French-speaking African countries fear a flight of their doctors to France
In its immigration law, the French government provides, among other measures, for the creation of a specific residence permit for foreign doctors. The countries of French-speaking Africa, major providers of French hospitals, fear a large-scale looting of their qualified resources.
Isn’t the French government lighting a counter-fire? In any case, this is what is assured in the ranks of the opposition. After several postponements, it was finally in the midst of social unrest on the pension reform, that the executive drew its immigration bill in the Council of Ministers, Wednesday, February 1.
Accused of laxity by the right and inaction by the left on the migration issue, the Minister of the Interior Gérald Darmanin and that of Labor Olivier Dussopt therefore presented a text which wonderfully illustrates the presidential antiphon of the “same time”. On the one hand, the draft law in its repressive section provides for measures to facilitate expulsions, especially of “delinquent” foreigners. On the other hand, the humanist component includes a reform of the right to asylum and an integration component, including the granting of residence permits for undocumented migrants employed in “short-term jobs”, such as catering, hotels , tourism, cleanliness, security, home help or health, like “Talent professions medical and pharmacy”. In short, it is a question of “being mean with the bad people and nice with the good people”, summarized the boss of the place Beauvau.
“We want to transfer our medical deserts to countries from our former colonies”
Problem, beyond political divisions, this text causes concerns on both sides of the Mediterranean. Some African countries fear in particular that article 7 of the bill, which proposes a new framework for health professionals, including doctors, midwives, dental surgeons and pharmacists, will de facto lead to an exodus of these professionals and therefore a reduction in access to care for the populations of the Maghreb and sub-Saharan Africa.
A column published on January 7 in the Sunday Journal (JDD) by four French practitioners goes in this direction. “We want to transfer our medical deserts to the countries from our former colonies. But how can we want to attract doctors from these countries without then agreeing to receive their sick populations left without care? We will not limit illegal immigration by continuing to deprive countries of origin of their natural, technological and human resources, assert André Grimaldi, Jean-Paul Vernant, Xavier Emmanuelli and Rony Brauman. On the contrary, we must accept to participate in the training of their future health professionals within the framework of agreements bilateral agreements responding to the needs of local populations”.
Another grievance formulated by critics of the law, the fact that the bill does not make foreign doctors more precarious, already less well paid than their French counterparts. Firstly because the residence permit of these doctors is only valid for four years without any guarantee for the future. Then because the bill does not mention the question of the validation of the achievements that the students came to look for in France. However, the steps to obtain them are often a headache: the authorization procedure (PAE), which has nevertheless been simplified, can still take several years.
A medical workforce from the Maghreb and sub-Saharan Africa
Currently, France is, in fact, making massive use of this qualified workforce to operate a health system that has become failing over the years. According to the Organization for Economic Co-operation and Development (OECD), France hired some 25,000 foreign-born doctors last year, or 12% of the total number of practitioners registered with the Order of Physicians. This trend does not date from the health crisis. The figures have been multiplied by thirty over the last twenty years.
And this trend is intensifying. The number of visas granted to African students in training for the 2020-2021 academic year has increased by 32.5%. The number of students from sub-Saharan Africa has increased by 41% in five years, according to data from the Campus France agency. The majority of foreign doctors come primarily from Eastern Europe but also from Algeria, Morocco, Tunisia, Madagascar, Senegal, Cameroon, Côte d’Ivoire, Benin and of the Democratic Republic of Congo (DRC).
A French government bill on immigration is to be presented to the Council of Ministers in January, with a proposal for a residence permit for foreign doctors. A column is entitled “Let’s not deprive Africa of its doctors”, with Rony Brauman. pic.twitter.com/aRQjsQiLNV
– The Africa TV5MONDE newspaper (@JTAtv5monde) January 12, 2023
A global practice
France is not the only country to plunder the intellectual resources of the countries of the South. This trend is part of a broader movement that is taking place throughout the West. France is even below some of its European neighbors. OECD countries have an average of 25% foreign doctors when France only has 12%. In the United Kingdom, more than one in three doctors who practice in public hospitals, comes from India, Nigeria or Egypt.
Critics of the French bill more generally criticize the lack of European cooperation. “What strikes me is that we talk a lot about what is happening in France with our administration, our institutions and very little about our cooperation with the countries of origin for whom migration represents a very important and a considerable lever for development, explains Camille Le Coz, an analyst at the think tank Migration Policy Institute. Immigration has effects on the countries of origin, on the countries of transit. If we want to obtain a long-term policy In the long term, we need a dynamic of win-win partnership.”
On this point, the war in Ukraine and the reception of refugees has shown that “the European Union was capable of considering a common migration policy and of coordinating on the reception of displaced populations. New measures have moreover tested on this occasion”, continues the specialist.
Such a “dynamic partnership” with the countries of French-speaking Africa does not seem to be on the government’s agenda. Gérald Darmanin and the Minister of Labor Olivier Dussopt, who carries the economic part of the bill, both suggested that adjustments to the text were possible. But modifications to the margin will be mainly intended to seduce the Republicans, members of the opposition essential to pass the law. The project will be discussed in mid-March in the Senate, and at the end of May in the Assembly. Once again, the executive could resort to the last 49.3 of the parliamentary session. “I am ready to compromise, without distorting everything,” said Gérald Darmanin, determined, during the day.