National Reporting Instrument 2024
Background
[INFOxNRI1]
National Reporting instrument 2024
[BGxINT]
Background
Adopted in 2010 at the 63rd World Health Assembly (WHA Res 63.16), the WHO Global Code of Practice on the International Recruitment of Health Personnel (“the Code”) seeks to strengthen the understanding and ethical management of international health personnel recruitment through improved data, information, and international cooperation.
Article 7 of the Code encourages WHO Member States to exchange information on the international recruitment and migration of health personnel. The WHO Director General is mandated to report to the World Health Assembly every 3 years.
WHO Member States completed the 4th round of national reporting in May 2022. The WHO Director General reported progress on implementation to the 75th World Health Assembly in May 2022 (A75/14). The report on the fourth round highlighted the need to assess implications of health personnel emigration in the context of additional vulnerabilities brought about by the COVID-19 pandemic. For this purpose, the Expert Advisory Group on the relevance and effectiveness of the Code (A 73/9) was reconvened. Following the recommendations of the Expert Advisory Group, the Secretariat has published the WHO health workforce support and safeguards list 2023.
The National Reporting Instrument (NRI) is a country-based, self-assessment tool for information exchange and Code monitoring. The NRI enables WHO to collect and share current evidence and information on the international recruitment and migration of health personnel. The findings from the 5th round of national reporting will be presented to the Executive Board (EB156) in January 2025 in preparation for the 78th World Health Assembly.
The deadline for submitting reports is 31 August 2024.
Article 9 of the Code mandates the WHO Director General to periodically report to the World Health Assembly on the review of the Code’s effectiveness in achieving its stated objectives and suggestions for its improvement. In 2024 a Member-State led expert advisory group will be convened for the third review of the Code’s relevance and effectiveness. The final report of the review will be presented to the 78th World Health Assembly.
For any queries or clarifications on filling in the online questionnaire please contact us at WHOGlobalCode@who.int.
What is the WHO Global Code of Practice?
Disclaimer: The data and information collected through the National Reporting Instrument will be made publicly available via the NRI database (https://www.who.int/teams/health-workforce/migration/practice/reports-database) following the proceedings of the 78th World Health Assembly. The quantitative data will be used to inform the National Health Workforce Accounts data portal (http://www.apps.who.int/nhwaportal/).
Adopted in 2010 at the 63rd World Health Assembly (WHA Res 63.16), the WHO Global Code of Practice on the International Recruitment of Health Personnel (“the Code”) seeks to strengthen the understanding and ethical management of international health personnel recruitment through improved data, information, and international cooperation.
Article 7 of the Code encourages WHO Member States to exchange information on the international recruitment and migration of health personnel. The WHO Director General is mandated to report to the World Health Assembly every 3 years.
WHO Member States completed the 4th round of national reporting in May 2022. The WHO Director General reported progress on implementation to the 75th World Health Assembly in May 2022 (A75/14). The report on the fourth round highlighted the need to assess implications of health personnel emigration in the context of additional vulnerabilities brought about by the COVID-19 pandemic. For this purpose, the Expert Advisory Group on the relevance and effectiveness of the Code (A 73/9) was reconvened. Following the recommendations of the Expert Advisory Group, the Secretariat has published the WHO health workforce support and safeguards list 2023.
The National Reporting Instrument (NRI) is a country-based, self-assessment tool for information exchange and Code monitoring. The NRI enables WHO to collect and share current evidence and information on the international recruitment and migration of health personnel. The findings from the 5th round of national reporting will be presented to the Executive Board (EB156) in January 2025 in preparation for the 78th World Health Assembly.
The deadline for submitting reports is 31 August 2024.
Article 9 of the Code mandates the WHO Director General to periodically report to the World Health Assembly on the review of the Code’s effectiveness in achieving its stated objectives and suggestions for its improvement. In 2024 a Member-State led expert advisory group will be convened for the third review of the Code’s relevance and effectiveness. The final report of the review will be presented to the 78th World Health Assembly.
For any queries or clarifications on filling in the online questionnaire please contact us at WHOGlobalCode@who.int.
What is the WHO Global Code of Practice?
Disclaimer: The data and information collected through the National Reporting Instrument will be made publicly available via the NRI database (https://www.who.int/teams/health-workforce/migration/practice/reports-database) following the proceedings of the 78th World Health Assembly. The quantitative data will be used to inform the National Health Workforce Accounts data portal (http://www.apps.who.int/nhwaportal/).
Disclaimer
[INFOxNRI2]
National Reporting instrument 2024
[disclaim]
Disclaimer
[1] Note: Case-based facility data collection as that in the WHO Global Bum Registry does not require WHO Member State approval.
[2] The world health report 2013: research for universal coverage. Geneva: World Health Organization; 2013 (http://apps.who.int/iris/bitstream/10665/85761/2/9789240690837_eng.pdf)
[3] WHO statement on public disclosure of clinical trial results: Geneva: World Health Organization; 2015 (http://www.who.int/ictrp/results/en/, accessed 21 February 2018).
For more information on WHO Data Policy kindly refer to http://www.who.int/publishing/datapolicy/en/
[1] Note: Case-based facility data collection as that in the WHO Global Bum Registry does not require WHO Member State approval.
[2] The world health report 2013: research for universal coverage. Geneva: World Health Organization; 2013 (http://apps.who.int/iris/bitstream/10665/85761/2/9789240690837_eng.pdf)
[3] WHO statement on public disclosure of clinical trial results: Geneva: World Health Organization; 2015 (http://www.who.int/ictrp/results/en/, accessed 21 February 2018).
For more information on WHO Data Policy kindly refer to http://www.who.int/publishing/datapolicy/en/
I have read and understood the WHO policy on the use and sharing of data collected by WHO in Member States outside the context of public health emergencies
Contact Details
[INFOxNRI3]
National Reporting instrument 2024
[CI]
Contact Details
Name of Member State:
Ireland
Name of designated national authority:
Breda Rafter
Title of designated national authority:
Principal Officer, Strategic Workforce Planning Unit
Institution of the designated national authority:
Department of Health
Email:
anderseny@who.int,riginao@who.int,breda_rafter@health.gov.ie,Strategic_WorkForce_Planning_Unit@health.gov.ie,WHOGlobalCode@who.int
Telephone number :
087 4057666
Contemporary issues
[INFOxNRI4]
National Reporting instrument 2024
[NRIxI]
The questions marked * are mandatory. The system will not allow submission until all mandatory questions are answered.
[INFOx1]
Contemporary issues on health personnel migration and mobility
[Q1x1]
In the past 3 years, has the issue of international recruitment of health personnel been a concern for your country?
Yes, and it is increasing in intensity
ISSUES - GENERAL: Ireland is a country with inward and outward migration of health and social care workers. The health services in Ireland operate in a competitive global market for skilled healthcare workers. There is significant demand for Irish healthcare internationally. - EMIGRATION: Ireland does not maintain a central register of those emigrating, however, there is evidence of increased mobility internationally (to other countries) of Irish registered/Irish trained professionals post pandemic. Research by the Central Statistics Office (CSO) and National Doctors Training Programme (NDTP) in the Health Service Executive (HSE) shows that a high proportion of emigrating doctors and nurses return to Ireland. - DOMESTIC STUDENTS STUDYING ABROAD: There are challenges with some Irish students studying abroad and not having the required competencies on return to gain registration. - ACCESS TO DOMESTIC STAFF: Stakeholders in the public and voluntary sector reported challenges accessing staff. Voluntary organisations also noted high care staff vacancy levels. - DOMESTIC SUPPLY: It takes many years to train new health and social care workers, recruiting them from abroad can provide a solution to address immediate shortages. - VISA PROCESS: Stakeholders reported that visa requirements can delay the recruitment process, as and a timeframe is required for processing. Some professions are not eligible for the Critical Skills Employment Permit - DATA: It is difficult to assess the scale of emigration as there is no central register, and for many professions, data on this is not currently collected by regulators. The country where workforce is emigrating from can at best capture “intent of emigration due to work” but this can only be captured by the countries these workforces are emigrating towards. MEASURES TO ADDRESS ISSUES - Ireland is seeking to improve self-sufficiency in accordance with our commitments under the WHO Global Code of Practice on the International Recruitment of Health Personnel. - BUILD STUDENT SUPPLY: Work is underway to expand the number of health and social care worker student places. - ATTRACT/ RETAIN EFFORTS: The Department of Health and the Health Service Executive work together to develop strategies that will positively impact recruitment and retention, including addressing issues such as workload, work–life balance, workplace culture, supportive management, career advancement and workplace safety. Examples of recently developed strategies that will be/are being implemented include the Health Service Executive (HSE) Resourcing Strategy, the Report of the Expert Review Body on Nursing and Midwifery, the Non-Consultant Hospital Doctor (NCHD) Taskforce Interim and Final Reports, the Report of the Strategic Workforce Advisory Group and Sharing the Vision. The primary pillar of the HSE Resourcing Strategy ‘Resourcing our Future’ is the retention of staff. From 2022 onwards there has been a steady increase in retention levels which is demonstrated by the recent turnover figures. This pattern is continuing in 2024. Within the Expert Review Body on Nursing and Midwifery, four recommendations are specifically focused on attracting, recruiting and retaining nurses and midwives and these recommendations are being led out by the HSE National HR Office as part of the implementation plan. - JOB OFFERS FOR GRADUATES: Retention of health care graduates has been at the forefront of resourcing for the public service over the last number of years, this has resulted in each HSCP and Nursing and Midwifery graduate getting offered permanent contracts of employment. In 2023 alone this has resulted in 83% of our nursing and midwifery graduates taking permanent positions in the publicly funded health services. Voluntary services also reported offering graduate positions/programmes. - EFFORTS TO ATTRACT DOMESTIC WORKERS TO IRELAND: The HSE works very closely with the regulators to attract both those trained in Ireland and overseas. An example of this was a partnership marketing campaign with CORU (regulator for Health & Social Care Professionals) to attract Irish applicants back to Ireland. - UNDERSTANDING MIGRATION PATTERNS: Recent research has been undertaken to better understand migration patterns. For example analysis by the Central Statistics Office on health graduates, and the National Doctors Training and Planning in the HSE on trainee doctors leaving the Irish health system and the numbers returning.
[Q1x2]
In the past 3 years, has the issue of international reliance on health personnel (international recruitment of health personnel to meet domestic needs) been a concern for your country?
