Germany is both a destination and a source country for migration in the health care sector. Foreign health professionals have long had a presence within Germany's health services and nearly half of these hold EU citizenship. However, the EU enlargements of 2004 and 2007 have not produced the expected strong effect on the migration inflows of health professionals. In 2008, foreign national health professionals still represented a relatively small percentage (about 6%) of the total health workforce in the country. At the same time, a number of German health professionals are leaving the country to work abroad, attracted by better working conditions and higher pay.