Experiences of hospitals with foreign health workers: how current practices relate to European circular migration policy.

Summary Circular migration is the phenomenon of staff moving to another country and then returning to their home countries after some time. The European Union proposed a circular migration policy to solve predicted health worker shortages in 2020. Because there is lack of evidence about the applicability of the policy in healthcare organizations, this thesis studied the experiences of hospitals with foreign workers and examined how current practices relate to the European circular migration policy. Ten conducted interviews in Dutch and Belgium hospitals provided insight into current practices and experiences with foreign workers and topics related to circular migration. It showed that European migration is a relevant topic, although respondents perceived the need for staff in hospitals is not as urgent as presented in European reports. Employment of foreign workers was practice in most participating hospitals and European countries were most common as country of origin. Several forces of migration were distinguished: income, social capital, human capital and power. Regarding the employment of foreign workers, five barriers for hospitals were mentioned: communication, medical education, recognition of qualifications, cultural differences and medical-ethical issues. To overcome these barriers and enhance social embedding, organizational support is necessary. Regarding other elements of circular migration: it appeared that the temporary character and its European policy perspective did not fit into current practices of hospitals. Temporary labour is of common use, but not for foreign workers, and hospitals usually deal with national legislation instead of European regulations. Taking the barriers and healthcare characteristics into account, the European policy proposal is not likely to be successful in its current form. Several improvements could be made, for example to start on regional scale and cross-border networks. The European circular migration idea provides valuable insights, of which the good should be taken and the bad left aside.