Yes, and it is increasing in intensity
ISSUES - Feedback from across the sector reports a reliance on international recruitment of health personnel to meet domestic needs. - PROPORTION: The proportion of foreign trained doctors and nurses has been increasing over the past number of years. In 2023, 52% of nurses and 43% of doctors were foreign educated. The percentage of foreign trained doctors rose by 2.91% between 2021 and 2023. The percentage of foreign trained nurses rose by 5.28% between 2021 and 2023. - INCREASING RELIANCE: Stakeholders reported that there is increasing pressure to recruit from overseas across the public, private and voluntary sectors. This is due to a number of reasons including: o Increased investment in the public health service and the associated requirement to recruit additional staff. o Increased outflows of staff post pandemic to other jurisdictions. o Implementation of various policies that required additional staff. o Requirement to source some staff/professions from the international market that previously were available in the Irish labour market. - CHALLENGES ACCESSING STAFF: Public and voluntary organisations reported challenges accessing domestic staff. This can often result in vacancy rates and agency use. Voluntary organization stakeholders reported a greater chance of retaining international staff for longer periods as their work permits are tied to their employment thereby impacting their mobility within the domestic labour market. The costs of international recruitment were reported as better value for money than paying agency placement fees locally for staff who may be unlikely to retain in the longer term. However, under the Employment Permits Acts 2024, to be commenced in the coming weeks, subject to certain conditions, a permit holder may change to a similar role with a new employer for any reason, after a prescribed period of nine months. MEASURES TO ADDRESS ISSUES - Ireland is seeking to improve self-sufficiency in accordance with our commitments under the WHO Global Code of Practice on the International Recruitment of Health Personnel. - BUILD STUDENT SUPPLY: Work is underway to expand the number of health and social care worker student places. - EXPANDING ENTRY: The Department of Health and stakeholders are examining the scope to develop non-traditional career pathways, including expanded application of Apprenticeships and earn as your learn models The public health service is currently expanding the routes of entry to the register for some professions via the introduction of apprenticeships – commencing with social work in 2024. - INTERNATIONAL RECRUITMENT: International recruitment is carried out in line with the WHO Code of Practice. - MODELLING: There are modelling activities underway by the Department of Health, HSE and ESRI which provide projections of workforce demand and supply. Outputs from these modelling tools informs workforce planning activities.
Health Personnel Education
[INFOxNRI5]
National Reporting instrument 2024
[INFOx2]
Health personnel education, employment and health system sustainability
[Q2]
Is your country taking measures to educate, employ and retain a health and care workforce that is appropriate for the specific conditions of your country, including areas of greatest need?
Yes
[Q2x1]
Please check all items that apply from the list below:
2.1 Measures taken to ensure the sustainability of the health and care workforce
2.2 Measures taken to address the geographical mal-distribution and retention of health and care workers*
2.3 Other relevant measures taken to educate, employ and retain a health and care workforce that is appropriate for the specific conditions of your country
[Q2x1x1]
2.1.1 Measures taken to ensure the sustainability of the health and care workforce
Forecasting future health and care workforce requirements to inform planning
- Modelling tools are being used and developed in the public sector. Some of the work currently informing the Department of Health’s understanding of future demand and supply include: o European Commission sponsored Technical Support Instrument (TSI) Project - Health and Social Care Workforce Planning Projection Model: An evidence-based planning tool that has the capacity to produce a variety of workforce projections, under different scenarios with differing levels of healthcare policy and reform, and varying levels of foreign educated healthcare workers. o Medical Workforce Supply Modelling: a medical workforce supply model using systems dynamics modelling. o Nursing and Midwifery Workforce Supply Modelling: The development of a nursing and midwifery workforce supply model using systems dynamics modelling to examine the potential increases in student nurse/midwife intake required to reduce Ireland’s reliance on the foreign-educated workforce. o National Doctors Training and Planning (NDTP) Modelling: Provides evidence-based data and projections for the current and future requirements of the medical workforce in Ireland which includes analysis on the required supply planning in light of future population, societal and health service change o ESRI Projections of Workforce Demand: The Department has a multi-annual research programme with the ESRI which includes a pro-gramme of work to develop a medium-term expenditure projection model. This “HIPPOCRATES” model is currently able to project healthcare demand for a significant proportion of health services e.g. public and private hospitals, GP and practice nurse services, long-term and intermediate care services, home care services (public and private), and physiotherapy, occupational therapy (OT) and speech & language therapy (S<) services. The Model was extended in 2022, as part of research commissioned by the Strategic Workforce Planning Team in the HSE, to project national and regional workforce requirements. o Capacity Review: A new refreshed "Health Service Capacity Review" is currently underway to identify future demand and capacity needs (both infrastructure and workforce) to inform long-term strategic capacity planning. - Private and Voluntary Sector: Some stakeholders reported utilizing software and data analytics to support planning.
Aligning domestic health and care workforce education with health system needs
- Utilizing model outputs – Utilising workforce modelling, projected demand can be compared to projected supply such that the projected surplus or deficit for each profession can be identified. The number of student places which would be required to reduce gaps in the profession emerge can then be identified. This is calculated under the preferred supply scenario whereby the inward migration of foreign educated professionals is gradually reduced allowing time for increased domestic education capacity. This process allows identification of the number of domestic student places to ensure supply will meet projected demand. - Student Expansion- There has been recent expansion to the number of student places: o In June 2022, 347 additional student places related to healthcare were announced including Medicine (60), Nursing (135), Medical Science (16), Pharmacy Technician (22), Dental Nursing (8), Health and Medical Information Science (7), Paramedic Studies (13), Physiotherapy Studies(Cert) (8), Physiotherapy (9), Pharmacy (8), Social Care/Social Work (59). o In relation to Medicine, the agreement reached with the medical schools began with an additional 60 EU students in September 2022, climbing to 120 in September 2023 and up to 200 by 2026. o In September 2023, 462 permanent additional places were created in higher education institutions in the State. Significant work was undertaken with HSE to significantly increase number of clinical practice placements for Nurses and Midwives and HSCPs and this led to the unprecedented increase of 255 student places in Nursing and Midwifery in September 2023. o In August 2024, further expansion of student places was announced with the prioritisation of funding to support the expansion of training places in priority healthcare areas including Speech and Language Therapy, Occupational Therapy and Physiotherapy. This will contribute to delivering expansion in the region of 35% in these vital disciplines over the next two academic years. - Clinical Education and Placement Supports for Health and Social Care Professions (HSCPs). The Department of Health is working with the Department of Further and Higher Education, Research, Innovation and Science to increase training places across Health and Social Care Professionals (HSCP). Practice placements in the healthcare settings are integral to the education programmes for HSCPs. The Department of Health is working with a number of stakeholders to implement governance and a centralised placement office to support the practice education of HSCP students. - Cross border collaboration: Through cross-border collaboration with our partners in Northern Ireland additional student places have been provided in Northern Ireland in Nursing & Midwifery, Allied Health Professionals and Medicine. Approximately 120 student Nursing and Midwifery places were provided in 2023 in Ulster University (UU) and Queen’s University Belfast (QUB), and 80 student places were provided in Allied Health Professional courses in Ulster University in Radiography (4), Physiotherapy (30), Occupational Therapy (28), Speech and Language Therapy (10), Podiatry (2), Radiotherapy and Oncology (1) and Dietetics (5). In addition, an agreement was reached in February 2024 between the Department of Health, Department of Health Northern Ireland, Queen’s University Belfast, and the Department of Further and Higher Education, which will see 25 additional medical places being made available for qualifying students from Ireland or Northern Ireland in QUB in September 2024, and a further twenty-five places will be made available in September 2025, bringing the total number of additional places available in Northern Ireland to 50. An MOA is in place for this agreement. - Aligning professional training with service needs: As Ireland works to build its domestic supply, discussions are ongoing with key stakeholders, including the education sector, to ensure that the output from programmes meet current and future need. There are several structures in place between the health service, the higher education sector and the professional regulators to ensure that the curricula and approach to the preparation of professions continues to evolve to meet the current and future needs of the population e.g. In nursing and midwifery there are Local Joint Working Groups between the Higher Education Institutions and the health service to support and manage many aspects of the undergraduate programmes. In addition, specific work is currently underway to expand the support to undergraduate and post graduate students during their experience in clinical settings (intention increase retention post registration and increase capacity to support increasing numbers of undergrad students). Significant investment is also supported in post graduate education and continuing professional development across the professions. - Developing career pathways: Clinical career pathways have been developed for Nursing and Midwifery with the introduction of a national policy framework to support same - including Clinical Nurse/Midwife Specialists and Advanced Nurse/Midwife Practitioners. A similar framework has been developed for Health and Social Care Professionals.
Improving quality of education and health personnel in alignment with service delivery needs
- Regulation: The individual healthcare regulators set the standard required to obtain registration. The standards and requirements of health professions registered are regularly reviewed by the relevant professional regulator. Some regulatory bodies complete undergraduate review e.g.NMBI completed in 2024 for introduction in 2025. - Higher Education: The Higher Education Institutes (HEI) are autonomous bodies, including course design. They review and update the curriculum on a regular basis aligning it with changing models of service delivery developed based on changing service need. The Department of Further and Higher Education, Research, Innovation and Science (DFHERIS) may provide capital grants for dispersal by the Higher Education Authority (HEA) to the institutions for improvements to infrastructure, equipment etc so that HEIs may be better equipped to meet standards if they deem it required. DFHERIS may provide funding towards other costs such as staff salary to assist expansion of places, maintain student ratios and other purposes, particularly where this seen as a key enabler and the expansion is seen as a priority. - Clinical Learning and Placements: Health service employers provide oversight and governance of clinical learning for all undergraduate and post graduate programmes leading to registration. Clinical placement audits by all professional regulators e.g. NMBI and HEI. Post registration professional development opportunities are targeted at areas of greatest service need. - CPD Programmes: Public, Private and Voluntary organisations reported CPD programmes for employees. - Nursing and Midwifery: Within the Expert Review Body (ERB) on nursing and midwifery, there are 17 recommendations dedicated to the education and professional development of nurses and midwives. Of these, 3 recommendations focus on access to education, increasing the undergraduate routes of entry, number of places, introduction of graduate entry programmes and understanding attrition from undergraduate programmes; 4 recommendations address preparation for practice, concentrating on alignment of curricula and clinical placements with national and global health priorities, eHealth, leadership, integrated care delivery and the social determinants of health; and 10 recommendations are targeted on professional development across the professions and different disciplines of nursing and midwifery recommending more primary care and community focused education and a greater emphasis on leadership, delegation, digital health, data analytics for practice and the development of pathways for careers in clinical and academic settings including joint clinical-academic appointments.
