Deep Dive: Hong Kong hopes foreign nurses can fight shortage

Hong Kong is facing a shortage of qualified nurses. Legislation passed earlier this year hopes to fight the problem by bringing in foreign-trained nurses.

The new measure was passed in July. It would allow qualified candidates to skip the city’s licensing exam if they work in public hospitals, clinics, and care homes.

Filipino domestic helper Lorna Sianen Pagaduan hopes the policy change will allow her to practise nursing again.

She obtained her degree in the Philippines and worked as a registered nurse in a hospital there for two years. Desperate to support her family, she came to Hong Kong as a domestic helper. She has worked here for 27 years.

In 2006, she founded the Filipino Nurses Association Hong Kong to support other women like her. She said some of its 150 members were qualified nurses or nursing graduates working as helpers.

Nurses are among the healthcare professionals Hong Kong needs more of. One government projection estimates a shortage of 9,500 nurses next year. The situation is projected to ease gradually. However, the city is still expected to be thousands of nurses short by 2045.

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From 2014 to 2023, the number of non-locally trained nurses who passed the city’s licensing exam and obtained full registration ranged from two to 26 each year.

Secretary for Health Lo Chung-mau said Hong Kong’s demand for medical services would only increase as the population aged.

“Adequate medical manpower is crucial to maintaining the quality of medical services,” he said before the Nurses Registration (Amendment) Bill 2023 was passed.

Those with three years of working experience may apply for special registration. This would allow them to apply for full registration after working in specific institutions for five years.

Indonesian nurse Matilda*, 25, is a private home care nurse in Jakarta. She has been preparing to work in Europe. She said she might have changed her plans if she had known about Hong Kong’s new measures sooner.

Registered nurses in Hong Kong public hospitals receive a starting monthly salary of HK$37,590. Nurses in Jakarta are generally paid about HK$1,780 to HK$2,500 a month.

“I would have chosen Hong Kong because it’s so much closer and I’ll be able to go home when I have some days off,” she said.

Staff writer

1. Based on News, which of the following is true?

(1) Under the new measure, qualified nurses still need to take the licensing exam if they work in public hospitals.
(2) Demand for medical services will continue to rise in Hong Kong.
(3) Hong Kong is facing a shortage of more than 9,000 nurses next year.
(4) Nurses in Jakarta make more money than nurses in Hong Kong.

A. (1), (2) only
B. (1), (3) only
C. (2), (3) only
D. (2), (3), (4) only

2. Using News, list TWO reasons why Hong Kong passed legislation allowing non-locally trained nurses to practise in the city.

3. Why did Matilda say she would have made a different choice if she had known about Hong Kong’s new law? Explain using News and Glossary.

1. What does the chart indicate about Hong Kong’s shortage of nurses?

2. What could happen if the city’s nursing shortage persists? Explain using News and your own knowledge.

1. Based on the information in News, what might the empty spaces represent?

2. Do you think this is a critical issue? Why or why not? Explain using News, Glossary and your own knowledge.

• Lack of Cantonese skills, heavy workload in public hospitals could put off potential applicants, experts warn

• Non-locally trained nurses could ease the workload if they were familiar with medical English for written records, one nurse says

Aside from the competitive pay in Hong Kong, Asian nurses are expected to be drawn to the city because it is closer to their homes.

However, two issues could put off potential applicants: the language barrier for foreign nurses who do not speak Cantonese and the notoriously heavy workload in public hospitals.

The response to the Hospital Authority’s recruitment drive in Singapore, Malaysia, Macau, and mainland China has been positive. Authority chairman Henry Fan Hung-ling said last month that around 600 applicants “had potential”, and interviews were being arranged for shortlisted candidates. So far, the authority has already hired 70 of these nurses.

The authority earlier said it would consider nurses’ professional qualifications, clinical experience, personal character and language proficiency. The ability to speak Cantonese was a plus.

Tse Kin-keung, chairman of the Association of Hong Kong Nursing Staff, did not expect the qualifications of foreign nurses to be an issue because the Nursing Council would ensure that applicants met the required standards. He was more concerned about bringing in those who could not speak Cantonese.

“Many patients in public hospitals speak Cantonese. If there are any issues in communication, there could be problems,” he said, adding that it would be an extra burden if foreign nurses needed interpreters to understand patients.

