A cycle of brain gain, waste and drain - a qualitative study of non-EU migrant doctors in Ireland.

BACKGROUND: Ireland is heavily reliant on non-EU migrant health workers to staff its health system. Shortages of locally trained health workers and policies which facilitate health worker migration have contributed to this trend. This paper provides insight into the experiences of non-EU migrant doctors in the Irish health workforce. METHOD: In-depth interviews were conducted with 37 non-EU migrant doctors in Ireland in 2011/2012. RESULTS: Respondents believed they had been recruited to fill junior hospital doctor 'service' posts. These posts are unpopular with locally trained doctors due to the limited career progression they provide. Respondents felt that their hopes for career progression and postgraduate training in Ireland had gone unrealised and that they were becoming de-skilled. As a result, most respondents were actively considering onward migration from Ireland. DISCUSSION & CONCLUSIONS: Failure to align the expectations of non-EU migrant doctors with the requirements of the health system has resulted in considerable frustration and a cycle of brain gain, waste and drain. The underlying reasons for high mobility into and out of the Irish medical workforce must be addressed if this cycle is to be broken. The heavy reliance on non-EU migrant doctors to staff the medical workforce has distracted from the underlying workforce challenges facing the Irish medical workforce

The siting of UK nuclear reactors

Choosing a suitable site for a nuclear power station requires the consideration and balancing of several factors. Some 'physical' site characteristics, such as the local climate and the potential for seismic activity, will be generic to all reactors designs, while others, such as the availability of cooling water, the area of land required and geological conditions capable of sustaining the weight of the reactor and other buildings will to an extent be dependent on the particular design of reactor chosen (or alternatively the reactor design chosen may to an extent be dependent on the characteristics of an available site). However, one particularly interesting tension is a human and demographic one. On the one hand it is beneficial to place nuclear stations close to centres of population, to reduce transmission losses and other costs (including to the local environment) of transporting electricity over large distances from generator to consumer. On the other it is advantageous to place nuclear stations some distance away from such population centres in order to minimise the potential human consequences of a major release of radioactive materials in the (extremely unlikely) event of a major nuclear accident, not only in terms of direct exposure but also concerning the management of emergency planning, notably evacuation. This paper considers the emergence of policies aimed at managing this tension in the UK. In the first phase of nuclear development (roughly speaking 1945–1965) there was a highly cautious attitude, with installations being placed in remote rural locations with very low population density. The second phase (1965–1985) saw a more relaxed approach, allowing the development of AGR nuclear power stations (which with concrete pressure vessels were regarded as significantly safer) closer to population centres (in 'semi-urban' locations, notably at Hartlepool and Heysham). In the third phase (1985–2005) there was very little new nuclear development, Sizewell B (the first and so far only PWR power reactor in the UK) being colocated with an early Magnox station on the rural Suffolk coast. Renewed interest in nuclear new build from 2005 onward led to a number of sites being identified for new reactors before 2025, all having previously hosted nuclear stations and including the semi-urban locations of the 1960s and 1970s. Finally, some speculative comments are made as to what a 'fifth phase' starting in 2025 might look like