Impacts of ASEAN Mutual Recognition Arrangements (MRAs) for Health Professionals on the Health System in Thailand: The Analysis of the Experience from the European Union Channarong Sungayuth, Cha-aim Pachanee
*International Trade and Health Program (ITH), International Health Policy Program, Bureau of Policy and Strat- egy, Ministry of Public Health
In 2006, ASEAN Member States signed the Mutual Recognition Arrangement (MRA) for Nursing Services and in 2009 signed the MRAs for Medical Practitioners and Dental Services. In view of the operationalization of the MRAs, review of the impacts in the European Union context was conducted to anticipate potential positive and negative impacts of the movement of health professionals within ASEAN under these MRAs. We found that MRAs in the EU were complex and took 30 years (1975-2005) for the detailed requirements in each directive to be completed. Unlike ASEAN, members of the EU have similar levels of economic development, administrative system and culture. Movement of the health profession- als flowed from member countries with lower level of development to countries with higher level of development. Each EU country has different responding measure to the health professional movements; countries in need of health professionals accepted foreign professionals immediately, while those not in need of health professionals delayed their acceptance. The movement created both positive and negative impacts. Positive impacts are job opportunities and knowledge exchange. Negative impacts are quality of services caused by language limitation, different levels of education and culture and insufficient number of health professionals in countries of origin. As an ASEAN member state, Thailand may be affected by the MRAs. Over the short term, health professionals should take a leading role in developing their coun- try positions with regard to the movement of health professionals. Longer-term preparation involves an analysis of probable scenarios for further improvement of the said positions.
Key words: Mutual Recognition Arrangement, European Union, ASEAN, Health Professionals
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