The recruitment of nurses by high-income countries from poorer nations is “out of control”, according to the chairman of one of the world’s leading nursing organisations.
The remarks were made after the BBC discovered evidence that Ghana's health system is faltering as a result of the "brain-drain."
A significant number of specialized nurses have left the country in West Africa in search of employment in other countries that provide higher wages.
In the year 2022, more than 1,200 Ghanaian nurses registered with the nursing registration in the United Kingdom.
This comes as the National Health Service (NHS) increasingly relies on employees from non-EU nations to fill vacancies.
The United Kingdom has a policy that prohibits active recruitment in Ghana; yet, because to social media, nurses are able to quickly view the positions that are open in NHS trusts. After that, they are able to submit applications directly to those employers. The precarious state of Ghana's economy serves as a significant driving force.
Concern has been expressed by Howard Catton of the International Council of Nurses (ICN) on the magnitude of the number of nurses departing countries such as Ghana.
He told the BBC, "My sense is that the situation currently is out of control," and he was right.
There is a significant amount of recruiting taking place, with the majority of it being driven by six or seven countries with rich incomes. However, there is also recruitment from countries that are among the weakest and most vulnerable, which cannot afford to lose their nurses.
The head of nursing at Greater Accra Regional Hospital, Gifty Aryee, recently told the BBC that her Intensive Care Unit alone has lost 20 nurses to the United Kingdom and the United States in the past six months; this has serious repercussions.
"Care is compromised because we are unable to accept any additional patients at this time. There are holdups, and it ends up costing more in mortality because people who are waiting die," she added.
She went on to say that because of the nursing shortages, patients who were critically ill were frequently need to remain in the emergency department for an extended period of time.
One of the nurses working there believed that almost half of the people who had graduated with her had already left the country, and she wished that she could go with them.
'All our expert nurses gone'
The BBC investigated and discovered a similar problem at the Cape Coast Municipal Hospital.
Caroline Agbodza, who is the deputy chief of nursing services at this hospital, mentioned that in the past year there have been 22 nurses who have left for the UK.
"All our critical care nurses, our seasoned nurses, have gone. As a result, we are left with nothing - no experienced staff members with whom to collaborate. Even if the government were to start recruiting nurses, we would still have to go through the ordeal of retraining them.
Smaller clinics are especially affected by employee migration because even one nurse leaving a small health care can have a major knock-on effect.
Both the small emergency department and the outpatients section at the Ewim Health Clinic in Cape Coast have lost a nurse as a result of recent staff turnover. Both of the nurses had years of experience and were successfully employed in the UK.
Dr. Justice Arthur, who was the head physician at the facility, stated that the consequences were significant.
"Let's consider for example services such as the vaccination of children. According to what he said to the BBC, "If we lose public health nurses, then the babies who have to be immunised will not get their immunization, and we are going to have babies die."
He stated that it was possible for adult patients to pass away as well if there were not enough nurses to care for them following surgery.
The majority of the nurses the BBC crew spoke to in Ghana expressed a desire to leave the country due to the fact that they could earn more in other countries.
Mercy Asare Afriyie shared her plans to relocate to the United Kingdom in an upcoming interview at the Kwaso healthcare center, which is located close to the city of Kumasi.
Because of the inadequate conditions of service that we provide, the mass departure of nurses is not going to stop. Our pay is nothing to write home about, and you manage to go through it in just two weeks. It's a matter of word of mouth."
According to statements made to the BBC by Ghanaian nurses, the pay scale for nurses in the United Kingdom is more than seven times more than in Ghana.
According to Perpetual Ofori-Ampofo, who works for Ghana's Nurses and Midwives Association, the healthcare system in her nation requires additional assistance.
"If you look at the numbers, then it is not ethical for the UK to recruit from Ghana because the numbers of professional nurses compared to trainee or auxiliary nurses is a problem for us," she added. "If you look at the numbers, then it is not ethical for the UK to recruit from Ghana."
However, she continued by saying that it was impossible to prevent nurses from leaving the country because migration was a right, and that the Ghanaian government needed to do more to convince them to remain in the country. The Ministry of Health in Accra, the nation's capital, refuses to comment on the matter.
The World Health Organization has identified 55 vulnerable countries, including Ghana, as having insufficient numbers of registered nurses to care for their respective populations. The list, which is intended to prevent systematic recruitment in these nations, has been given the nickname the "red list" by some.
Recently, the government of the United Kingdom contributed £15 million ($18.6 million) to Ghana, Nigeria, and Kenya in order to assist in improving their respective healthcare workforces.
On the other hand, it is common knowledge that the nation is investigating the possibility of striking a formal agreement with Ghana, under which it would be able to recruit nurses in a more aggressive manner in exchange for paying a quantity of money to the Ghanaian government for each one.
It has already reached an agreement of this kind with Nepal.
However, Mr. Catton from the ICN questioned whether or not it was sufficient.
In an interview with the BBC, he expressed his belief that agreements of this nature were "trying to create a veneer of ethical respectability rather than a proper reflection of the true costs to the countries which are losing their nurses."
Jim Campbell, the Director of Health Workforce for the WHO, recently gave an interview to the BBC in which he highlighted that one cause in the United Kingdom looking to African countries for nurses to fill gaps in the National Health Service was Brexit.
"The labor market is extremely competitive around the world, and because we have cut off the potential labor market from the freedom of movement of Europeans, what we are seeing are the consequences of that in terms of attracting people from the Commonwealth and other jurisdictions,"