Creating employment opportunities aligned with population health needs
- Health Service Structure Reform: The public health service in Ireland is currently undergoing significant structural realignment, designed to enhance integrated hospital and community care for a defined population via the establishment of six health regions. As part of wider programme of reform (Sláintecare); population need, and a patient centered model of care inform the workforce skill-set required. - Service delivery models and roles: In the HSE, service delivery models and roles are reconfigured to best serve identified need based on best practice advice from the National Clinical Programmes. Also reported by stakeholders was an increase in community and chronic condition pathways and associated roles. - Advanced Practice: Ongoing is the development and implementation of the Policy on Advanced Practice for Health & Social Care Professions. Advanced Practice for Health and Social Care Professionals (HSCP) is an important part of the programme of work underway. It will support the efficient use of existing workforce, through a better distribution of tasks and by supporting development of additional skills to support the skillset of HSCPs. It will also utilise the skills and abilities of the healthcare staff currently working in the system and support retention of highly skilled HSCPs in patient facing roles. - Recruitment Practices: Voluntary organisations reported applying recruitment and retention strategies to meet high demand for services and to address gaps in workforce. - Population Based Resource Allocation: As part of the HSE Health Regions reform, the Department of Health is progressing work to establish a population-based resourcing approach (PBRA) to funding health and social care services in Ireland. This approach takes account of the socio-demographic factors which influence healthcare utilisation (i.e. age, sex, social deprivation, rurality) and was a key recommendation in the 2017 Sláintecare Report. The goal of PBRA is to equitably distribute available healthcare funding to regions according to their populations’ health needs and the cost of providing services to meet those needs. In doing so, PBRA seeks to address health inequalities by equipping each region with an equal opportunity in terms of healthcare resources to address the health needs of their populations. Following recommendations in the 2023 Spending Review "Towards Population-Based Funding for Health - Model Proposal" and in line with international practice, a DoH-chaired PBRA Expert Group has been established with responsibility for developing and maintaining the PBRA methodology. It is intended that there will be a multi-year phasing in of PBRA with a shadow process for the Estimates 2025 process ahead of a wider implementation from 2026 onwards.
Managing international recruitment of health personnel
- Public Sector: The public health service has procured external recruitment expertise to compliment domestic supply. Further information is available here: https://www.hse.ie/eng/staff/resources/recruitment-standards/before-you-recruit/international-recruitment.html Processes have been in place for some time to support international recruitment of nurses and doctors. A specific process to support the management of international Health and Social Care Professionals is currently being established and linked to associated developments in CORU. All of which is in alignment with the WHO Global Code of Practice on the International Recruitment of Health Personnel. - Relocation Packages: Public and voluntary employers reported offering relocation packages. - Guidelines: Employer stakeholders across the public and voluntary reported introducing guidelines on international recruitment. - Voluntary organisations also reported initiatives that corroborate building connections between expatriate employees e.g. Virtual Connection Café by Rehab Group - Efforts to attract domestic workers to Ireland: The HSE works very closely with the regulators to attract both those trained in Ireland and overseas. An example of this was a partnership marketing campaign with CORU to attract Irish applicants back to Ireland.
Improving management of health personnel
- Public Service Structures/ Teams: As part of the wider reform programme, whole system re-structuring is taking place across the public health service, to support having the right person, in the right place, at the right time – including a management restructuring. In the public services, there are specific national offices/small teams to advance the development of the professions including the National Doctors Training and Planning (NDTP), the Office of the Health and Social Care Professionals (HSCP Office) and the Office of the Nursing & Midwifery Services Director (ONMSD). For example, the ONMSD includes a National Clinical Leadership Centre for Nursing and Midwifery. The Capability and Culture team progresses the development and provision of leadership and management education and training and education across all professions. - A number of funding streams are in place to support the professional development of doctors which include exams, conferences, innovation projects and courses. - Non-Consultant Hospital Doctor Taskforce: A specific programme of work is being undertaken to put in place sustainable workforce planning strategies and policies to improve the experience of junior doctors to provide enhanced structures and supports on clinical sites (National Taskforce on the Non Consultant Hospital Doctor Workforce)
Specific provisions on health personnel regulation and recruitment during emergencies
- Pandemic Response: The Irish public health service streamlined its approach to recruitment in response to the pandemic. During the COVID-19 pandemic, the Emergency Measures in the Public Interest (Covid-19) Act 2020 facilitated the re-employment of retired health sector professionals by empowering regulators to adopt a more streamlined and simplified restoration process to the register of their profession for individuals who wish to respond to the Covid-19 emergency. This included Doctors, Nurses, Midwives, Dentists, Pharmacists and other health and social care professionals such as social workers, physiotherapists, radiographers, dietitians, opticians and occupational therapists. - Ukraine: The Department of Health, together with the HSE and the health profession regulators have been actively working to support health professionals fleeing the war in Ukraine to gain registration with their respective regulators and take up employment in Ireland. The Department of Health made €1m available for training and registration costs in 2023 and a further €200,000 is available in 2024. The focus has been on English language training and other supports to enable registration with the regulator and thereby enable those fleeing the war to take up employment and also maintain their competencies.
Others
- Health and Wellbeing Programmes: Public and Voluntary organisations reported Health & Wellbeing programmes in place to help build resilience, including Employee Assistance Programmes. The HSE is committed to providing a supportive environment that protects and promotes the physical, mental and social wellbeing of its workforce. The Workplace Health and Wellbeing Unit delivers high quality staff support services including Occupational Health Services, a rehabilitation programme that supports injured or sick employees to remain at or return to the workplace, an Employee Assistance programme and specialist Health & Safety support, guidance, advice and training. In addition to the wider Public Health initiatives, the Staff Health & Wellbeing Unit promotes positive lifestyle choices for staff with initiatives such as the Cycle to Work scheme, the Steps to Health Challenge and Staff Lifestyle Assessment checks. National HR also provide a free, confidential coaching service to support staff when they want to bring about personal or professional change in their lives or work, to shift their perspective, reflect on their choices and realise their individual potential. - Work-Life Balance: Stakeholders also reported promoting work-life balance through flexible working policies.
[Q2x2x1]
Check all that apply for Measures taken to address the geographical mal-distribution and retention of health and care workers
2.2.1 Education
2.2.2 Regulation
2.2.3 Incentives
2.2.4 Support
[Q2x2x1x1]
2.2.1.1 Education Measure
Education institutions based in rural/underserved areas
• Geographical Spread: There is a good geographical spread of educational institutions across the country – for example there are 13 undergraduate /post graduate nursing and midwifery schools located in higher education institutions and the postgraduate training scheme in General Practice is organized through 13 regional schemes to support appropriate geographic spread for General Practice across the country. - Attracting Workers: With regard to domestic supply there is greater liaison now with local education providers to attract people into healthcare jobs and provide placements for them in localities to enhance retention. - Postgraduate Training: Postgraduate training schemes for doctors are moving towards regional schemes to support appropriate distribution of doctors across both the urban and regional areas. - Investment: In March 2024 €4.5 million was granted to support higher education institutions that have multiple campuses in remote regional locations. The Distributed Campus Support Fund has been established to support Higher Education Institutions (HEIs) with multi-campuses in regions. These costs include those such as the delivery of core campus services across multiple sites, including travel costs between campuses, and unique demographic profiles that can result in smaller classes and lower staff student ratios than is the case in larger population centres. - Further potential opportunity: As part of Expression of Interest (EOI) process which asked HEIs to submit proposals for the expansion of healthcare disciplines including medicine, nursing, pharmacy, dentistry (as well as veterinary), a proposal was received regarding the creation of programmes with a specific focus on community-based care and addressing workforce needs in rural areas. Engagements are still ongoing in relation to the proposals received during the Higher Education Authority (HEA) EOI process and no government decision of funding for these proposals in the EOI report has been announced.
Student intake from rural/underserved areas and communities
- The Higher Education Access Route (HEAR) is an admissions scheme for students from socially disadvantaged backgrounds. The scheme aims to improve access to college for school-leavers from socio-economic backgrounds that are under-represented in third-level education. Under the HEAR scheme a number of third-level places are allocated to school-leavers on a reduced points basis. To be eligible for the scheme you must meet certain indicators (or criteria) related to your financial, social and cultural circumstances he Higher - The Disability Access Route to Education (DARE) supports students with disabilities to access college. There are several support systems for students with disabilities who are undertaking courses at third level. Many third-level colleges have a disability or access service which is responsible for giving support and advice to students with disabilities.
Scholarships and subsidies for education
- Public service scholarships and bursaries: To expand the domestic talent pipeline, scholarships, bursaries etc. are being awarded to attract people into ‘difficult to fill’ posts within particular geographies. For medical scholarships, further information is available here: https://www.hse.ie/eng/staff/leadership-education-development/met/ed/scholarships/ - Scholarships and subsidies for education programmes are available. - University: Ireland offers the ‘free university fees’ initiatives for domestic school leavers and EU applicants who meet eligibility criteria. Publicly funded Higher Education Institutions (HEIs) are listed here: https://hea.ie/higher-education-institutions/ - Education: There are a number of bursaries and scholarships available to students detailed on the Higher Education Authority (HEA) website. https://hea.ie/funding-governance-performance/funding/student-finance/ - Useful Links: o HEA course data https://hea.ie/statistics/data-for-download-and-visualisations/ o Information on bursaries: https://hea.ie/funding-governance-performance/funding/student-finance/ o Other bursaries and scholarships |https://hea.ie/funding-governance-performance/funding/student-finance/other-finance-bursaries-scholarships/
Relevant topics/curricula in education and/or professional development programmes
- Higher Education Institutes (HEI) review and update the curriculum aligning with the service need – concepts relating to organising and providing healthcare to rural/urban populations are included. - Regulatory bodies ensure high standards of professional conduct and professional education, training and competence among registered providers.
(Re)orientation of education programmes towards primary health care
- Curricula for a number of professions has been reviewed in line with the implementation of the Slaintecare health policy – which has placed an increased focus on Primary and community care.
Others
- Voluntary stakeholders reported graduate programmes for therapy grades and community based recruitment - The International Medical Graduate (IMG) Rural GP programme aims to identify, support and integrate a cohort of GPs into the rural Irish GP workforce. It incorporates two years of a self-directed learning and supervised practice. IMG GPs are enabled to work in routine, daytime rural GP practice for two years, with some GP out-of-hours work. The Irish College of GPs and the 'host' GP practice provide ongoing education supports and the GP practice will provide clinical mentorship. - Periods of Adaptation: With regard to international workers, amongst other cohorts, where the Irish regulator identifies a requirement for compensation measures / periods of adaptation, these are facilitated in Irish healthcare settings to support people into Irish healthcare jobs.