The Indonesian National Nurses Association, which oversees nursing education and services in the country, was also concerned about language proficiency.

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Agung Waluyo, head of its collaboration division, said Indonesian nurses are used to working long hours. Still, the language barrier could pose problems.

The professor of nursing at the University of Indonesia said nurses fluent in English usually did not look for jobs in Asia. They preferred working in Europe, North America or Australia.

Thousands of Indonesian women already worked in the city as domestic helpers, and many could speak Cantonese. However, the language demands in a healthcare setting were much higher, as miscommunication could lead to a patient’s death, Waluyo explained.

The Hospital Authority said it would provide basic Cantonese training for non-locally trained nurses to help them adapt and integrate.

Public hospital nurse Tracy Chan*, who works in an emergency ward, said she usually handled more than 10 patients on her own in a shift.

But at night, with less staff, a nurse might care for more than 20 patients. The ward could descend into chaos if several people needed attention at the same time.

She said non-locally trained nurses could ease the workload if they were familiar with medical English for written records. They could perform common nursing procedures, such as inserting urinary catheters and feeding tubes.

1. List TWO factors that could potentially dissuade non-locally trained nurses from working in the city.

2. According to Chan, how could foreign nurses benefit the city’s overburdened healthcare sector?

3. To what extent do you support Hong Kong’s decision to bring in registered nurses from abroad to practise in the city? Explain using News, Issue, and your own knowledge.

Nurses Registration (Amendment) Bill 2023: A bill passed by Hong Kong’s Legislative Council in July that opens up new pathways for non-locally trained nurses to practise in Hong Kong. Candidates with at least one year of full-time clinical experience would be able to work through a limited registration or enrolment scheme. They could be employed at care homes and in “specified settings” under the Department of Health and Hospital Authority.

special registration: a measure that would allow nurses with at least three years of full-time clinical experience to work at public clinics and hospitals with no restrictions on their area of practice. They would be eligible for full registration or enrolment after gaining at least five years of experience in Hong Kong and being assessed as having performed “satisfactorily and competently”.

integrate: to mix with and join a society or group of people, often changing to suit their way of life, habits and customs

urinary catheters: a flexible tube inserted into the bladder to empty it of urine and collect it in a drainage bag

1. C

2. Hong Kong is facing a chronic shortage of nurses. According to a government projection last year, the city will be short of thousands of nurses by 2045. In addition, the demand for medical services will only increase as Hong Kong’s population ages, according to the city’s health secretary.

3. For Matilda, working in Hong Kong means better pay. Registered nurses in Hong Kong public hospitals receive a starting monthly salary of HK$37,590, while nurses in Jakarta are generally paid about HK$1,780 to HK$2,500 a month. Matilda is planning to move to Europe to make more money, but Hong Kong is much closer to her home country. Living in Hong Kong would allow her to visit her family more easily.

1. Hong Kong faces a chronic shortage of nurses. According to a government projection made last year, the city will be short thousands of nurses by 2045.

2. The quality of Hong Kong’s healthcare sector will suffer, leading to longer wait times at public hospitals and heavier workloads for nurses and other healthcare professionals. This could create a vicious cycle of staff resignations and a lack of nurses.

1. vacancies in nursing positions.

2. The city’s shortage of nurses is a critical issue. With the ageing population, the healthcare system will be overburdened, leading to heavier workloads for nurses, longer wait times, and decreasing quality of medical services. Recruiting trained nurses from outside of Hong Kong is crucial as it can alleviate the workload of frontline nurses working in public hospitals and even care homes, which also face nursing staff shortages. (accept all reasonable answers)

1. The language barrier for foreign nurses who do not speak Cantonese and the notoriously heavy workload in public hospitals.

2. Chan said non-locally trained nurses could ease the workload if they were familiar with medical English for written records. They could also perform common nursing procedures, such as inserting urinary catheters and feeding tubes.

3. I support the city’s decision to recruit nurses trained in other countries to support the city’s overburdened healthcare sector. The city’s shortage of nurses is a critical issue. Nurses are already overworked, and this issue will only worsen as the population ages. Tihs could impact the health of patients. Recruiting nurses from outside Hong Kong can alleviate stress, and these nurses can also bring in new knowledge from their countries. (accept all reasonable answers)