In recent years, the migration of health professionals between the private and state sectors has become an increasingly prevalent phenomenon, with profound implications for the quality and accessibility of health care. This phenomenon is driven by a variety of factors, from pay differentials and working conditions to professional autonomy and work-life balance.

Here are the main reasons behind this migration and its impact on the public health system, as well as some possible solutions to curb it:

 Determinant factors of migration 

1. Significant salary differences 

One of the main factors contributing to the migration of health professionals from public to private health care is the substantial salary differences. In general, the private sector offers superior salary packages, which is a significant incentive for health professionals to opt for the private sector. In a context of high financial pressures, the opportunity to earn a higher income becomes a crucial factor in the migration decision.

2. Superior workplace conditions

Working conditions play a key role in the job satisfaction of health professionals. The private sector generally offers superior working conditions, including state-of-the-art medical equipment and a more comfortable and better organized environment. The public system, on the other hand, often faces material shortages and insufficient resources, which can lead to frustration and encourage migration to the private sector.

 3. Increased professional autonomy

The private sector tends to offer greater professional autonomy to health professionals, allowing them to make clinical and therapeutic decisions with fewer bureaucratic constraints. This increased autonomy is particularly attractive to professionals who wish to practice their profession to the highest standards without external interference.

4. Greater program flexibility

Another significant factor is the flexibility of working hours offered by the private sector. Healthcare professionals who want to manage their time more efficiently or reduce their working hours may find the private sector a more appropriate solution to maintain a work-life balance.

Impact of migration on the public health system

Shortage of medical staff - The massive migration of health professionals to the private sector is leading to an acute shortage of staff in the public system. This results in a decrease in the capacity of public health facilities to provide adequate and affordable care, directly affecting the quality of care.

Increased waiting times for patients - A direct consequence of understaffing is increased waiting times for patients in the public system. With fewer doctors available, patients are forced to wait longer for consultations and interventions, which can lead to worsening of their conditions and a lower quality of life.

Declining quality of healthcare - As the best trained specialists migrate to the private sector, the quality of care in public facilities can be negatively affected. The lack of experienced specialists can lead to less efficient management of complex cases and an increased risk of medical errors, which undermines public confidence in the public health system.