Much has been written concerning the shortage of qualified nurses in Hong Kong. As several well-positioned commentators have noted, Hong Kong currently suffers a shortfall of approximately 1,000 nurses per year as the growth in demand combined with departures from the field exceed the number of new graduates. Attrition among the senior ranks is particularly concerning, as the depletion in the numbers of experienced nurses moves junior professionals to the front lines of patient care earlier than hospital administrators may wish. Indeed, in some areas, almost 80% of departing nurses are not replaced within a six-month period.
Turnover has consequently impacted nurse-to-patient ratios – certainly in the public hospitals where statistics are publicly available. During the typical day shift, the nurse-to-patient ratio stands at 1:11 in the public hospital system (in contrast the WHO recommended standard of 1:4 to 1:6), while at night that ratio goes to 1:21. In some localities, such as the New Territories, the ratio at night can reach 1:24. Teaching universities, nursing schools and hospitals all have attempted to fill the void by increasing class sizes, although the gap still remains.
This leaves the question of whether this shortage will continue to be a persistent problem or whether there is the proverbial light at the end of the tunnel. Unfortunately, present trends fail to signal an amelioration of the problem. The North Lantau Hospital, which is coming online in phases this year, requires 170 nurses of all tenures, while the expansion and the redevelopment of Tseung Kwan O Hospital and Caritas Medical Center in 2013 and 2014, respectively, will likewise lead to resource pressures. A number of additional hospitals are being planned or discussed in an effort to meet public healthcare needs, so demand will continue to increase over the next five to ten years. Complicating matters further, surveys of nurses in public hospitals on Hong Kong Island indicate that more than 25% are planning to retire or resign in the near future, leading administrators grappling with how to keep their employees in place.
In our view the “wild card” that has not received as much attention is the migration from Mainland China to Hong Kong for healthcare services. Whether it is for complex surgery or merely a simple vaccination, increasingly wealthy (and older!) Mainlanders are opting to travel to Hong Kong for their care, where there is greater confidence in the quality of the services and products received. And unless China quickly addresses its shortage of trained professionals, the spillover effect will continue to yield additional complications for Hong Kong’s officials in addressing its shortfalls.
May 22, 2013
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