Towards a Trade and Development Approach in the Caribbean Region

Date: 1 Apr 2005

Address by Commonwealth Deputy Secretary-General Winston Cox to the Mode IV Symposium in the Caribbean, 30-31 March 2005, Sherbourne Conference Centre, Barbados.

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Opening Remarks

Honourable Jerome Walcott, Minister of Health
Representatives from the Governments of the Commonwealth Caribbean
Representatives from the Governments of Canada, and the United Kingdom
Dr Edward Greene, Assistant Secretary-General, CARICOM Secretariat
Representatives from Regional and International Organisations
Colleagues
Ladies and Gentlemen

On behalf of the Commonwealth Secretariat I welcome you to this meeting to discuss a trade and development approach to the temporary movement of health service professionals. On your behalf, and on my own behalf, I am sure that you would wish me, through the Minister of Health, to thank the Government of Barbados for its hospitality and for the efficient arrangements made for this meeting.

As you know, many countries in the Caribbean are experiencing a loss of skilled professionals to developed countries. Recent studies estimate that for 1999-2000 the cost of nurses migrating from CARICOM countries was in the region of US$16.7 million. This is in fact a transfer of resources from lower-income Caribbean countries to higher-income destination countries that is only partially offset by the reverse flow of remittances.

Studies have also shown that due to the ageing population in OECD countries, the demand for health care professionals, especially nurses, in those countries will rise rapidly over the next 15 years. In the face of such demand we can confidently expect that the number of nurses and other health service professionals leaving the Caribbean will only accelerate. Caribbean countries must therefore have an appropriate policy response to this evolving situation otherwise, in spite of their substantial investment in training, they will suffer from a shortage of persons with the skills required to meet the needs of their own populations, a situation which will compromise the solid progress that most countries in the region are making towards achievement of the millennium development goals with respect to the provision of health care. We hope that this conference will create the atmosphere for a discourse between the recruiting countries, the source countries and the professionals and that out of it will emerge a framework for the development of an appropriate policy that satisfies the needs of all parties.

The Commonwealth Secretariat has accumulated some experience in assisting its member states to address the loss of human resources through migration. The Commonwealth Code of Practice for the International Recruitment of Health Workers was adopted in May 2003 and in September last year The Commonwealth Teacher Recruitment Protocol was adopted at a specially convened meeting of Commonwealth Education Ministers in the United Kingdom. Both of these codes were in response to requests from responsible ministers and their evolution is evidence of the Commonwealth working at its best to reconcile, through dialogue and compromise, the interests of all its members. Neither code is legally binding but by virtue of their moral authority, they provide guidelines for the international recruitment of health workers and teachers in a manner that takes into account the interests and welfare of the professionals, the obligations of the recruiting countries and the potential impact of such recruitment on health and education services in the source countries, which are for the most part developing countries. As a matter of interest The Commonwealth Teacher Recruitment Protocol had its genesis here in the Caribbean, through the Savannah Accord agreed by Caribbean Education Ministers in July 2002.

The Commonwealth Business Council has also produced CBCAfricaRecruit in collaboration with the NEPAD Secretariat, to address the migration of human resources from the African continent.

This meeting forms part of the initiative by the Commonwealth Secretariat to provide a trade and development approach to the migration of human resources. This approach seeks to achieve increased market access to developed country markets under Mode IV of the WTO General Agreement on Trade in Services (GATS). At the same time, we are seeking, through mutual agreement between developed and developing countries - recruiting and source countries - improvements in the training capacity of the source country so that the migration of trained personnel does not lead to a failure to meet key policy objectives in health and education. We are searching for a 'win-win' approach that would be owned by and be mutually beneficial to both developed and developing countries.

This is clearly recognised in the pre-feasibility study commissioned by the Secretariat on this initiative. The authors of that study noted that: "The best option for addressing the net losses accrued by Caribbean countries is to channel migration into temporary movement arrangements that maximize the connection between those seeking overseas employment and their home country. This would increase the length and quantity of remittances and other external benefits".

The study makes several recommendations on creating incentives for nurses to return and creating disincentives to overstay. The study also proposes a Canada-Bound Pilot Programme for Nurses. While this is only a proposal at this stage other development partners may also wish to consider the possibilities that such a programme may offer for combining trade and development assistance. Similar studies are currently being undertaken in the Eastern and Southern Africa Region and the Pacific.

The Council for Human and Social Development (COHSOD) of CARICOM, in their April 2004 meeting supported a review of existing policies to ensure that they are consistent with enhanced recruitment and retention of nurses in the Region and in their Communiqué referred to the importance of the outcome of this meeting in helping to chart a way forward. We certainly hope that the outcome of this meeting will satisfy those expectations.

In the face of the challenges associated with migration there is growing recognition that the process needs to be managed in a cooperative way in order to maximise the benefits and minimise the costs to the countries and professionals concerned. I see this meeting as the continuation of the process to incorporate the phenomenon of migration into regional and national socio-economic development strategies.

In passing let me note an interesting statistic that is very relevant to this 2-day meeting. Over the last 35 years the number of persons living outside their country of birth has more than doubled to over 175 million persons. I have also been informed that worldwide one in every 35 persons is a migrant. The Caribbean has always been a region characterised by high migration and your deliberations will therefore be of paramount importance to these countries. The work you do here will inevitably have its impact on some of the fundamental problems relating to the development and retention of human capital that is so essential to the enhancement of the quality of life of the citizens of the region.

Ladies and Gentlemen I wish you a successful meeting and I thank you for your kind attention.

Thank you.

30 March 2005

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