The HA only has itself to blame for acute nurse shortage

January 22, 2019 18:48
Hong Kong authorities have been accused of not doing enough to address the problem of nurse shortage in the city’s public hospitals. Photo: HKEJ

With the winter flu season in full swing, doctors and nurses in government hospitals are having increased workloads as the public healthcare sector grapples with acute manpower shortage.

Last Sunday, members of the Association of Hong Kong Nursing Staff (AHKNS) decided enough is enough and staged a mass protest at the Central Government Offices, demanding prompt responses from the government and the Hospital Authority (HA) on the pressing concerns.

At the core of the AHKNS’s demands is that the nurse-to-patient ratio in the public hospitals be set to 1:6.

Short-staffing in public hospitals and clinics has been a problem for decades.

Unfortunately, it appears the government bureaucrats in charge of the healthcare system are still lacking the determination to address the issue and strive for a healthy “new norm”.

Angry and frustrated, nurses who took to the street on Sunday referred to the current conditions in the public hospitals as absolutely dreadful, as if things had regressed to the 1950s.

Some even said the situation in the hospitals has become so bad that it is virtually like a war zone.

On average, every nurse in public hospitals run by the HA has to look after 10 patients or so every day.

Given that, the AHKNS has reiterated its long-standing demand that authorities should hire more people so as to bring the nurse-to-patient ratio to a more reasonable 1:6.

Other demands include suspending unnecessary administrative procedures, ensuring greater flexibility in handling paperwork, and increasing the numbers of hospital beds and medical staffers during peak flu seasons.

Meanwhile, the AHKNS has also urged the HA to reintroduce the 16.5 percent cash allowances and incremental jumps of pay for healthcare workers in public hospitals.

Hong Kong's current shortage of public hospital nurses dates back to about 20 years. In 2000, the then government shut down over 20 nursing schools in one-go in a desperate attempt to narrow the huge government budget deficit at that time.

Worse still, local universities didn’t increase the number of places in their nursing degree programs accordingly.

As a consequence, the number of nursing graduates in Hong Kong plummeted from 2,500 to less than 600 that year.

It wasn’t until after the severe SARS epidemic in 2003 that the HA reopened government-funded nursing schools in 2008.

Yet the remedies carried out by the government were simply too little too late, as the pace with which new nurses are trained has continued to lag far behind the growing demand among patients in recent years.

According to the standards laid out by the Organization for Economic Cooperation and Development (OECD), there should be nine qualified nurses for every 1,000 people.

At present, Switzerland has the highest nurse-to-patient ratio in the world -- 17.9 nurses for every 1,000 Swiss. The comparative figure in Hong Kong is just 7.1.

In order to meet the OECD standards, the city will need to hire an extra 10,000 plus nurses. Yet the question is, does the HA have the necessary resolve and motivation to accomplish that?

The answer given by Professor Sophia Chan Siu-chee, the Secretary for Food and Health, at a Legislative Council Question and Answer Session on April 25 last year speaks volumes about the government’s half-heartedness and inaction when it comes to increasing the number of nurses in the public hospitals.

Chan said the number of nurses in the public healthcare sector already rose from 24,587 on March 31, 2016 to 26,103 on March 31, 2018. And the numbers were expected to reach a further 26,560 by March 31 this year.

Simply put, from March 2016 until March 2019, the HA would only hire less than 2,000 nurses, which is, if anything, just a drop in the ocean in face of the ever-increasing public demand.

Although Chief Executive Carrie Lam Cheng Yuet-ngor diverted a one-off and extra HK$500 million in January 2018 into the HA in an attempt to ease the manpower shortage in the public healthcare sector, the measure has failed to address the fundamental issue of us not having enough nurses in our public hospitals.

It is because the money was actually spent on hiring back-office staffers to share the excessive amount of paperwork of frontline medical workers, rather than on recruiting more nurses.

As far as the suggestion of importing foreign nurses into the city is concerned, it would involve a lot of complicated issues, not to mention the backlash from the local healthcare sector.

That said, the government must study and scrutinize the suggestion very carefully before responding to the problem.

Suffice it to say that the HA cannot escape censure for the acute shortage of both nurses and doctors in the public hospitals over the past 20 years.

The agency will continue to remain in the firing line until it can come up with a thorough solution to the problem.

This article appeared in the Hong Kong Economic Journal on Jan 21

Translation by Alan Lee

[Chinese version 中文版]

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Hong Kong Economic Journal