In the comparison countries, the two groups of nurses are labeled differently. The level and length of training for both groups of nurses varies from country to country.
The extent of the shortage of nurses
How much do nurses earn in South Africa compared to nurses in the UK, USA and Australia. However, associate nurses in the US earn 164 percent more than their counterparts in South Africa.
The emigration of nurses
The extent of nurse emigration
Former Commonwealth countries Australia and the United Kingdom have already recruited large numbers of nurses from South Africa, while the USA has only recently begun actively recruiting from the country (Bruch et al. 2004). As noted above, the US has only recently begun to actively recruit nurses from South Africa (Brush et al. 2004).
Implications of nurse emigration
With South Africa having scant immigration of skilled professionals to balance the scale, the country is therefore experiencing a critical and growing skills shortage. Britain is the main receiving country for all skilled migration from South Africa (Bhorat et al. 2002).
Ethical considerations and policy implications
The emigration of nurses places additional pressure on nurses who still have to provide care to an increasing number of patients (Kline 2003). Another ethical consideration lies in the recruitment sector, as some countries have acted very aggressively and unethically in the recruitment of nurses (Buchan and Calman 2004).
Theories of migration
General theory
These theories largely assume that migration is a response to market needs, leading to the redistribution of labor. The more integrated approaches emphasize that migration is a complex phenomenon, which is why a more pluralistic and holistic understanding is needed (Boyle et al. 1998).
Nurse emigration
Apart from the contrasting approaches of determinist and humanistic accounts of migration, more integrated approaches to migration have emerged with the argument that migration cannot be seen as an inevitable response to particular circumstances or as a completely individual action. A more integrated approach can also be used to explain and understand the motivation behind nurse emigration, which considers the phenomenon as an individual action combined with a rational response to particular circumstances.
Factors affecting nurse migration
- Job factors
- Broader societal factors
In the same survey, nurses also complained about the long working hours in South Africa. In the study by Oosthuizen and Ehlers (2007), a majority were also dissatisfied with the unsatisfactory conditions in the hospitals. According to the findings of Oosthuizen and Ehlers (2007), almost half of respondents were concerned about their safety in the workplace in South Africa.
Introduction
Research objectives and questions
As a benchmark for nurses' relative pay, how much do nurses earn compared to four selected professions - teachers, engineers and architects, accountants and doctors - in the various countries. There are likely to be fewer differences in access to employment-based benefits between South Africa and the comparator countries, as benefits in South Africa tend to be high among nurses. This is because most nursing jobs are found in the formal, public sector of the economy and are strongly unionized (based on own calculations from LFS 14).
Scope of analysis
In this study I did not distinguish between economic work factors in the public and private sectors. First, nurses emigrating from South Africa are likely to work abroad in both the public and private sectors. Second, the majority of nurses in South Africa work in public hospitals, therefore there are a limited number of observations of private sector professional nurses in the South African LFS sample, probably too few to provide reliable findings.
Sources of Data
South African data
Although professional nurses were the focus of this study, both groups were included in the analysis, although the data were separated to explore the different work characteristics of these two groups. In addition to family, demographic and biographical information, there are a number of modules in the questionnaire that focus on specific areas of labor market activity (such as unemployment/employment status, type of employment, public works programs, etc.). Statistics SA has made available population weights based on the 2001 Census, which I have used to weight the number of nurses in the sample to arrive at estimates of the total number of nurses in South Africa.
Comparison country data
The OWW data extracted for the UK is drawn from four different national sources, all carried out by the UK Department of Employment. The sample is selected from income tax data and personnel/salary data of large public and private sector employers and is based on a random sample of one percent of employees. The third survey, the Wages and Wages Survey, is conducted monthly and covers personnel/salary data of large public and private sector employers.
Limitations of the data and methods
Difficulties with comparing data across countries
For the employment-based services in the UK, I have mainly used sources from the National Health Service (NHS), the UK's public health provider, where the majority of UK nurses work (75 per cent). While all sources of pay used in this study provided "gross pay", it is possible that not all countries in the study include all forms of financial remuneration for nurses, such as allowances for unfavorable working hours (e.g. evening/night ). shift work). Although all salaries used in this study have been adjusted for cost of living through purchasing power parity (explained below), comparing salaries is still very problematic as nurses in different countries pay different government taxes and other deductions.
