A four-month investigation by Belgian broadcaster RTBF has revealed that Wallonia hospitals are turning to illegal recruitment agencies to provide staff for their hospitals.
Across Belgium, there is a shortage of around 20,000 nursing staff and hospitals are scrambling to hire foreign talent to meet legal obligations of one nurse per 30 patients. These hospitals are now turning to agencies that ferry over medical staff from Lebanon.
These agencies however, are implicated in a web of accusations, ranging from mafia-like practices to human trafficking, and modern slavery.
Since 2004, the share of foreign nurses in the capital has more than doubled, as Belgium’s hospital staff is imported from abroad. Originally hiring staff from Portugal or Romania, the majority of new hires are now from Lebanon.
Since the downturn in the Lebanese economy in 2020, more than two-thirds of all Lebanese nursing staff have left the country, leaving the country short of medical expertise.
One Lebanese hospital that normally has 500 nurses has seen 133 leave to go abroad, a huge blow to the beds available in the crisis-ridden country. This is now costing lives. Pregnant mothers, one hospital director said, are now routinely turned away due to a lack of nurses.
The agencies that Belgian hospitals rely on to supply these nurses are often of questionable status and with dodgy, or at times illegal, hiring practices.
One agency identified by RTBF, the International Nursing Network (INN), recruited nearly 200 nurses over two years on behalf of major hospitals in Belgium such as the Chirec Group, the CHC in Liège, and the CHU Brugmann in Brussels.
This agency charged hospitals an administrative fee of €10,000 per nurse to pay for procuring equivalent diploma certificates, among other costs.
But according to Lebanese staff hired by the agency, nurses were also forced to pay for these certificates out of their own pocket, costing at least €2,500. In reality, this service should cost a maximum of €200.
“It asked me to pay so that it could find me a job in a Belgian hospital,” one Lebanese nurse said. “In all, it wanted to charge me $5,000… It takes advantage of people’s naivety.”
Furthermore, the contracts that Lebanese nurses are made to sign for Belgian hospitals include disturbing and illegal demands. Staff are instructed to “speak softly”, working in the hospital for two years under the threat of a €15,000 fine. Female nurses must not become pregnant for two years.
One nurse attested that to keep their job, a fellow nurse underwent an abortion. “For me, it’s trafficking in white coats. It’s modern slavery,” a Lebanese nurse said.
In a response to the investigation, the head of the agency defended these clauses, stating that they were just “a warning” and put in place to please Belgian hospitals.
Illegal hiring practices
Whether Belgian hospitals were fully aware of these abusive contracts is not clear. Both Chirec and CHC Liège hospitals have condemned these contracts and vowed to break their collaboration with INN.
Yet one hospital admitted that they had been attracted to the agency by assurances that staff would remain for at least two years. However, it claimed ignorance of the clauses that enforced this.
Whether conscious of the abuse or not, the INN agency is not approved in the Brussels region, meaning that hospitals in the capital were knowingly hiring from a completely unlicensed entity. Hospitals face fines of €100–€5,000 per nurse illegally hired.
The Wallonia-Brussels Federation recorded a significant increase in forgeries of nursing diplomas. These documents are modified or fabricated to allow Lebanese nurses to join Belgian hospitals. According to the investigation, around a third of all incoming Lebanese nursing degrees and certificates were fraudulent in 2021.
The Wallonia-Brussels Federation is now launching legal proceedings against these fraudulent recruitment agencies but for now, the abusive contracts remain in place.