Making it to the Registers: Documenting Migrant Carers' Experiences of Registration and Fitness to Practise

在英国，谁可以成为并保持专业的医疗保健工作者？鉴于人口老龄化的高收入国家普遍缺乏合格的医护人员，这个问题变得尤为突出。目前英国医疗保健劳动力的国际构成是几个因素的结果，其中之一是卫生专业的守门功能的斗争。更具体地说，注册和执业资格（FtP）的监管工具，涉及专业人员必须满足的技能，知识，健康和性格，在建设现代化，专业化，多样化的医疗保健劳动力方面发挥着关键作用。“进入登记册”放大到深入询问这两个工具对全球移民照顾者的生活维度。最近的大流行凸显了英国医疗保健对国际劳动力的依赖，但使用海外培训的护理人员作为灵活的资源来适应英国间歇性的卫生人力挑战既不是新的，也不是例外。因此，“进入注册”将重点关注这两项要求（注册和FtP）的演变，并通过比较法定监管机构对三种“危机”情况的不同反应来建立历史文献：第二次世界大战，20世纪60 - 70年代外国医学毕业生的“供过于求”，以及冠状病毒大流行。在某些情况下，监管机构更容易扩大法定登记册，以增加医疗保健人员的可用性，而在其他情况下，监管机构收紧了要求，使登记册更难进入。危机期间的监管选择对医疗保健劳动力的结构具有长期持久的影响;因此，深入研究它们可以为更广泛的专业监管改革提供见解。“进入注册”是与BAPIO（英国印度裔医生协会）一起构思的，BAPIO是一个在游说和支持来自亚洲和欧洲的移民医生和护士在英国专业工作方面拥有25年经验的组织。BAPIO的工作对监管政策的变化和专业人员的个人迫切需求做出了可以理解的反应，与“使其进入登记册”的合作将使其能够回顾其机构历史并评估其对移民工人的影响，以规划其未来的工作。该项目将部署历史，法律的研究，人类学，健康多样性社会学和用户参与活动的学科和方法，以及我们的合作伙伴和其他组织的经验和专业知识。在第一阶段，我们将使用档案研究方法，以生成有关注册和FtP工具的原始知识，这些工具在历史上是如何被专业监管机构和其他机构推广，颁布，修改，使用和记录的。在第二阶段，该项目将评估第一阶段调查结果中出现的主题，以调查移徙工人目前在监管制度方面的经历。这将通过访谈和用户参与活动与BAPIO一起完成。在第三阶段，我们将在文化机构（Brotherton Special Collections、利兹剧场、YARN和难民理事会）的支持下展示该项目更广泛的适用性。我们将以各种无障碍格式制作，分享和保存原始见解，以扩大学术，政策和公众对移民医疗工作者和支持他们的活动家如何体验专业监管工具的理解。这将得到一个分享活动的支持，该活动将移民医疗保健工作者，专业监管机构和政策制定者以及媒体聚集在一起，共同策划开放获取数字档案，以及以英国移民医疗保健工作者为主题的政治戏剧项目。

Who gets to become and remain a professionalised healthcare worker in the UK? This question has become particularly salient given the endemic shortage of qualified healthcare workers in high-income countries with ageing populations. The current international make-up of the UK healthcare workforce is the result of several factors, one of which is the struggle over the gate-keeping functions of the health professions. More specifically, the regulatory tools of registration and fitness to practise (FtP), which relate to the skills, knowledge, health, and character that professionals must satisfy, play a key function in the construction of the modern, professionalised, diverse healthcare workforce. 'Making it to the Registers' zooms in to interrogating in-depth the lived dimensions of these two tools for global, migrant carers. The recent pandemic highlighted the reliance of UK healthcare on an international workforce, but the use of overseas-trained carers as flexible sources to adjust to the UK's spasmodic health workforce challenges is neither new nor exceptional. 'Making it to the Registers' will therefore focus on the evolution of these two requirements (registration and FtP) and build on historical literature by comparing the differentiated responses of statutory regulators to three 'crisis' situations: WWII, the 'oversupply' of foreign medical graduates in the 1960-70s, and the coronavirus pandemic. In some instances, regulators made it easier to expand the statutory registers to increase the availability of healthcare personnel while in other instances, regulators tightened requirements to make it more difficult to get onto the registers. Regulatory choices during periods of crisis have long lasting effects on the structure of the healthcare workforce; studying them in depth can therefore provide insights for the reform of professional regulation more broadly.'Making it to the Registers' was conceived with BAPIO (British Association of Physicians of Indian Origin) an organisation with 25 years of experience in lobbying for and supporting migrant doctors and nurses from Asia and Europe to work professionally in the UK. BAPIO's work has been understandably reactive to regulatory policy changes and to the individual pressing needs of professionals, and this collaboration with 'Making it to the Registers' will enable reflecting back on its institutional history and assessing its impact on migrant workers to plan its future work. This project will deploy together the disciplines and methods of history, legal studies, anthropology, sociology of diversity in health, and user-engagement activities, as well as the experience and expertise of our partner and other organisations. In Phase 1, we will use archival research methods to generate original knowledge about how the tools of registration and FtP for overseas-trained healthcare workers historically came to be promoted, enacted, modified, used, and documented by professional regulators and other institutional bodies. In Phase 2, the project will take stock of the themes emerging from the Phase 1 findings to investigate current experiences of migrant workers with regulatory systems. This will be done in conjunction with BAPIO via interviews and user-engagement activities. In Phase 3, we will show the project's wider applicability with the support of cultural institutions (Brotherton Special Collections, Leeds Playhouse, YARN, and Refugee Council). We will produce, share, and preserve, in a variety of accessible formats, original insights to enlarge academic, policy and public understandings of how regulatory tools of the professions get experienced by migrant healthcare workers and the activists that support them. This will be supported with a sharing event bringing together migrant healthcare workers, professional regulators and policymakers and media, a co-curated open access digital archive, and a political theatre project on the theme of UK's migrant healthcare workforce