[Q2x2x2x1]
2.2.2.1 Regulation Measure
Scholarships and education subsidies with return of service agreements
- Public Sector Scholarships/ Bursaries: Those provided with scholarships / bursaries by the Health Service Executive are required to provide a defined number of years’ service back to the organisation upon graduation. Individual services will develop bursary systems for local talent to train overseas with a commitment to employment in that area thereafter. This would be limited to remote areas where recruitment and retention of new talent is challenging. - Apprenticeship Model: The Department of Health and stakeholders are examining the scope to develop non-traditional career pathways, including expanded application of Apprenticeships and earn as your learn models (e.g., for Health Care Assistants, Medical Scientists). Apprenticeship programmes are proposed as one of the long-term solutions to attract and build the health care workforce. The preparation of healthcare professions via an apprenticeship model is being considered (in addition to the academic route), for example with the recent launch of the apprenticeship in Social Work in 2024. - Professional Programmes: The Health Service Executive Return to Nursing and Midwifery Practice Programme provides nurses and midwives who wish to return to nursing and midwifery practice following an absence of 5 years or more, with the opportunity to update their knowledge and clinical skills. As part of the “Return to Nursing and Midwifery Practice Programme”, there is a requirement to work a period of time in the HSE. Further information is available https://healthservice.hse.ie/about-us/onmsd/careers-in-nursing-and-midwifery/return-to-nursing-and-midwifery.html - Northern Ireland Agreement: following agreement between Queens University Belfast, the Department of Further and Higher Education, Research, Innovation and Science and the Departments of Health Ireland and Northern Ireland, funding for twenty-five (25) additional medical places will be made available for qualifying students from Ireland or Northern Ireland in Queen’s from September 2024. A further twenty-five places will be made available in September 2025 bringing the total number of additional places available to 50. These places will be co-funded by the Department of Further and Higher Education, Research, Innovation and Science and the Department of Health. Students who take up these places will pay the same student contribution rate as their counterparts studying in medical schools in Ireland and will commit to applying to take up a position in the HSE as an intern at the end of their studies – It is expected that students in the scheme will apply to work in the HSE as an intern (year one after qualification). If offered a post, they will accept and complete their internship year in the HSE. These students are not being asked to commit to working for the HSE beyond their internship year. - International Doctors: The HSE has in place the International Medical Graduate Training Initiative (IMGTI) scholarship programme. The aim of this programme is to enable suitably qualified overseas doctors from countries with less developed health sectors to undertake a fixed period of structured training in clinical services in Ireland. The initiative provides these doctors with access to clinical experiences and training that they cannot get in their own country, with a view to enhancing and improving the individual’s medical training and learning and in the medium to long term, the health services in their own countries. To date over 500 trainees from our international partner countries, Pakistan and Sudan, have participated in the programme. This programme is governed by a partnership agreement which is signed by the HSE and the partner organization Pakistan and Sudan.
Mandatory service agreements with health personnel that are not related to scholarships or education subsidies
Enhanced scope of practice of existing health personnel
- Advanced Practice Frameworks: Specialist and advanced practice frameworks are in place to support enhanced practice. - Supporting professionals to work at the top of the license: As part of the wider reform agenda (Sláintecare) there is a focus on enhancing the scope of practice of professions and putting supports in to enable professions work to the top of their license. A workforce reform is underway to support physiotherapists to deliver effective and efficient patient care by designating appropriately trained physiotherapists as referrers for radiological procedures. The necessary legislative change will be implemented to enable Physiotherapists who have completed the relevant training and meet the competency requirements to refer patients for medical radiological procedures including X-Ray. This policy will address duplication of referrals and improve efficiency of the existing services.
Task sharing between different professions
- Integrated Teams: Task sharing is more common in some areas of care such as within purposefully designed integrated teams – e.g. mental health and teams recently established to implement integrated care approaches for Older persons and persons with a chronic disease. - Standardisation of task sharing: A specific programme of work to increase and standardize task sharing between doctors and nurses/midwives across similar services nationally was undertaken approx 10 years ago. A core principle underpinning the allocation and sharing of tasks is that the task is undertaken by the staff member who is most appropriate to do so at that time and in that location. Examples of tasks that have been successfully shared include Intravenous cannulation, Phlebotomy, Intravenous drug administration and nurse led delegated discharge of patients. - Models of Care: Models of care are redesigned by the National Clinical programmes based on international evidence – all consider the most appropriate workforce to provide the service. - Further Consideration: Task sharing is being further explored as part of the wider reform agenda.
Provisions for pathways to enter new or specialised practice after rural service
- There are no restrictions on movement rural/ community to special/acute.
Others
[Q2x2x3x1]
2.2.3.1 Incentives Measure
Additional financial reimbursement
- Relocation Packages: Public and voluntary stakeholders reported offering relocation packages to international recruits.
Education opportunities
- Equal opportunities for domestic/ international workers: In the public service, once appointed to a position, international colleagues have access to the same educational opportunities as domestically trained staff.
Opportunities for career advancement or professional growth
- Advanced Practice: Development and implementation of the Policy on Advanced Practice for Health & Social Care Professions will provide a pathway to further career advancement and professional growth for HSCPs
Professional recognition
- All registered individuals have the same professional recognition and standing regardless of the jurisdiction of their professional qualification.
Social recognition
- The Health Service Executive has programmes in development to support inclusion and social recognition
Opportunity for pathways to permanent residency and/or citizenship for international health personnel
- Employment permit holders, excluding Intra-Company Transfer Employment Permits, have a pathway to permanent residency. - General Employment Permit holders, which includes professions such as health care assistant and home carer, are eligible for Long Term Residency permission after 60 months. - Critical Skills Employment Permit holders, which includes professions such as Doctor, Nurse, and Midwife, are eligible for a Stamp 4 immigration permission, providing full labour market access without an employment permit after 21 months working in the state on such a permit. - Time spent on these permits is also reckonable towards naturalisation.
Others
- Stakeholders from the private and voluntary sector reported offering flexible work arrangements, referral bonus, retention initiatives (e.g. long-term service rewards, relocation package etc), CPD, supervision and facilitating access to education, online courses and workshops.
[Q2x2x4x1]
2.2.4.1 Support Measure
Decent and safe working conditions
- There are employment and health and safety legislation and policies in place across the public, private and voluntary sectors. - International health personnel in Ireland are subject to the same employment laws as Irish workers, which cover aspects like wages, working hours, and workplace safety. The Workplace Relations Commission (WRC) oversees the adherence to employment rights
Decent and safe living conditions
- International workers have access to the same civil infrastructure as domestically trained staff.
Distance learning/e-learning opportunities
- Once appointed, international colleagues are entitled to the same educational opportunities as domestically trained staff.
Others
- The HSE is committed to providing a supportive environment that protects and promotes the physical, mental and social wellbeing of its workforce. The Workplace Health and Wellbeing Unit delivers high quality staff support services including Occupational Health Services, a rehabilitation programme that supports injured or sick employees to remain at or return to the workplace, an Employee Assistance programme and specialist Health & Safety support, guidance, advice and training. In addition to the wider Public Health initiatives, the Staff Health & Wellbeing Unit promotes positive lifestyle choices for staff with initiatives such as the Cycle to Work scheme, the Steps to Health Challenge and Staff Lifestyle Assessment checks. National HR also provide a free, confidential coaching service to support staff when they want to bring about personal or professional change in their lives or work, to shift their perspective, reflect on their choices and realise their individual potential. - Targeted Marketing: The HSE has worked with Clinicians and HR to target particular specialities for remote locations. This was first piloted in Donegal for Psychiatry. This approach has been successful and has now been expanded to other parts of the west coast and the Breast Screening Services. - Targeted Profiling: The HSE is also profiling individual professions/service through a ‘Service in the Spotlight’ feature on the HSE Careerhub. An example of which is the focus on Midwifery which was launched in May, to attract perspective applicants both nationally and internationally to midwifery roles in Ireland. - Model 3 Hospital Report: The public is entitled to the same high standard of medical care across Ireland, regardless of their location. Outside of main urban areas, Model 3 hospitals play a pivotal role in providing access to high-quality and timely healthcare. The model 3 hospitals report acknowledges the challenges in filling consultant posts in model 3 hospitals due to the challenges of geographic location, voluntary versus statutory, and Model 3 versus Model 4 considerations. The report sets out recommendations to remedy issues like geographical location by implementing a more localised recruitment model.
[Q2x3x1]
2.3.1 Please describe - Other relevant measures taken to educate, employ and retain a health and care workforce that is appropriate for the specific conditions of your country.
- With regard to international workers, amongst other cohorts, where the Irish regulator identifies a requirement for compensation measures / periods of adaptation, these are facilitated in Irish healthcare settings to support people into Irish healthcare jobs.
- Other measures are noted in the questions above.
[Q3x1]
Are there specific policies and/or laws that guide international recruitment, migration and integration of foreign-trained health personnel in your country?
Yes
[Q3x1x1]
Please provide further information in the box below:
Law/policy 1
Employment Permit Acts of 2003 - The Employment Permits System, through which the majority of non-EEA recruitment is conducted, is governed by the Employment Permit Acts of 2003 and 2006 as amended. This will be replaced by the Employment Permits Act 2024 in Q3 2024.
Law/policy 2
Directive 2005/36/EC of the European Parliament and of the Council of 7 September 2005 on the recognition of professional qualifications – Mutual recognition of the regulated professional qualifications of doctors, dentists, pharmacists, nurses and midwives within the EU and EEA (27 EU Member States, Norway, Iceland, Liechtenstein and Switzerland).
Law/policy 3
S.I. No. 8/2017. European Union (Recognition of Professional Qualifications) Regulations 2017 gives further effect to Directive 2005/36/EC in Irish law.
[Q3x2]
Are there any policies and/or provision for international telehealth services in your country through health personnel based abroad?
Yes
[Q3x2x1]
Please describe
- The regulatory landscape re provision of telehealth services remains very underdeveloped and fragmented in Ireland. However:
o The Medical Council has published Telemedicine phone and video consultations - A guide for doctors https://www.medicalcouncil.ie/news-and-publications/publications/overview/telemedicine-guide-for-doctors.html.
o The NMBI developed a position paper supporting the American National Council of State Boards of Nursing (NCSBN) Guiding Principles for Telehealth Nursing (2022).
[Q3x3]
Has your country established a database or compilation of laws and regulations related to international health personnel recruitment and migration and, as appropriate, information related to their implementation?
No
[Q4]
Recognizing the role of other government entities, does the Ministry of Health have mechanisms (e.g. policies, processes, unit) to monitor and coordinate across sectors on issues related to the international recruitment and migration of health personnel?
Yes
[Q4x1]
Please describe
The Department of Health leads on health and social care workforce planning activities and policy, including working in collaboration with the education sector, HSE, regulators, and professional bodies to improve the availability of health professionals across the entire health service. As part of this work, the Department considers the long-term needs of the health and social care sector utilising a variety of workforce projections, under different scenarios with differing levels of healthcare policy and reform, and varying levels of inward migration of foreign educated healthcare workers. In Ireland, the Health Service Executive has responsibility for recruitment into the public health service.
[Q5]
Please describe the steps taken by your country to implement the following Code recommendations.
Check all items that apply from the list below:
Check all items that apply from the list below:
5.1 Measures have been taken or are being considered to introduce changes to laws or policies on health personnel consistent with the recommendations of the Code.
