Filipino nurse migration to the UK: Understanding migration choices from an ontological security-seeking perspective.

Abstract

The Philippines remains the world's largest exporter of nurses, with over 22,000 employed in the NHS (Baker, 2020). In this article, we analyse the migratory rationales and choices of Filipino nurses either about to embark or already working in the UK's National Health Service (NHS), through an ontological security framework. Qualitative interviews and focus groups were undertaken with 24 nurses in the Philippines and UK one element of which set out to understand why, in the context of high global demand for overseas nurses the nurses had chosen the UK as their destination. Findings highlight how collective imageries of 'home' and of different overseas destinations are rooted in shared understandings of underlying social structures, and their perceived capacity to generate ontological security for their citizens. Social and institutional pressures in the Philippines engendered a generalised insecurity that was corrosive to the nurses' identity and sense of agency and undermined the ability to meet cultural norms of family support. The nurses favoured the UK due to the comparative ease of moving there; a prevailing perception of social stability and of its political and institutional structures as being based on transparency and meritocracy, facilitating professional development and social mobility. The findings extend 'culture of migration' perspectives by illuminating why nurses migrate to where they do by emphasising place as a source of ontological security, with migratory preferences influenced by the perceived capacity of different national systems to minimise social risks. This also implies that as global social risks and volatilities intensify, plugging nursing gaps in the economically developed world with nurses from the developing world will become increasingly unpredictable as the ability of governments in destination countries to guarantee ontological security becomes more uncertain.