Sample size
Characteristics of nurses in the sample
Method of analysis
Conversions and adjustments of the data
To find countries' purchasing power, a PPP rate is calculated based on the price of a given basket of consumer goods. When converting the various countries' salaries to OPP, the amount is divided by the countries' specific OPP rate. After a brief overview of the health systems in South Africa and the comparison countries, a profile of the nurses in the AKU sample follows to provide more information about the characteristics of nurses in South Africa, as the focus of the study is on what leads to the emigration of South African nurses.
Brief overview of the healthcare systems in South Africa and the comparison
Data published by the US Census Bureau (2008) indicated that the majority of the population had health insurance, either privately or publicly. % of the population was uninsured, and 59.3% of the population had health insurance through employment. Despite universal access to the public health sector, almost half of the Australian population has private health insurance (Colombo and Tapay 2003).
Profile of the nurses in the LFS sample
In addition, there is a large private sector that is actively supported by the government, as individuals who take out private insurance receive a 30 percent subsidy from the state (Department of Health and Aged Care 2000). Regarding the employment contract, 91 percent of the 367 nurses have a written contract with their employer. If we distinguish between the two groups of nurses, 88 percent of professional nurses and 92 percent of assistant nurses have a written contract.
Wages/salary
Average earnings
The average monthly salary for professional nurses working in the UK after adjusting for PPP was 3050 international dollars. In the US, the average salary for professional nurses was US$4,961 per month, while associate nurses earned an average of US$3,099. As can be seen in Figure 3, there is a large wage gap between professional nurses in South Africa and comparator countries.
Relative earnings
Engineers, with an average monthly salary of 4,939 international dollars, earn 48 percent more than professional nurses. Accountants with an average monthly salary of $4,557 international earn 49 percent more than professional nurses. Doctors in the country have an average monthly salary of 8,902 international dollars, earning 165 percent more than professional nurses in the UK.
Salary advancement
In OSD, general nurse practitioners and nurse practitioners are paid according to three levels. Since there are no national statistics available on salary advancement for nurses in the US, finding representative information about salary advancement was difficult. As seen above, salary progression in the UK and Australia is concentrated in the early years of nurses.
Average hours worked
The average working hours of professional nurses in the UK in 2006 was 37.5 hours per week. In the US, registered nurses worked an average of 38.9 hours per week, while associate nurses worked an average of 39 hours per week. In addition to working longer hours per week in South Africa, findings reported in the literature have shown that there is a significantly greater shortage of nurses in South Africa than in comparison countries.
Benefits received from the employer
Pension benefits
As shown by the findings on employment-based pension benefits, access to this benefit appears to be generally good for nurses in all the countries examined, although slightly lower in the USA. First, while access is high in South Africa, all nurses in the UK (at least in the NHS) and Australia received pension benefits from their employer. If pension packages are significantly better in the comparison countries than in South Africa, receiving a better package may influence emigration from South Africa.
Medical aid/health insurance benefits
In the United Kingdom, health care, as mentioned above, is mainly provided by the National Health Service. In other words, healthcare is provided to all nurses working in the UK provided they are residents of the country (National Health Service 2009). Although private health insurance is available for use in the private health service, employer contributions are not common.
Paid leave
In the US, the amount of paid vacation received each year varies, usually by length of service. The number of days of paid leave for nurses in the different countries cannot be stated with certainty, as the findings from South Africa, the UK and Australia are only reported if a minimum number of days of paid leave is required of employers to provide their employees with to grant legislation. . It is therefore possible that nurses in the different countries receive additional paid leave from their employers.
Summary of main findings
As a result, an in-depth comparison of the benefits received in South Africa and in the comparator countries is not possible. The other job factors and wider societal factors play a major role in the emigration of nurses from South Africa. Based on the results, which show the huge salary gap between South Africa and the comparison countries, a salary increase is essential to improve the retention of nurses in the country.
QUESTIONS USED FROM THE LFS 2006:2 QUESTIONNAIRE