- Refer to the laws above under question 3.1. - Regulated Professions (Health and Social Care) (Amendment) Act 2020 - full commencement awaited. - Regulated Professions (Health and Social Care) (Amendment) Act 2023 - full commencement awaited - Ireland is seeking to improve self-sufficiency in accordance with our commitments under the WHO Global Code of Practice on the International Recruitment of Health Personnel. Work is underway to expand the number of health and social care worker student places. There has been recent expansion to the number of student places: o In June 2022, 347 additional student places related to healthcare were announced including Medicine (60), Nursing (135), Medical Science (16), Pharmacy Technician (22), Dental Nursing (8), Health and Medical Information Science (7), Paramedic Studies (13), Physiotherapy Studies(Cert) (8), Physiotherapy (9), Pharmacy (8), Social Care/Social Work (59). o In relation to Medicine, the agreement reached with the medical schools began with an additional 60 EU students in September 2022, climbing to 120 in September 2023 and up to 200 by 2026. o In September 2023, 462 permanent additional places were created in higher education institutions in the State. Significant work was undertaken with HSE to significantly increase number of clinical practice placements for Nurses and Midwives and HSCPs and this led to the unprecedented increase of 255 student places in Nursing and Midwifery in September 2023. o In August 2024, further expansion of student places was announced with the prioritisation of funding to support the expansion of training places in priority healthcare areas including Speech and Language Therapy, Occupational Therapy and Physiotherapy. This will contribute to delivering expansion in the region of 35% in these vital disciplines over the next two academic years. - Cross border collaboration: Through cross-border collaboration with our partners in Northern Ireland, additional student places have been provided in Northern Ireland in Nursing & Midwifery, Allied Health Professionals and Medicine. Approximately 120 student Nursing and Midwifery places were provided in 2023 in in Ulster University (UU) and Queen’s University Belfast (QUB), and 80 student places were provided in Allied Health Professional courses in Ulster University in Radiography (4), Physiotherapy (30), Occupational Therapy (28), Speech and Language Therapy (10), Podiatry (2), Radiotherapy and Oncology (1) and Dietetics (5). In addition, an agreement was reached in February 2024 between the Department of Health, Department of Health Northern Ireland, Queen’s University Belfast, and the Department of Further and Higher Education, which will see 25 additional medical places being made available for qualifying students from Ireland or Northern Ireland in QUB in September 2024, and a further twenty-five places will be made available in September 2025, bringing the total number of additional places available in Northern Ireland to 50. An MOA is in place for this agreement. - The Department of Health and the Health Service Executive work together to develop strategies that will positively impact recruitment and retention, including addressing issues such as workload, work–life balance, workplace culture, supportive management, career advancement and workplace safety. Examples of recently developed strategies that will be/are being implemented include the Health Service Executive (HSE) Resourcing Strategy, the Report of the Expert Review Body on Nursing and Midwifery, the Non-Consultant Hospital Doctor (NCHD) Taskforce Interim and Final Reports, the Report of the Strategic Workforce Advisory Group and Sharing the Vision. - The Report of the Expert Review Body on Nursing and Midwifery includes recommendations consistent with the Code, in particular relating to increasing the domestic supply of nurses and midwives. Related to this are recommendations 4 and 15.
5.2 Actions have been taken to communicate and share information across
sectors on the international recruitment and migration of health personnel, as well as to publicize the Code, among relevant ministries, departments and agencies,
nationally and/or sub-nationally.
sectors on the international recruitment and migration of health personnel, as well as to publicize the Code, among relevant ministries, departments and agencies,
nationally and/or sub-nationally.
- The Health Service Executive national supplier contracts with international recruitment partners ensure compliance with best practice including the WHO Global Code of Practice. In accordance with this, the public sector Framework suppliers were instructed to stop all active recruitment in any country listed on the WHO safeguards list. Further communications to suppliers and of HR (Community Healthcare Organisations) and Group Directors of HR (Hospital Groups) was circulated by the HSE with regard to obligations. Details of these Frameworks are available online: https://www.hse.ie/eng/staff/resources/recruitment-standards/before-you-recruit/international-recruitment.html - The Department of Health promotes the Code as part of workforce planning activities. The Department engaged with multiple stakeholders to gather information for this response, and in doing so has further publicized the Code.
5.3 Measures have been taken to consult stakeholders in decision-making
processes and/or involve them in activities related to the international recruitment of health personnel.
processes and/or involve them in activities related to the international recruitment of health personnel.
- In the public sector, the relevant professions are actively involved in the procurement process. The public health service works in partnership with all relevant stakeholders i.e. government departments, regulatory bodies, staff representative bodies etc.
5.4 Records are maintained on all private recruitment agencies for health
personnel authorized by competent authorities to operate within their jurisdiction.
personnel authorized by competent authorities to operate within their jurisdiction.
- Public national contracts are awarded in line with EU Directive 2014/24/EU on public procurement
5.5 Good practices, as called for by the Code, are encouraged and promoted among private recruitment agencies.
- Public national contracts with HSE international recruitment partners ensure compliance with best practice including the WHO Global Code of Practice on the International Recruitment of Health Personnel
5.5a Promotion of the Code among private recruitment agencies.
- Public national contracts with HSE international recruitment partners ensure compliance with best practice including the WHO Global Code of Practice on the International Recruitment of Health Personnel
5.5b Domestic legislation or policy requiring ethical practice of private recruitment agencies, as consistent with the principles and articles of the Code.
- It is an offence to carry out the business of a Recruitment Agency without a license under the Employment Agency Act 1971. The terms of the license require the Agency to operate to particular standards.
5.5c Public or private certification of ethical practice for private recruitment agencies.
- As 5.5b
5.5d Others
5.6 None of the above
Government Agreements
[INFOxNRI6]
National Reporting instrument 2024
[INFOx3]
Government-to-Government agreements on migration or mobility of health personnel
[Q6]
Has your country or sub-national governments entered into any bilateral, multilateral, or regional agreements and/or arrangements with respect to the international recruitment and/or mobility of health personnel?
Yes
[Q6x1xA]
Please use the table below to describe each of the active bilateral, regional or multilateral agreements or arrangements:
| a. Title of Agreement | b. Type of Agreement | |
|---|---|---|
| Agreement 1 | Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland | 1 |
| Agreement 2 | Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan | 1 |
| Agreement 3 | Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB) | 1 |
| Agreement 4 | EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU | 2 |
| Agreement 5 | ||
| Agreement 6 | ||
| Agreement 7 | ||
| Agreement 8 | ||
| Agreement 9 | ||
| Agreement 10 | ||
| Agreement 11 | ||
| Agreement 12 | ||
| Agreement 13 | ||
| Agreement 14 | ||
| Agreement 15 |
Government Agreements - 6.1 A
[INFOxNRI7]
National Reporting instrument 2024
[Q6x1xAx1]
c. Countries involved
Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland
IRL
Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
IRL,PAK
Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
IRL,SDN
EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
IRL
[Q6x1xAx2]
d. Coverage
Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland
Sub-national
Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
Sub-national
Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
Sub-national
EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
National
[Q6x1xAx2x]
Please enter the names of the subnational units (states, provinces, etc) which are involved in this agreement
Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland
The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland
Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
Between the Health Service Executive and The Sudan Medical & Specialisation Board (SMSB)
EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
[Q6x1xAx3]
e. Main focus of agreement (check all that apply)
| Education and training | Health cooperation | Promotion of circular migration | Philanthropy or technical support | Qualification recognition | Recruitment of health personnel | Trade in services | Others | |
|---|---|---|---|---|---|---|---|---|
| Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland | 1 | |||||||
| Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan | 1 | |||||||
| Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB) | 1 | |||||||
| EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU | 1 | |||||||
[Q6x1xAx4]
f. Categories of Health Personnel (check all that apply)
| Doctors | Nurses | Midwives | Dentists | Pharmacists | Other occupations | |
|---|---|---|---|---|---|---|
| Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland | 1 | |||||
| Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan | 1 | |||||
| Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB) | 1 | |||||
| EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU | 1 | 1 | 1 | 1 | 1 | 1 |
[Q6x1xAx4xoth]
Please specify category of health personnel:
Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland
Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
o Doctors o Nurses o Midwives o Dentists o Pharmacist s o Dietitian o Dispensing Optician o Occupational Therapist o Optometrist o Physiotherapist o Radiation Therapist o Radiographer o Podiatrist o Dental Hygienist o Dental Nurse o Clinical Dental Technician o Orthodontic Therapist o Audiologist o Orthoptist o Psychologist o Advanced Paramedic o Emergency Medical Technician o Paramedic In addition, the Directive relates to professions regulated in other Member States (EEA countries & Switzerland) that are not regulated in Ireland. Those professions regulated in other Member States can be viewed at https://ec.europa.eu/growth/tools-databases/regprof/professions/bycountry
[Q6x1xAx5]
g. Validity period
| Start Year | End Year | |
|---|---|---|
| Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland | 2024 | 2030 |
| Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan | 2011 | Ongoing |
| Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB) | 2017 | Ongoing |
| EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU | 2005 | Ongoing |
[Q6x1xAx6]
h. Signatory of the agreement from your country
Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland
Ministry of Health
Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
Others:
Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
Others:
EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
Others:
[Q6x1xAx6xoth]
If other signatory of the agreement from your country(Please specify:)
Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland
Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
Health Service Executive
Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
Health Service Executive
EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
Per EU Directives
[Q6x1xAx6x1]
If Ministry of Health is not a signatory, did the Ministry of Health participate in the development of the agreement?
Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland
Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
No
Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
No
EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
Yes
[Q6x1xAx7]
i. Signatory of the agreement from the partner country (ies)
Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland
Ministry of Health
Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
Others:
Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
Others:
EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
Others:
[Q6x1xAx7xoth]
If other signatory of the agreement from your country(Please specify:)
Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland
Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
The College of Physicians and Surgeons Pakistan
Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
The Sudan Medical & Specialisation Board (SMSB)
EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
Per EU Directive
[Q6x1xAx7x1]
If Ministry of Health is not a signatory, did the Ministry of Health participate in the development of the agreement?
Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland
Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
Don’t Know
Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
Don’t Know
EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
Don’t Know
[Q6x1xAx8]
j. Content of agreement
[Q6x1xAx8x1]
j.i. Does the agreement include elements to benefit the health system of your country and the partner country(ies)?
Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland
Yes, has elements to
benefit the health system of my country and partner country(ies)
benefit the health system of my country and partner country(ies)
Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
Yes, has elements to
benefit the health system of my country and partner country(ies)
benefit the health system of my country and partner country(ies)
Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
Yes, has elements to
benefit the health system of my country and partner country(ies)
benefit the health system of my country and partner country(ies)
EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
Yes, has elements to
benefit the health system of my country and partner country(ies)
benefit the health system of my country and partner country(ies)
[Q6x1xAx8x1x]
Please explain:
Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland
In addition, an agreement was reached in February 2024 between the Department of Health, Department of Health Northern Ireland, Queen’s University Belfast, and the Department of Further and Higher Education, which will see 25 additional medical places being made available for qualifying students from Ireland or Northern Ireland in QUB in September 2024, and a further twenty-five places will be made available in September 2025, bringing the total number of additional places available in Northern Ireland to 50.
Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
This is not general recruitment agreement that apply for all doctors coming from Sudan and Pakistan. These are agreements to participate in a programme that provides structured two year training programmes for doctors in Pakistan and Sudan who are enrolled on the national training scheme in their country to work in Ireland for two years. These two years will then be recognised towards their postgraduate training scheme in Pakistan or Sudan. There is a competitive recruitment process to enter this programme which is run by the relevant Irish Postgraduate Medical Training body
Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
This agreement is linked to the International Medical Graduate Training Initiative (IMGTI) scholarship programme that enables overseas doctors from countries with less developed health sectors to undertake a period of training in Ireland. The initiative provides these doctors with access to clinical experiences and training that they cannot get in their own country, while also reducing Ireland’s over reliance on Non-Training Scheme Doctors (NTSDs). This is not general recruitment agreement that apply for all doctors coming from Sudan. This agreement is to participate in a programme that provides structured two year training programmes for doctors in Sudan who are enrolled on the national training scheme in their country to work in Ireland for two years. These two years will then be recognised towards their postgraduate training scheme in Sudan. There is a competitive recruitment process to enter this programme which is run by the relevant Irish Postgraduate Medical Training body.
EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
This agreement is linked to the International Medical Graduate Training Initiative (IMGTI) scholarship programme that enables overseas doctors from countries with less developed health sectors to undertake a period of training in Ireland. The initiative provides these doctors with access to clinical experiences and training that they cannot get in their own country, while also reducing Ireland’s over reliance on Non-Training Scheme Doctors (NTSDs). This is not general recruitment agreement that apply for all doctors coming from Pakistan. This agreement is to participate in a programme that provides structured two year training programmes for doctors in Pakistan who are enrolled on the national training scheme in their country to work in Ireland for two years. These two years will then be recognised towards their postgraduate training scheme in Pakistan. There is a competitive recruitment process to enter this programme which is run by the relevant Irish Postgraduate Medical Training body.
[Q6x1xAx8x2]
j.ii. Does the agreement include elements on health worker rights and welfare?
Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland
No
Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
No
Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
No
EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
Yes
[Q6x1xAx8x2x]
Please explain:
Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland
Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
The right of Europeans to pursue economic activities in another EU country is a fundamental right enshrined in the Treaty on the Functioning of the European Union. However, within the limits of the single market rules and in particular the principle of proportionality, each country may allow access to a particular profession only if the individual has a specific professional qualification. This is an obstacle to the free movement of professionals in the EU as far as those qualified to practise the same profession in another Member State hold a different professional qualification, i.e. the qualification acquired in their own country. The EU has set up rules to ensure that Member States fully test how professions are regulated in future in terms of whether they are nondiscriminatory, justified to protect overriding reasons in the public interest and necessary to achieve that protection. There are also rules to make it easier for EU countries to recognise each other’s professional qualifications. This is the aim of Directive 2005/36/EC on the recognition of professional qualifications as amended by Directive 2013/55/EU. While this may make recognition easier, in practice there is no one single solution for the recognition of professional qualifications within the EU.
Government Agreements - 6.1 B
[INFOxNRI8]
National Reporting instrument 2024
[Q6x1xB]
Please use the table below to describe the implementation of each of the active bilateral, regional or multilateral agreements or arrangements
[Q6x1xBx1]
Has the agreement been implemented?
Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland
No
Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
Yes
Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
Yes
EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
Yes
[Q6x1xBx1x1]
| Start year of implementation: | |
|---|---|
| Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland | |
| Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan | 2011 |
| Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB) | 2017 |
| EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU | 2008 |
[Q6x1xBx2b]
How many health personnel have left or entered your country through this agreement since its implementation?
Agreement: Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
Agreement: Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
| Number of personnel | |
|---|---|
| Doctors | |
| Nurses | |
| Midwives | |
| Dentists | |
| Pharmacists | |
[Q6x1xBx2c]
How many health personnel have left or entered your country through this agreement since its implementation?
Agreement: Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
Agreement: Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
| Number of personnel | |
|---|---|
| Doctors | |
| Nurses | |
| Midwives | |
| Dentists | |
| Pharmacists | |
[Q6x1xBx2d]
How many health personnel have left or entered your country through this agreement since its implementation?
Agreement: EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
Agreement: EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
| Number of personnel | |
|---|---|
| Doctors | |
| Nurses | |
| Midwives | |
| Dentists | |
| Pharmacists | |
| o Doctors o Nurses o Midwives o Dentists o Pharmacist s o Dietitian o Dispensing Optician o Occupational Therapist o Optometrist o Physiotherapist o Radiation Therapist o Radiographer o Podiatrist o Dental Hygienist o Dental Nurse o Clinical Dental Technician o Orthodontic Therapist o Audiologist o Orthoptist o Psychologist o Advanced Paramedic o Emergency Medical Technician o Paramedic In addition, the Directive relates to professions regulated in other Member States (EEA countries & Switzerland) that are not regulated in Ireland. Those professions regulated in other Member States can be viewed at https://ec.europa.eu/growth/tools-databases/regprof/professions/bycountry | 8,875 medical professionals with Irish qualifications were recognized in another Member State. -16,279 medical profession were recognized in Ireland. Statistics available at https://ec.europa.eu/growth/tools-databases/regprof/statistics/establishment/ranking |
[Q6x1xBx3]
Please explain if and how has the health system of your country benefitted from the agreement.
Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland
Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
The initiative provides these doctors with access to clinical experiences and training that they cannot get in their own country, while also reducing Ireland’s over reliance on Non-Training Scheme Doctors (NTSDs).
Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
The initiative provides these doctors with access to clinical experiences and training that they cannot get in their own country, while also reducing Ireland’s over reliance on Non-Training Scheme Doctors (NTSDs).
EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
Through flow of health and social care workers
[Q6x1xBx4]
Please describe if and how the health system of other country(ies) has benefitted from the agreement.
Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland
Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
The initiative provides these doctors with access to clinical experiences and training that they cannot get in their own country, while also reducing Ireland’s over reliance on Non-Training Scheme Doctors (NTSDs).
Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
The initiative provides these doctors with access to clinical experiences and training that they cannot get in their own country, while also reducing Ireland’s over reliance on Non-Training Scheme Doctors (NTSDs).
EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
Through flow of health and social care workers
[Q6x1xBx5]
Please explain if and how the provisions on health workers rights and welfare were implemented.
Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland
Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
The Department of Further and Higher Education, Research, Innovation and Science (DFHERIS) serves as the national coordinator and national assistance centre for Directive 2005/36/EC on the recognition of professional qualifications. In DFHERIS’ coordination role, it works with the European Commission, other Member States and Irish regulatory bodies to support the operation of the Directive and to assist citizens seeking the recognition of their qualifications. In this capacity DFHERIS has and will continue to work with regulators to deepen the implementation of this Directive and to share broader international best practice in respect of the recognition of qualifications.
[Q6x1xBx6]
Please provide any other relevant information on the agreement (e.g., context, positive elements, gaps and lessons learnt).
Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland
Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan
Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB)
EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU
[Q6x1xBx7]
Full text of the agreement and associated documents (implementation plan, progress report, implementation report, evaluation report, etc.)
| Upload document(s) | |
|---|---|
| Memorandum of Agreement Between The Queen’s University of Belfast And Minister for Further and Higher Education, Research, Innovation and Science Ireland And Minister for Health Ireland and Department of Health Northern Ireland | |
| Memorandum of Understanding Between the Health Service Executive and with The College of Physicians and Surgeons Pakistan | |
| Memorandum of Understanding Between the Health Service Executive andThe Sudan Medical & Specialisation Board (SMSB) | |
| EU Directive 2005/36/EC;EU Directive 2013/55/EU; EU Directive 2018/958/EU | |
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[Q6x1xBx7xfile7]
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[Q6x1xBx7xfile9]
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[Q6x1xBx7xfile11]
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[Q6x1xBx7xfile15]
Responsibilities, rights and recruitment practices
[INFOxNRI9]
National Reporting instrument 2024
[INFOx4]
Responsibilities, rights and recruitment practices
[Q7]
If your country employs/hosts international health personnel to work in the health and care sectors, which legal safeguards and/or other mechanisms are in place for migrant health personnel and to ensure that enjoy the same legal rights and responsibilities as the domestically trained health workforce?
Please check all items that apply from the list below:
Please check all items that apply from the list below:
Migrant health personnel are recruited using mechanisms that allow them to assess the benefits and risk associated with employment positions and to make timely and informed decisions on the employment.
- Public Health: Under Health Service Executive national contracts prospective applicants are provided with the job specification, Department of Health salary scales, statutory registration requirements, residence / visa permissions, relocation allowance, information on promotional career opportunities, family reunification and the cost of living in Ireland. - Permits: The minimum annual remuneration is prescribed for the issuance of employment permits, including: o €27,000 for Health Care Assistants, Home Carers and Care Workers o €34,000 for all other health care roles on a General Employment Permit o €38,000 for all roles on a Critical Skills Employment Permit
Migrant health personnel are hired, promoted and remunerated based on objective criteria such as levels of qualification, years of experience and degrees of professional responsibility on the same basis as the domestically trained health workforce.
- In line with public pay policy. International colleagues in the public sector are remunerated based on the same objective criteria as the domestically trained health workforce.
Migrant health personnel enjoy the same opportunities as the domestically trained health workforce to strengthen their professional education, qualifications and career progression.
- Once appointed, international colleagues are entitled to the same professional education, professional development and promotional opportunities as domestically trained staff.
Institutional arrangements are in place to ensure safe migration/ mobility and integration of migrant health personnel.
- Yes, under national contracts there are holistic support arrangements for international colleagues arriving to work and live in Ireland. - Under the Employment Permits Acts 2024, to be commenced in the coming weeks, a permit holder may change to a similar role with a new employer for any reason, after a prescribed period of nine months. - Mobility between employers prior to the nine months is facilitated where there are extenuating circumstances.
Measures have been taken to promote circular migration of international health personnel
- The HSE has in place the International Medical Graduate Training Initiative (IMGTI) scholarship programme to enable suitably qualified overseas doctors from countries with less developed health sectors to undertake a fixed period of structured training in clinical services in Ireland. The initiative provides these doctors with access to clinical experiences and training that they cannot get in their own country, with a view to enhancing and improving the individual’s medical training and learning and in the medium to long term, the health services in their own countries. To date over 500 trainees from our international partner countries, Pakistan and Sudan, have participated in the programme. This programme is governed by a partnership agreement which is signed by the HSE and the partner organization Pakistan and Sudan. The programme has received national and international recognition as an example of best practice in promoting circular migration.
Other measures (including legal and administrative) for fair recruitment and employment practices of foreign-trained and/or immigrant health personnel (please provide details)
- Yes, recruitment within the public services is conducted in line with the Recruitment and Appointments Act and the Commission for Public Service Appointments Codes of Practice together with national legislation for the protection of workers - It is an offence under the Employment Permits Acts of 2006 and 2024 for an employer to seek to recover any costs incurred by the employer through the employment permit application, recruitment process and related travel. - An employer may not penalise a permit holder for reporting any contraventions of the Employment Permits Act. - Additionally, where the permit holder has not received sufficient remuneration for work done, the Minister may institute civil proceedings on behalf of that permit holder. - Offences of employment law can lead to employers being unable to access the employment permit system for up to five years.
No measures in place
Not applicable – does not host/employ foreign health personnel
[Q8]
If health personnel from your country are working abroad in the health and care sectors, please provide information on measures that have been taken or are planned in your country to ensure their fair recruitment and employment; safe migration; return; and diaspora utilization in your country, as well as difficulties encountered.
Please check all items that apply from the list below:
Please check all items that apply from the list below:
Arrangements for fair recruitment
- Recruitment within the public services is conducted in line with the Recruitment and Appointments Act and the Commission for Public Service Appointments Codes of Practice. - The HSE also ensures that all international recruitment is conducted in line with WHO ethical recruitment guidelines
Arrangements for decent employment contracts and working conditions in destination countries
- All public health sector recruitment, either nationally or internationally, is conducted under a framework of legislation for the protection of workers in the Irish state.
