Hong Kong has an aging population and a shortage of nursing staff. The problem is urgent.
Last Wednesday (December 14), Chief Executive Lee Ka-chiu in conjunction with the Executive Council approved that Section 14(3) of the Employees Retraining Ordinance (Chapter 423) launched a special plan for the importation of caregivers in institutions (hereinafter referred to as the "Scheme"), adding The number of imported foreign workers has been increased to 7,000, the qualifications for hiring foreign workers in all institutions have been relaxed, and the ratio of local employees to imported foreign workers has been relaxed to 1:1 or 2:1 to deal with manpower shortages.
However, relying solely on importing foreign labor to alleviate the pressure has not focused on the fundamental problem of manpower shortage, that is, the qualification structure of nursing staff has not been restructured, and professional nursing grades other than nurses have not been established, which has led to their long-term lack of qualification certification and salary. Remuneration and social status are "lower than others", so it is naturally difficult to attract more newcomers to the industry.
Chief Executive Lee Ka-chao, in conjunction with the Executive Council, launched a special plan for the importation of nursing staff in institutions, increasing the number of imported foreign workers to 7,000 to alleviate the shortage of nursing staff.
(File photo/photo by Zheng Zifeng)
Chronic shortage of nursing staff and
governments never addressing needs
The "plan" is mainly divided into four aspects: one is to increase the number of foreign workers, and import an additional 3,000 caregivers, with a total of up to 7,000; the other is to expand the scope of eligible applications from private institutions to include subsidized institutions The third is to set the recruitment conditions and salary level. The nursing home must prove that it has recruited locals through the channels designated by the SWD but failed to fill the vacancy, and stipulates that the salary of the imported nursing staff should not be lower than the nursing staff compiled by the Statistics Department. The median monthly salary of staff, as for the salary of local recruits must not be lower than the salary of imported nursing staff; the last is to streamline the approval process, it is expected that the application approval time will be shortened from about five months currently required by the Supplementary Labor Scheme to About two months.
The government hopes to launch the "plan" as soon as the second quarter of next year.
The authorities estimate that the nursing home industry will need at least an additional 4,500 caregivers in the next three years. Taking into account the 3,000 imported foreign workers, there are still 1,500 vacancies to be filled.
However, Law Chi-kwong, the former Secretary of the Labor and Welfare Bureau, published the Secretary's blog on April 3 this year, indicating that the entire residential care industry needs 45,000 people, but there were already nearly two vacancies at that time, that is, there was still a shortage of 11,250 people staff.
Based on this calculation, taking into account the importation of about 2,800 private caregivers each year under the "Supplementary Labor Scheme" and the temporary introduction of 3,500 mainland caregivers due to the fifth wave of the epidemic, there is still a need for about 4,500 manpower.
However, the temporary two-year contracts for caregivers introduced this year will need to be renewed after the contract expires, which means that the supply is hardly stable. The authorities may have underestimated the demand too optimistically.
Furthermore, Chief Executive Lee Ka-chao has stipulated in his "Policy Address 2022" that the number of residential care places for the elderly will increase from 75,000 to 81,200 by the end of 2027. It is believed that this increase of 6,200 places will also require a lot of nursing staff.
It is undeniable that importing foreign labor and streamlining the approval process will have an immediate effect on alleviating the problem, but in order to fundamentally reverse the "supply in short supply" of nursing staff, it is also necessary to face up to the reason behind the "unmanned entry", which is based on the "disgust" of nursing work itself. "Nature, coupled with negative factors such as hard work, poor salary, and long working hours, have discouraged those who intend to join the nursing industry, and may even choose better salary, clearer promotion ladder, and more respectable perception. nurses, not caregivers.
In the final analysis, the key is that the Hong Kong government has never paid attention to the seriousness of population aging, and has not actually assessed the needs of the elderly care industry. Therefore, it has not sorted out the qualifications structure of the nursing industry, and has not established professional nursing grades other than nurses. It also fails to provide sufficient manpower for the elderly service and care industry.
The Sailing Program was launched in 2015. By the end of June 2021, a total of 1,158 trainees have been recruited, of which 530 have graduated, and only 302 graduates continue to be employed in social welfare service units.
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From qualification certification to salary and treatment
, the medical care industry is very different from the elderly care industry
It is not that Hong Kong does not have a qualification framework and career ladder for nursing staff, but there is a huge difference in the qualification certification and salary packages in the "medical care industry" and "elderly care industry".
According to the "Occupational Qualification Ladder for the Elderly Service Industry" formulated by the Education Bureau in 2018 to assist the elderly care industry, it mainly provides four-level qualification certification for "elderly care" employees. A nurse with a training certificate has a starting salary of 14,150 yuan; the third level is a health worker who has five years of senior service and a health care training diploma, and the salary ranges from 20,540 to 32,545 yuan; the fourth level is the highest level. Residential supervisors with years of service for the elderly and associate degrees or advanced diplomas in residential management training courses have a monthly salary of 30,000 to 70,000 yuan. After working for more than seven years, they can become directors of residential buildings with a maximum salary of 90,000 yuan.
