A recent report from the Australia Institute underscores the escalating health workforce crisis in the Pacific, particularly highlighting the exodus of registered nurses and skilled workers who are seeking lower-skilled personal care positions in Australia and New Zealand. While the study acknowledges that labour mobility schemes contribute significantly to the economies of Pacific Islands, it raises concerns about how the expansion of temporary migration options, specifically in aged care, is detrimental to these countries’ health sectors.
Fiji, with a population nearing 930,000, faces ongoing labour market challenges reflected in high unemployment rates and notable disparities in workforce participation. Women’s labour force participation stands at only 36 percent, compared to 77 percent for men, while one in five young individuals lack employment, education, or training opportunities. Although the minimum wage has been increased to FJ$5 (US$2.50) per hour as of 2025, a staggering 40 percent of employment remains informal, further complicating economic stability.
The report criticizes Fiji for underinvesting in healthcare, particularly in primary health services, as non-communicable diseases accounted for 68 percent of deaths in 2021. It highlights the challenges in accessing quality healthcare, despite Fiji meeting WHO’s minimum threshold for skilled health workers, suggesting that this metric may not accurately reflect the actual needs of the healthcare system.
In the five years leading to August 2023, approximately 80,000 Fijians departed the country in search of better employment opportunities, with over 50,000 leaving between July 2022 and December 2023. The number of Fijians residing in Australia surged from 13,470 in 2022 to 22,599 in 2023, with work visas doubling. Remittances also represented 9.2 percent of Fiji’s GDP in 2023, further emphasizing the economic impact of this migration.
Participation in the Pacific Australia Labour Mobility (PALM) scheme notably increased after the COVID-19 pandemic, with 5,340 Fijian workers employed in Australia by July 2025, mainly in agriculture and meat processing, while only 4 percent were involved in healthcare and social assistance. Similarly, student visa numbers climbed, with 5,665 Fijian students pursuing studies in Australia in 2024.
To mitigate the loss of skilled staff, the Fijian government has raised the retirement age twice, especially for specialists in critical skill areas. However, health workers and unions revealed troubling trends, stating that public hospitals are losing personnel not just to emigration, but also to private hospitals operating within Fiji, which undermines patient access and trust in the public healthcare system. Reports of deteriorating facilities, staff shortages, and inadequate training further exacerbate these issues.
The concerning status of mental health services was notably highlighted, with Fiji’s only mental health hospital, St. Giles, described as being in dire condition. A lack of experienced nurses leads to unsafe staffing levels, which adversely impacts mentorship and training for junior staff, jeopardizing the future of healthcare in Fiji.
Participants of workshops addressing these challenges emphasized the necessity for labour migration policies that bolster rather than weaken Pacific health systems. They have called for greater transparency regarding emigration processes, stricter regulations on recruitment agencies, and union involvement in pre-departure briefings. Furthermore, there is a strong need for strategies to retain health professionals within Fiji and ensure they can reintegrate effectively upon returning from mobility programs.
Despite these considerable challenges, there remains hope that with reform and collective effort, the Pacific’s healthcare landscape can be strengthened, ultimately benefiting not only the professionals but the communities they serve.
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