Arrangements for safe mobility
Arrangements for return and reintegration to the health labour market in your country
- There are no barriers to the return of domestically trained health care professionals. Career opportunities are accessible globally. - The HSE works very closely with the regulators to attract both those trained in Ireland and overseas. An example of this was a partnership marketing campaign with CORU to attract Irish applicants home.
Arrangements for diaspora engagement to support your country health system
- Informal networks have been developed to support the engagement with the diaspora. Services are encouraged to “keep in touch” with staff who have emigrated. - Career breaks are promoted and offered to encourage return to employment on the completion of travel, experience across the world.
Other
No measures in place
Not applicable – health personnel from my country are not working abroad
International migration
[INFOxNRI10]
National Reporting instrument 2024
[INFOx5]
International migration and mobility pathways for health personnel
[Q9x1]
9.1 If your country hosts international health personnel to work in the health and care sector, how do they come to your country? (check all that apply)
| Direct (individual) application for education, employment, trade, immigration or entry in country |
Government to government agreements that allow health personnel mobility |
Private recruitment agencies or employer facilitated recruitment |
Private education/ immigration consultancies facilitated mobility |
Other pathways (please specify) | Which pathway is used the most? Please include quantitative data if available. | |
|---|---|---|---|---|---|---|
| Doctors | 1 | 0 | 1 | 0 | Private Recruitment Agencies | |
| Nurses | 1 | 0 | 1 | 1 | Large framework Recruitment | Private Recruitment Agencies |
| Midwives | 1 | 0 | 1 | 1 | Large framework Recruitment | Private Recruitment Agencies |
| Dentists | 1 | 0 | 1 | 0 | EURES | |
| Pharmacists | 1 | 0 | 1 | 1 | ||
| Other occupations | 1 | 0 | 1 | 1 | ||
| Other occupations | 1 | 0 | 1 | 0 | ||
| Other occupations | 1 | 0 | 1 | 0 | ||
| Other occupations | 1 | 0 | 1 | 0 | ||
| Other occupations | 1 | 0 | 1 | 0 |
[Q9x1oth]
Psychologists
Occupational therapists
Physiotherapists
Speech and Language Therapists
Soical Workers
[Q9x2]
9.2 If health personnel from your country work/study abroad, how do they leave your country?
(check all that apply)
| Direct (individual) application for education, employment, trade, immigration, or entry in the destination country |
Government to government agreements that allow health personnel mobility |
Private recruitment agencies or employer facilitated recruitment |
Private education/ immigration consultancies facilitated mobility |
Other pathways (please specify) | Which pathway is used the most? Please include quantitative data if available. | |
|---|---|---|---|---|---|---|
| Doctors | 1 | 0 | 1 | 0 | Not currently available. Later in 2024, the MCI will produce a report which will include information on doctors leaving and joining the register | |
| Nurses | 1 | 1 | 1 | 1 | Application for education/employment Application for education/employment | |
| Midwives | 1 | 1 | 1 | 1 | Application for education/employment Application for education/employment | |
| Dentists | 1 | 0 | 1 | 0 | EURES | |
| Pharmacists | 1 | 0 | 1 | 0 | ||
| Other occupations | 1 | 0 | 1 | 0 | ||
| Other occupations | 0 | 0 | 0 | 0 | ||
| Other occupations | 0 | 0 | 0 | 0 | ||
| Other occupations | 0 | 0 | 0 | 0 | ||
| Other occupations | 0 | 0 | 0 | 0 |
[Q9x2oth]
Health and Social Care Professionals e.g. but not limited to Dieticians, Occupational therapists, Physiotherapists, etc
Recruitment & migration
[INFOxNRI11]
National Reporting instrument 2024
[INFOx6]
Data on international health personnel recruitment & migration
Improving the availability and international comparability of data is essential to understanding and addressing the global dynamic of health worker migration. Please consult with your NHWA focal point, if available, to ensure that data reported below is consistent with NHWA reporting*.
(The list of NHWA focal points is available here. Please find the focal point(s) for your country from the list and consult with them.)
For countries reporting through the WHO-Euro/EuroStat/OECD Joint data collection process, please liaise with the JDC focal point.
[Q10]
Does your country have any mechanism(s) or entity(ies) to maintain statistical records of foreign-born and foreign-trained health personnel?
Yes
[Q10x1]
Where are the records maintained? (check all that apply)
Employment records or work permits
Ministry of health personnel database
Registry of health personnel authorized to practice
Other
[Q10x1x1]
Please specify:
- This information is held by the regulatory bodies. Public health service holds data on HR system on Nationality (self-declared) - - Employment Permit data available covering all non-EEA workers not in possession of an alternative permission to work (e.g. through protection status, spousal permission). - - Country reported refers to the country where the first qualification (i.e. foreign-trained) was achieved and not to the country of birth (i.e. foreign-born). This data is only available for physicians and nurses.
[Q10x2]
Does the record include gender-disaggregated data on the foreign-born and/or foreign-trained health personnel?
Yes
Inflow and outflow of health personnel
[INFOxNRI12]
National Reporting instrument 2024
[INFOx7]
Inflow and outflow of health personnel
[Q11]
Do you have a mechanism to monitor the inflow and outflow of health personnel to/from your country? (check all that apply)
Inflow
Outflow
No
[Q11xI]
If yes for inflow:
Fill in the table below
[Q11x1]
How many foreign-trained or foreign-born health personnel were newly active (temporarily and/or permanently) in your country in the past three years (inflow)?
| Doctors | Nurses | Midwives | Dentists | Pharmacists | Remarks | |
|---|---|---|---|---|---|---|
| 2021 | 1707 | 3468 | 27 | 98 | 106 | |
| 2022 | 2192 | 4003 | 47 | 178 | 194 | |
| 2023 | 2266 | 5225 | 84 | 270 | 340 | |
| Data Source (e.g. Regulatory authority, immigration records, work permits, etc.) | Medical Council Data, compiled to fulfil EU Regulation (EU)2022/2294 | NMBI Data, compiled to fulfil EU Regulation (EU)2022/2294 | The Nursing and Midwifery Board of Ireland provided the data directly. | The Dental Council of Ireland provided the below data directly. | The Pharmaceutical Society of Ireland (PSI) provided the below data. Data cut off 23 July 2024. | • Figures in this report many not be directly comparable to other reports from the same data sets due to divergence in methodologies applied by data sources and EU regulatory requirement. |
[Q11xO]
If yes for outflow:
Fill in the table below
[Q11x2]
How many domestically trained health personnel left your country in the past years for temporary or permanent migration (outflow)?
| Doctors | Nurses | Midwives | Dentists | Pharmacists | Remarks | |
|---|---|---|---|---|---|---|
| 2021 | 191 | |||||
| 2022 | 322 | |||||
| 2023 | ||||||
| Data Source (e.g. letters of good standing, emigration records, government to government agreements etc.) | The Medical Council of Ireland, regulatory body, provided the data below directly. Doctors voluntarily withdrawing from the register. | * Figures in this report are not directly comparable to EU regulation (EU) 2022/2294 due to divergence in methodologies applied by data sources and EU regulatory requirement. *Note on doctors voluntarily withdrawing from the register: Data here refers to doctors who trained in Ireland, who voluntarily withdrew from the register and stated that they intended to ‘practice medicine abroad’. Doctors who did not retain and were removed would not be included and some may have been Irish trained and migrated. * The Nursing and Midwifery Board of Ireland are able to provide data on Certificate of Current Professional Status (CCPS Applications). However, CCPS Request does not directly relate to nurses migrating. * Data on outflows for dentists and pharmacists is not currently available. * Data on emigrating domestically trained health personnel is not available. * For regulated HSCPs, CORU noted that there is some ‘blunt’ data about registrants wishing to be removed from the Register, but what is not stated specifically as a reason to leave by the registrant remains only conjecture. |
[Q11x3]
If you have any document with information on health worker inflows and outflows for your country, please upload
Additional detail and links in relation to Q11.3
Additional detail and links in relation to Q11.3
Stock of health personnel
[INFOxNRI13]
National Reporting instrument 2024
[INFOx8]
Stock of health personnel
[Q12x1]
Consolidated stock on health personnel, disaggregated by place of training and birth
For the latest year available, consistent with the National Health Workforce Accounts (NHWA) Indicators 1-07 and 1-08, please provide information on the total stock of health personnel in your country (preferably the active workforce), disaggregated by the place of training (foreign-trained) and the place of birth (foreign-born).
For the latest year available, consistent with the National Health Workforce Accounts (NHWA) Indicators 1-07 and 1-08, please provide information on the total stock of health personnel in your country (preferably the active workforce), disaggregated by the place of training (foreign-trained) and the place of birth (foreign-born).
[Q12x1a]
Please provide data on the stock of active health personnel in your country by one of the following ways:
Fill in the table below
[Q12x1x1]
| Medical Doctors (generalist + specialists) | 19328 | 11709 | 7619 | Irish Medical Council - provided data directly. | 2023 | Data provided directly by Medical Council. These figures represent “clinically active”. Figures in this report are not directly comparable to EU regulation (EU) 2022/2294 due to divergence in methodologies applied by data sources and EU regulatory requirement. | |||||
| Nurses | 72543 | 34931 | 37609 | 7713 | 29896 | 39107 | 33436 | NMBI data compiled by Dept of Health to fulfil EU Regulation (EU)2022/2294 | 2023 | Practicing only | |
| Midwives | 4251 | 3298 | 953 | 535 | 418 | 3405 | 846 | NMBI provided data directly | 2023 | Practicing only | |
| Dentists | 3442 | 2145 | 1297 | Register of dentists - Dental Council provided data directly. | 2022 | Data provided directly by Dental Council. Figures in this report are not directly comparable to EU regulation (EU) 2022/2294 due to divergence in methodologies applied by data sources and EU regulatory requirement. | |||||
| Pharmacists | 7578 | 3822 | PSI –The Pharmacy Regulator provided the data directly from the professional register | 2024 | Data provided directly by PSI. Figures in this report are not directly comparable to EU regulation (EU) 2022/2294 due to divergence in methodologies applied by data sources and EU regulatory requirement. |
[Q12x1x1x]
If you have any document with information on stock of active health personnel for your country, their distribution by place of training and place of birth, please upload
Additional links and detail in relation to Q12.1.1
Additional links and detail in relation to Q12.1.1
[Q12x2]
Please provide data on the top 10 countries of training for foreign-trained health personnel in your country.
