HEALTHCARE REFORMS AND INTRA-EU HEALTH LABOUR MIGRATION. THE CASE OF ROMANIA

The Romanian healthcare system has undergone a series of reforms after 1989 aimed at transforming the system into an efficient, competitive one. Despite these measures, the Romanian healthcare system still faces considerable challenges including underfinancing and, more recently, high migration rates among health professionals. The number of Romanian health professionals choosing to work in a foreign country (mostly within the EU, due to the single labour market and the lack of labour migration barriers, at least from a juridical perspective) has increased steadily over the last few years. This affects the system negatively on different levels. Firstly, it severely reduces the number of highly trained professionals, thus both creating shortages of specialists and decreasing the overall quality of the medical act due to a lower average qualification of medical personnel. Secondly, since a major part of medical education is provided free of charge, it means that the Romanian system loses the funds invested in training for these professionals. The article takes on this challenge and aims to critically discuss the effect healthcare reforms in the last two decades have had on the efficiency of the Romanian healthcare system with particular emphasis on their connection to the increased migration trends of health professionals. The analysis is conducted based on official documents, policy papers, reports and media articles on the healthcare system as well as building on general statistics regarding demographics, wages and migration trends in Romania. Results show that low wages, legislative instability and the lack of opportunities for professional development influence health professionals' decision to migrate which then puts increased pressure on a system dealing with workforce shortages. The paper's value lies in the fact that it presents a critical analysis over a span of 25 years with the aim to discuss the relation between healthcare reforms and health professionals migration, two aspects of considerable importance for further Romanian healthcare reformation projects.