Health worker mobility and employment relations responses in Romania

Abstract

The public sector in Romania is undergoing dramatic change as the state continues to come to terms with the post-Communist era, liberalisation encouraged further by accession to the European Union in 2007, and the impact of austerity measures implemented as a result of IMF loans in 2010. In this context Romania may be thought of as predominantly a ‘sender’ country of migrant health workers to Western Europe. Although this is undoubtedly the case, this paper shows how the situation regarding mobility of health workers in Romania is complex, involving multiple patterns of mobility - public to private, rural to urban, outward migration and circular migration. These are influenced by a potent mix of contributory factors, including the economic austerity measures (a public sector salary cut of 25 per cent, a recruitment freeze, and a limit on hospitals’ staff budgets); centralised and decentralised aspects of financial and employment controls (within which there are differing forms of hospital governance and funding); poor working conditions; and that this mobility is variable according to skill specialism. Further, the paper finds that whilst there is some creativity in management and trade union responses to these problems at local level, largely the employment relations system is struggling to cope with these challenges.