Fiji signs up to national registration

A NSW symposium canvassed the latest trends in nurse migration, reports Linda Belardi.

In the past decade, Fiji has lost 57 per cent of its graduating nurses to external migration, the head of the Fiji Nurses' Association has told a Sydney audience.

The union's general secretary, Kuini Lutua, said between 2000 and 2010 Fiji trained 1381 nurses but only kept 372 - a retention rate of 27 per cent.

A further 17 per cent retired or died while in the workforce. Last year alone, nurses made up 50 per cent of all resignations from the local health workforce to take up positions overseas.

"In 2010 the total number of health professionals that resigned to migrate overseas was 64 and of that number - 30 were nurses," Lutua told the symposium, co-hosted by the NSW Nurses' Association and Public Services International.

Nurses are also trained and lost in the highest numbers when compared to other health workers such as doctors and dentists.

The Fijian exodus can be traced to a diverse range of destination countries, including New Zealand, Australia, the Caribbean and the United Arab Emirates.

Last year, Fiji sent its first nurse to Iraq - one of the island nation's few nurse practitioners. "Iraq is a new interest at the moment. We are receiving a lot of enquiries from Iraq wanting to recruit Fijian nurses."

Internally, Fiji also loses publicly trained nurses to the nation's three private hospitals and to big business. The hotel industry, Fiji's sugar corporation and forestry industries have all started poaching nurses from the public health system, she said.

Lutua said poor career pathways, low wages and political instability are driving the international migration of nurses, and new graduates were the most vulnerable to this trend.

Job insecurity is an ongoing concern and for the last decade all civil servants have experienced a wage freeze. "Nurses who graduated in 2000 are sitting on the same salary as a nurse who graduated in 2010, despite the rising cost of living."

Since 2009, Fiji's interim military government mandated compulsory retirement within the public sector at age 55 and all new graduates were placed on three-year contracts.

However, Lutua noted some important changes. In November 2009, in an effort to meet the chronic shortage of nurses, cabinet approved 510 new positions over the next three years. This means that the government has committed to employing all new graduates in the public sector between 2010-2012.

"The cabinet has also approved an increase in the student nurse intake. We used to train between 100 to 120 nurses per year but under that agreement the government has committed to increase that number to 200."

Lutua said it was too early to see the effects of this net increase in training positions.

In a small win, the union also successfully negotiated a 3 per cent salary rise for nurses at the end of 2010. However, this outcome was significantly lower than the wage increases for the military and police, she said.

Mentoring has also begun to help fill the vacuum created with the loss of experienced nurses retiring at age 55.

"We have convinced the government that they must rehire the retired nurses who turned 55 for 12 months to retrain people to take over," she said.

While the loss of locally trained nurses overseas is significant, Lutua said interestingly Fiji is also a destination country for foreign nurses. The association has received inquiries from nurses in India, Canada, New Zealand, Australia and the UK.

Annual registration for local and international nurses

Following in the footsteps of Australia and New Zealand, Fiji's interim government passed laws in September introducing a national system to regulate the nursing workforce.

All local and foreign nurses will now have to renew their practicing licence annually with the newly created Fiji Nursing Council to be able to work in the country.

A Professional Conduct Committee appointed by the Minister for Health and the Fiji College of Nursing will also be created. Continued professional development will now be required of every registered nurse and nurses unable to meet required competencies will have their licences revoked or suspended.

Lutua called upon her Australian and New Zealand colleagues to share their lessons of national registration with the association as it prepares for the changes.

The symposium, Nurses on the move: Migration in the Health and Social sector, was held in October by the NSW Nurses' Association in conjunction with Public Services International.

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