If the Swiss authorities decide this week to limit immigration from European Union member countries by enacting a quota clause, health workers say it will put a strain on local hospitals, already worried about red tape and staffing problems.
Anybody born at the Bürgerspital Solothurn in northwestern Switzerland gets a breath of multiculturalism within his or her first few minutes on Earth.
When swissinfo.ch visited the maternity ward, the team caring for the newborns and their mothers was represented by various nationalities. There was an Austrian head doctor, a German assistant doctor, midwives with Spanish and Zimbabwean roots, and nurses from Italy, Britain, Kosovo, Serbia and Sri Lanka.
Nishanthy Thirunavukkarasu has Tamil roots but speaks perfect Swiss-German. In addition to bathing, diapering and dressing the babies, the 30-year-old nurse often serves as an interpreter.
«Patients appreciate it very much if someone not only speaks their native language, but also has the same cultural background,» she says.
Station manager Claudia Zuberbühler also has an immigrant background. Born in Austria and raised in neighbouring Germany, she came to Switzerland 22 years ago. She sees the cultural diversity of her 27-member team as an asset.
«Very early in my career, it bothered me when mothers from certain cultures swaddled their babies in very tight wraps – practically tying them in a bundle,» she recalls.
But today it’s known that after nine months in the confines of the womb, newborns feel insecure if they have too much freedom of movement right after birth, says Zuberbühler: «Wrapping them up gives them a sense of security.»
Communication
The station manager says care professionals need two things in particular: a diploma recognised by the Swiss Red Cross and proficiency in the German language.
«We’re responsible for the safety of mother and child, and we have to be able to convey that,» Zuberbühler says.
In the maternity ward, understanding and being understood is important not only in terms of care services, but also when offering support and preparing families for the time after the hospital stay.
Meanwhile, the hospital management has implemented various measures to improve communication in recent years.
It includes not only language courses for its staff, but also interpreting services and information leaflets for new parents in more than a dozen languages. The Bürgerspital as well as all other hospitals of the region are among the Migrant Friendly Hospitals. (See infobox.)
Trained abroad
A German is in charge of the internal medicine casualty ward. Head doctor Eva Maria Kifmann came to the Bürgerspital 11 years ago. She had done part of her training in the Solothurn region and was later offered a job there.
At the time, assistant doctors in Switzerland earned significantly more than their colleagues in Germany.
Many of her colleagues, whose training was funded in Germany, look for work in Switzerland not only because the compensation is higher. In the Solothurn hospital they also appreciate the «pleasant and less hierarchical atmosphere».
To fill the void left by general practitioners in particular, Germany for its part recruits medical professionals from other countries, especially eastern and southern Europe. Where the ratio of staff to patients is strained, the medical care deteriorates.
Andreas Woodtli, staff director of Solothurn Hospitals Group, is familiar with the problem.
«Because Switzerland trains too few doctors, it is partly responsible for the fact that professionals are missing elsewhere.»
Therefore it is high time for a massive increase in the number of internships for doctors, says Woodtli, «so that in ten years, we will be in a position to recruit 90-95 per cent of new doctors and nurses within Switzerland».
«Wouldn’t kill us, but …»
Until then, hospitals in Switzerland will continue to depend on foreign employees. If the government re-introduces the quota system (see infobox) to restrict the immigration of foreign workers, the decision would have «far-reaching» consequences for all of the Solothurn hospitals
.
«Especially if the clause also applies to German-speaking countries,» says Woodtli. «The problem would be most serious in terms of doctors.»
The personnel director is concerned that there could be a run on the quotas, leaving those who apply too late out in the cold. In addition, there would be more of an administrative burden again.
«The clause wouldn’t kills us, but it would make life harder because there would be problematic staffing gaps,» predicts Woodtli.
Better working conditions
Nursing associations have also demanded that Switzerland assume its responsibility in the global shortage of health workers.
This would include an improvement in working conditions, especially in hospitals where staff work around the clock. Here, lobbying nurses have called for measures to reconcile work and family life.
This is also an issue at the Bürgerspital. For example, its day care centre, open from 7am until 8pm, «is very much appreciated», says head nurse Barbara Camen. However, the demand for spaces is greater than the supply.
Because of the night shifts, some employees wish that the nursery was open 24 hours a day.
«We would have to consider how great the need is and whether it can be financed,» staff director Woodtli says. «But as a father of three, I wonder whether this would also be in the interest of the children.»