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Mismatches in the Formal Sector, Expansion of the Informal Sector: Immigration of Health Professionals to Italy

Listed author(s):
  • Jonathan Chaloff


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    Italy has an aging population which is placing a strain on the public health system and on families. At the same time, it has a distorted market of supply of health professionals. Past over enrolment in medical faculties has produced a current glut of doctors, although shortages will appear as this cohort retires. It is difficult for foreign-trained doctors, and Italian-trained foreigners, to practice medicine in Italy. In nursing, the situation is more critical, with far fewer graduates of nursing schools than necessary even to meet replacement needs. Care for the aged, which was traditionally borne by families, has increasingly been delegated to informal immigrant workers. In the absence of major changes in the care industry, recruitment efforts for nurses and other health technicians has expanded to include other source countries. Obstacles to international recruitment of nurses have been reduced, both by simplifying recognition of foreign qualifications and by exempting nurses from limits on labour migration to Italy. However, a ban on permanent employment in the public sector has relegated foreign nurses largely to private sector and shorter-term contract work. National and local health authorities have also become involved in supporting international recruitment of nurses, often through private agencies. In the home-care sector, families have been granted more opportunities to hire care workers from abroad legally, and many local authorities are attempting to integrate this spontaneous private care into their eldercare system through skill upgrades and support. Nonetheless, international migration will not be sufficient to solve Italy’s health care professional needs. Le vieillissement de la population en Italie pèse lourdement sur le système de santé public et les familles. Parallèlement, l’offre de professionnels de la santé sur le marché du travail est déséquilibré. Dans le passé, le nombre excessif d’inscriptions dans les facultés de médecine a entrainé une surabondance de médecins, mais des pénuries apparaîtront au fur et à mesure qu’ils partiront à la retraite. Il est difficile pour les médecins ayant étudié à l’étranger et les immigrés qui se sont qualifiés en Italie d’exercer la médecine dans ce pays. En ce qui concerne les infirmières, la situation est plus critique, avec un trop petit nombre de diplômés des écoles d’infirmières, même pour satisfaire uniquement les besoins de remplacement. Les soins aux personnes âgées, incombant traditionnellement aux familles, ont été de plus en plus délégués aux immigrés du secteur informel. En l’absence de changements majeurs dans les politiques de la santé, des efforts ont été faits pour recruter des infirmières et personnels de santé dans d’autres pays d’origine. La simplification de la reconnaissance des qualifications acquises à l’étranger et l’exemption de quotas d’infirmières étrangères sur le marché du travail en Italie ont réduit les obstacles au recrutement international d’infirmières. Cependant, l’interdiction de les employer de façon permanente dans le secteur public a relégué la majorité des infirmières étrangères dans le secteur privé et dans les contrats de travail à court terme. L’administration sanitaire nationale et locale a aussi contribué au recrutement international des infirmières souvent par le biais d’agences privées. Dans le secteur des soins à domicile, les familles se sont vu octroyer plus d’opportunités pour recruter légalement à l’étranger du personnel de soins à domicile. Beaucoup d’autorités locales s’efforcent d’intégrer ce type de soins privés dans leurs systèmes de soins aux personnes âgées en assistant les personnels soignants privés et en renforçant leurs compétences. Néanmoins, les migrations internationales ne seront pas suffisantes pour répondre aux besoins de l’Italie en professionnels de la santé.

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    Paper provided by OECD Publishing in its series OECD Health Working Papers with number 34.

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    Date of creation: 01 Oct 2008
    Handle: RePEc:oec:elsaad:34-en
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