workers, and engage in flexible hiring and firing, in line with economic and business conditions, and short term savings in integration costs.

Yet, very little information exists with regard to the employers’ perspective relating to circular migration. This has been confirmed by the ILO-DWAB through an initial review of existing literature on the very same matter, which was conducted in the spring April 2012.
The ILO therefore sees the opportunity to expand the knowledge on the subject and contribute to the international debate by documenting the sending and receiving countries’ private and public employers’ perspective on the issue of circular migration. This is necessary to foster informed policy dialogue on this issue.

Assignment Overview

In 2011, the European Union awarded the ILO funding to better understand the issue of circular migration (INT/09/11/EEC), especially of health professionals. This project, named Decent Work Across Borders (DWAB) project: A Pilot project for Migrant Health Professionals and Skilled Workers, seeks to facilitate an approach to migration that benefits migrant workers, and the source and destination countries within a rights-based framework for labor migration management. A component of this project will be to address the need to raise the awareness of the challenges associated with access and portability of social protection of trade unions in source and host countries and to build their capacity to address those challenges.

This study aims to document the opinions of public and private employers of health professionals with what concerns migration of health professionals and in particular the opportunities and challenges associated with the concept of circular migration of such skilled workers. The assignment will put specific emphasis on Filipinos, Indian and Vietnamese health professional migrant workers to Europe and associated public and private employers. The study employs a review of relevant literature and the conduct of key informant interviews covering the impact/effect of circular migration on the quality of care provided, cost of circular migration patterns, training of circular migration patterns and other opportunities and challenges associated with circular migration. This segment of the project commenced on 23 September 2013 and will end on 31 January 2014.