This information can be provided by one of the following two options:
This information can be provided by one of the following two options:
Fill in the table below
[Q12x2x1]
| Doctors | Nurses | Midwives | Dentists | Pharmacists | |
|---|---|---|---|---|---|
| Total foreign trained personnel | 7619 | 37609 | 953 | 1297 | 3822 |
| Country 1: Top country of training | PAK | IND | GBR | GBR | GBR |
| Country 1: No. of foreign trained health personnel | 1851 | 16851 | 651 | 454 | 2849 |
| Country 2: Top country of training | SDN | GBR | GHA | POL | PRT |
| Country 2: No. of foreign trained health personnel | 1060 | 9917 | 73 | 141 | 181 |
| Country 3: Top country of training | GBR | PHL | ITA | ROU | ESP |
| Country 3: No. of foreign trained health personnel | 709 | 6277 | 60 | 141 | 158 |
| Country 4: Top country of training | ZAF | ZWE | IND | HUN | ITA |
| Country 4: No. of foreign trained health personnel | 513 | 633 | 49 | 106 | 103 |
| Country 5: Top country of training | ROU | NGA | POL | PRT | POL |
| Country 5: No. of foreign trained health personnel | 505 | 558 | 22 | 54 | 97 |
| Country 6: Top country of training | IND | ROU | DEU | ESP | ROU |
| Country 6: No. of foreign trained health personnel | 310 | 495 | 19 | 52 | 81 |
| Country 7: Top country of training | EGY | POL | NGA | LTU | HUN |
| Country 7: No. of foreign trained health personnel | 249 | 464 | 14 | 45 | 53 |
| Country 8: Top country of training | POL | PRT | AUS | IND | ZAF |
| Country 8: No. of foreign trained health personnel | 212 | 234 | 13 | 45 | 30 |
| Country 9: Top country of training | HUN | ESP | GRC | FRA | AUS |
| Country 9: No. of foreign trained health personnel | 206 | 231 | 9 | 29 | 21 |
| Country 10: Top country of training | NGA | USA | ESP | DEU | EGY |
| Country 10: No. of foreign trained health personnel | 125 | 203 | 5 | 26 | 20 |
| Source (e.g. professional register, census data, national survey, other) | Medical Council Register | Nursing and Midwifery Board of Ireland (NMBI) | Nursing and Midwifery Board of Ireland (NMBI) | Dental Council | PSI – The Pharmacy Regulator, professional register of the statutory regulator for pharmacy in Ireland |
| Year of data (Please provide the data of the latest year available) | 2023 | 2023 | 2023 | 2022 | 2024 midpoint |
| Remarks | This data was received directly from the Medical Council. 7,619 doctors qualified outside of Ireland. Primary Qualification Country was available for 7,605 of these doctors. The top 10 countries are outlined above. | These figures refer to practicing only. The data was compiled for this table by the Department of Health, to comply with EU regulation (EU) 2022/2294. Hence, figures in this report many not be not directly comparable to other reports | Figures provided directly from NMBI. | This data was received directly from the regulator (Dental Council). | Note that the UK figures would include a large number of ROI students, but the data only refers to the country where the training was completed |
[Q12x2x1x]
If you have any document with information on the distribution of foreign-trained health personnel for your country by their country of training, please upload
Additional links and detail in relation to Q12.2.1
Additional links and detail in relation to Q12.2.1
Technical and financial support
[INFOxNRI14]
National Reporting instrument 2024
[INFOx9]
Technical and financial support
[Q13]
Has your country provided technical or financial assistance to any source countries or countries in the WHO health workforce support and safeguards list 2023, or other low- and middle-income countries on health workforce development, health system strengthening, or for implementing other recommendations of the Code (e.g., strengthening data, information and research on health workforce for translation to policies and planning, etc.)
Yes
[Q13x]
Please provide additional information below (check all that apply):
Support for health workforce development (planning, education, employment, retention)
Support for other elements of health system strengthening (service delivery; health information systems; health financing; medical products and technology; and health leadership and governance)
Other areas of support:
[Q13x1]
Please specify support for health workforce development (planning, education, employment, retention)
| Country supported | Type of support (please specify) | |
|---|---|---|
| Zambia | Technical assistance to Zambia College of Medicine and Surgery to strengthen capacity for training of medical specialists | |
| Sudan | Collaboration with Sudan Medical Specialization Board on specialist medical training | |
[Q13x2]
Please specify support for other elements of health system strengthening (service delivery; health information systems; health financing; medical products and technology; and health leadership and governance)
| Country supported | Type of support (please specify) | |
|---|---|---|
| Ethiopia | Technical assistance and training for Ministry of Health on hospital accreditation Training of hospital teams on quality improvement | |
| Mozambique | Training and coaching in quality improvement for Ministry of Health and hospital teams | |
| Tanzania | Technical advice to Ministry of Health and President’s Office for Regional Government and Local Administration for developing national plans and resources to improve quality of care. Benjamin Mkapa Foundation and Amref Health Africa (Irish Mission partners):Through this programme Ireland supports recruitment and deployment of clinicians and nurses to primary health facilities in underserved areas both in Tanzania Mainland and Zanzibar. As part of the agreement with the Ministry of Health, the staff are remunerated for limited period of time and later mainstreamed to the government payroll. Ireland also supports recruitment, training, and deployment of community health workers through this partnership as part of the Government of Tanzania Community Based Health Programme. Ireland provided €1.1 million to this Programme in 2023. Health Basket Fund: The Health Basket Fund (HBF), which is the pooled fund arrangement currently funded by nine donors including Ireland, supports primary healthcare services including Human resources production and capacity development for the mid-level cadres. Ireland contributes € 5 million to the Health Basket Fund annually. The HBF also supported recruitment of over 500 Accountants to support financial management systems at primary healthcare level as part of the Direct Health Facility Financing (DHFF) approach of sending monies directly to local health facilities. These accounts were later on mainstreamed to the government payroll system. | |
| Sudan | In 2023, the HSE provided humanitarian assistance to Sudan, donating €1 million worth of medical equipment and supplies. |
[Q13x3]
Please specify other areas of support
| Country supported | Support Area | Type of support | |
|---|---|---|---|
| East, Central and Southern Africa | Institutional Health Partnership for health workforce development between College of Surgeons of East Central and Southern Africa (COSECSA) and the Royal College of Surgeons in Ireland | Small grant and technical assistance to support postgraduate education and training in Obs and Gynae. | |
| East, Central and Southern Africa | Institutional Health Partnership for health workforce development between College of Obstetricians and Gynaecologists (ECSACOG) and Royal College of Physicians of Ireland | Small grant and technical assistance to support postgraduate education and training in Obs and Gynae. | |
| Tanzania | Institutional partnership for health service strengthening between Irish Blood Transfusion Service (IBTS) and Tanzania National Blood Transfusion Service (NBTS). | Small grant and technical assistance to improve quality of blood transfusion service. |
[Q14]
Has your country received technical or financial assistance from any WHO Member State or other stakeholders (e.g., development partners, other agencies) for health workforce development, health system strengthening, or for implementing other recommendations of the Code (e.g., strengthening data, information and research on health workforce for translation to policies and planning, etc.)?
Yes
[Q14x]
Please provide additional information below (check all that apply):
Support for health workforce development (planning, education, employment, retention)
Support for other elements for health system strengthening (service delivery; health information systems; health financing; medical products and technology; and health leadership and governance)
Other areas of support:
[Q14x1]
Please specify support for health workforce development (planning, education, employment, retention)
| Supporting country/entity | Type of support (please specify) | |
|---|---|---|
| European Commission | The Department of Health commenced a project in 2022 supported by the European Union via the Technical Support Instrument, in cooperation with the Directorate-General for Structural Reform Support of the European Commission. The project developed an evidence-based planning tool that has the capacity to produce a variety of workforce projections, under different scenarios with differing types of healthcare policy and reform, and supply side parameters. | |
Constraints, Solutions, and Complementary Comments
[INFOxNRI15]
National Reporting instrument 2024
[INFOx10]
Constraints, Solutions, and Complementary Comments
[Q15]
Please list in priority order, the three main constraints to the ethical management of international migration in your country and propose possible solutions:
| Main constraints | Possible solutions/recommendations | |
|---|---|---|
| Gap between supply and demand of health and social care workers | Strategic partnership agreements; Increase domestic supply | |
| Application by individuals to publicly advertised jobs, and individual applicants seeking to voluntarily relocate to other jurisdictions. | ||
[Q16]
What support do you require to strengthen implementation of the Code?
Support to strengthen data and information on health personnel
- In Ireland, there is limited data on the number of emigrating health and social care workers. Data inflows are collected by Eurostat on % of foreign educated doctors/ nurses. It may be useful to broaden these professions and to also include requests for emigrating workers. - A summary slide deck that could be shared with broader stakeholders explaining the code and responsibilities in simple language would be beneficial.
Support for policy dialogue and development
- Good practice sharing would be beneficial in terms of supporting countries to influence across the public and private sector, noting successful strategies, and providing templates and dialogue for these. - It would be interesting to capture “roles” of different actors in the system in terms of implementing the code e.g. service delivery, government, regulatory bodies.
Support for the development of bilateral/multi-lateral agreements
- Continued support/guidance on good practice is useful.
Others
No support required
[Q17]
Considering that the Code is a dynamic document that should be updated as required, please provide reflections from your country on the past 14 years since the resolution on the Code.
[Q17x1]
Please comment on if/how the Code has been useful to your country.
- Useful Guide: The Code, and associated materials, are useful to guide policies and provide evidence to support recruitment approaches.
- Streamlines Approach: The Code provides a streamlined approach for countries to align with.
- Trusted Source: The WHO is a trusted source for information and guidance.
[Q17x2]
Do any articles of the Code need to be updated?
No
[Q17x3]
Does the process of reporting on Code implementation and the review of the Code relevance and effectiveness need to be updated?
Yes
Suggest that some questions could be simplified/ clarified. Some were misinterpreted by stakeholders when responding
[Q17x4]
Please comment on the WHO health workforce support and safeguards list (e.g. if your country is included in the list, how has that affected you; if your country is reliant on international health personnel, how has the list affected you; if your country is not in the list, how has it affected you)
- It is useful to have a safeguards list to refer to.
- Ireland currently has a high portion of foreign educated health and social care workers. This is due to several reasons. Time and resources are required to increase the number of student places, and while there are efforts to do so, international recruitment is required to support the gap between supply and demand. However, efforts are ongoing to ensure adherence to the Code in relation to this.
- There are internationally trained health and social care workers who are on the safeguards list working in Ireland as can be seen in the data provided in this document. Instruction was issued by the HSE to stop all active recruitment in any country listed on the WHO safeguards list.
- In some instances, stakeholders noted that the safeguards list disadvantages professionals seeking to leave listed countries of their own accord.
[Q18]
Submit any other complementary comments or material you may wish to provide regarding the international recruitment and migration of health personnel, as related to implementation of the Code.
Please describe OR Upload (Maximum file size 10 MB)
Please describe OR Upload (Maximum file size 10 MB)
Please see attachments including additional details where the online survey would not allow us to enter the full information.
[Q18x1]
List of Acronymns
List of Acronymns
Additional detail for Q3.4 and Q13.3
Additional detail for Q3.4 and Q13.3
Additional Notes and Acknowledgements
Additional Notes and Acknowledgements
Warning
[INFOxNRI16]
National Reporting instrument 2024
[WARN]
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