The "Youth Nursing Service Pilot Scheme" ("Vibration Scheme") launched by the authorities in July 2015 to attract young people aged 17 to 29 to enter the nursing industry is also in the above-mentioned ladder: as long as they have completed Form 5 or have an equivalent education young people enrolling in the "Start-Sail Project" need to pay their own tuition fees to complete the two-year Diploma in Health Studies (Community Health Nursing) course at the Open University of Hong Kong. Tuition fees will be refunded in full three months after graduation; , will be arranged to work as a caregiver in a nursing home in the first year, with a starting salary of 9,900 yuan (now 14,150 yuan), working 44 hours a week (now 40 hours), and being promoted to a registered health worker in the next year, with a monthly salary of 11,890 yuan ( Today it ranges from $20,540 to $32,545).
However, compared with the qualification certification of nursing staff in the "medical care industry", employees in the "elderly care industry" obviously do not have a competitive advantage.
The former provides five levels of qualification certification. The first three levels are similar to the latter, but the fourth level is for registered nurses who need to complete the two-year training course offered by the nursing school and pass the "Hong Kong Nursing Council" examination. The monthly salary ranges from 20,540 yuan to 43,610 yuan; and the fifth level is a registered nurse who needs to complete the three-year nursing degree program offered by the university. The monthly salary ranges from 32,545 yuan to 52,370 yuan, and can be promoted to The head nurse, the monthly salary ranges from 54,840 yuan to 92,090 yuan.
It is not difficult to see that the promotion ladder of "medical care industry" is more clear than that of "elderly care industry".
Compared with the qualification certification of nursing staff in the "medical care industry", employees in the "elderly care industry" obviously do not have a competitive advantage.
It is difficult for Qihang to attract newcomers to enter the industry and
set up a professional nursing grade as soon as possible
Theoretically, if the above-mentioned young people who have completed the "Starting Plan" aspire to devote their lives to the nursing industry, they can obtain certification through the nursing qualification framework of "elderly care industry" or "medical care industry"; In addition to being standardized and clear, the entry and promotion thresholds of the "medical care industry" are also more basic than those of the "elderly care industry".
For example, in the "medical and nursing industry", as long as you are at least 18 years old and have passed five subjects in the HKDSE, or you have graduated from the one-year course of the Foundation Diploma and Yi Jin Diploma, you can apply for enrolling nurses in nursing schools Training courses, and then can be promoted through the above-mentioned channels.
But in the "elderly care industry", take the above-mentioned young workers who have completed the "Start Sail Project" as an example. After accumulating certain management experience, complete the Vocational Training Council's Higher Diploma in "Community Health and Nursing for the Elderly", or the "Professional Certificate in Residential Supervisor Training" course of the Li Ka Shing School of Professional and Continuing Education of the Open University of Hong Kong - the Higher Diploma in "Community Health and Nursing for the Elderly" Higher qualification requirements, need to hold an advanced diploma or associate degree, bachelor's degree or master's degree in aged care, health care services, long-term care management, public health, public administration, business administration or medical management; "The course is suitable for supervisors who are currently working in residential care homes for the elderly or homes for the disabled, or other employees who have been nominated by the homes for further study, and are open to social workers, nurses, doctors, Chinese medicine practitioners, occupational therapists, physical therapists, pharmacists, etc. It can be seen that the competition is fierce and the promotion prospects are not quite clear.
In addition, they are also nurses, but in terms of social status and public image, the "medical care industry" is more popular than the "elderly care industry". For example, nurses often have the reputation of "white angels", but nurses are regarded as Works for the low end.
Furthermore, nurses serve as the upper ladder of health workers, which will naturally push nursing staff from the elderly care industry to the medical care industry.
Actual data also shows that from the launch of the "Sailing Project" in 2015 to the end of June 2021, a total of 1,158 students have been recruited, of which 530 have graduated, and only 302 graduates continue to be employed in social welfare service units.
Therefore, it is the first step to increase the entry salary of nursing staff and bring them on par with registered nurses.
In addition, it is still crucial to establish a professional grade and promotion ladder for residential nursing staff to attract more people to enter the industry.
And this is not difficult. For example, continue to deepen the professional nature of health workers. On top of their ranks, add ranks linked to professional courses such as bachelors and masters, qualification examinations, and seniority, and provide corresponding remuneration and qualification certification. Such as senior health workers, nursing health workers, or nurses who are dedicated to nursing homes.
At the same time, to promote the reform of the nursing industry, health workers are not only engaged in basic nursing and first aid work, but also need to share professional medical work, such as follow-up of chronic diseases, diabetes and chronic strain, so that the elderly can get timely and appropriate help, and also Helps build the professional image of nursing staff.