The man-power of Hong Kong medical care is decreasing in previous years. According to the annual report from Hong Kong Hospital Authority in 2011, it state that loss rate of man power in public hospital in 2010 is 5.1% which is higher than the loss rate of 2009’s 3.8%. Hong Kong government has put 200 million dollar to recruit medical care professionals in Hong Kong in the past year. Hong Kong Authority recruited 1600 medical care professionals to replace the shortage of man power. However, the shortage of man power is still not solved. In order to settle this problem, recruit professionals from outside Hong Kong is a way to solve the problem in short period.
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Doctors and nurse are the mainly man power which is essential of operation of a public hospital. Even they are important to a public hospital, nurse may not need to recruit more man power from oversea or other region. The way to increase the man power of doctors and nurses will be analyzed and the different will be pointed out below. Hospital Authority doctors from outside Hong Kong but nurse are unnecessary to import from outside Hong Kong.
Reason of recruit doctors from other region
First of all, all of the doctors from Hospital Authority are working in public hospital. According to a new which is reported by AM730, it state a research to indicate the working hour of doctor who working in the public hospital. In the research, it pointed out that over 40% of doctor has problem of over working time in 2010. There are 700 doctor were interviewed and all of them have to work 65 hours per week. Also, over 3% of them have to work over 100 hours per week. This result show that the doctor’s man power is not enough, the demand of doctor is greater than the supply of doctor. Most of doctors have to put more effort and time on their works, it also can indicate that the workload of doctors is overdose. This reason can reduce the willing of those doctors working in public hospital.
(Over working hours,2011)
Secondly, attractiveness of working in private hospital will reduce the doctor working in public hospital. Working in a private hospital can receive more salary than working in public hospital. According to the pay scale of 2012, the starting salary point of doctor is point 32($49,355 per month), and the top salary is point 44B point ($85,945 per month). Also, working in the public hospital can just receive the stable salary without any welfare. However, the salary of working in private hospital is different with working in public hospital. Doctors who are working in private hospital, they can earn more money because they receive salary per case but nit per month. Also, they can work in their own clinic instead of spend one day in the hospital, they go to the hospital after they receive the order, otherwise they can stay in their own clinic to operate their own businesses. This can show that, the salary of a doctor who work in a private hospital can have more salary and freely working hour than working in the public hospital. That’s why the doctor loss rate of public hospital is higher than private hospital.
( Master pay scale, 2012)
Thirdly, the training of doctor and the imperfect system lead to doctor man power shortage. According to the news which is reported by the Hong Kong Commercial Daily, it shows the proportion between patient and doctor in different developed country including Hong Kong. Singapore has 22 doctors per 10,000 patients, British has 27 doctors per 10,000 patients, United State has 31 doctors per 10,000 patients and Hong Kong has only 18 doctors per 10,000 person. Hong Kong get the lowest proportional in the research, and the mainly reason is the training of doctors is scarcity in Hong Kong. Before the regression of Hong Kong, financial deficits occur. In order to improve the economy of Hong Kong, Hong Kong government reduced the operation cost in different aspects such as education. For instance, there are over330 medical course students in 1996 to 1999 but just 255 medical course students in 2008. 80 study places were reduced in a decade which leads to the shortage of Hong Kong doctors because the training of doctors is limited.( Doctor recruitment from oversea, 2011 )
Furthermore, the medical system had changed. Before regression of Hong Kong, Hong Kong is a commonwealth country of British. Those medical students in England are qualified to be a doctor in Hong Kong without any professional exam. However, after the regression, those medical students have to pass a professional exam before they become a qualified doctor in Hong Kong which raises the requirement to become a doctor in Hong Kong. Most of the medical students from oversea refuse to participant the exam so that the scarcity of doctor man power cannot be solved.( Medical professionals are suffering great pressure,2010)
Strategies to recruit doctor from outside Hong Kong
Firstly, the salary of doctors who are working in public hospital should be increased. In order to attract medical professionals to work in public hospital, the salary has to be raised to a level equal or comparable to private hospital.
Otherwise, although the Hospital Authority import doctors from outside Hong Kong, the professionals will prone to work in private hospital after they get the qualification to be a doctor in Hong Kong. This is the mainly method to increase doctor manpower in public hospital.
Secondly, lower the requirement or cancel the professional exam for the doctors from other region. In order to absorb more doctors from outside Hong Kong to work in public hospital in Hong Kong, complicated procedure should be eliminated. This way can attract more doctors be imported to Hong Kong instead of other country. For example, Australia did not require any professional exam to those import doctors so that most of the doctors are willing to work in Australia instead of working in Hong Kong because of the higher requirement.
Thirdly, Hong Kong government should hold some recruitment fair oversea. This strategy can introduce the medical system to doctors from outside Hong Kong which can enhance the confident of doctors from outside Hong Kong. Also, after the briefing of Hong Kong medical system such as Advancement Avenue in Hong Kong medical career and future prospects which can distribute more information to those doctors and become factors to be considered.
Finally, protectionism of Hong Kong medical system should be eliminated. Since most of the medical professionals think that the import doctors from outside Hong Kong will harm to Hong Kong medical system such as the manpower of medical will be depended on the import of doctors. Those professionals should realize that the import of doctors can be just satisfied the excess demand of doctor in Hong Kong, they have to solve the shortage of medical manpower from the root. Such as increase the academic places in Hong Kong universities, persuade the local doctors stay in public hospital. After they can settle these problems, import doctors from outside Hong Kong is unnecessary.
The factor of nurse shortage in Hong Kong
There are few factors that affect the scarcity of nurse human resources in public hospital. They are the salary rate different with private hospital, morale of nurses and lack of training human resources in nurses, including enrolled nurse and registered nurse.
Before analyze the reason of the nurse manpower shortage, the human resources of nurse in Hong Kong should be mentioned.
According to the Legislative Council of Hong Kong question 10 in 2011, it state that there are 340 nurse loss in 2005, 546 nurses loss in 2006, 741 nurses loss in 2007, 767 nurses loss in 2008 and 673 nurses loss in 2009. There are total 3067 public hospital nurses, including enrolled nurse and registered nurse drained in 5 years. However, the report also showed the recruits of nurses within 2005-2009. There are only 950 nurses were recruited in 5 years which indicate the shortage of nurses human resources problem. The reasons lead to the human resources shortage will be analyzed below.
Difference of salary
The differences of salary rate between public hospital and private hospital is a mainly cause of shortage in nursing. Here is a comparison of salary range between public hospital and a private hospital in Hong Kong which is called Hong Kong Sanatorium & Hospital.
According to the recruit advertisement of Hospital Authority in 2012, the salary range of registered nurse is $26,040 to $41,898 per month and the salary range of Hong Kong Sanatorium & Hospital of registered nurse is $30,025 to $45,505 per month. The starting salary of Hong Kong Sanatorium & Hospital is higher than public hospital 15%. Most of the nurses who worked in the public hospital were willing to work in private hospital instead of public hospital. The salary of private hospital is higher than public hospital which is a factor to attract nurse work in private hospital. The shortage of nurses can be accounted for this reason. It’s because employee is mainly focus in the income from the work rather than other aspects. That’s why the loss rate of nurses in public hospital is high
(Hong Kong Sanatorium & Hospital recruitment, 2012)
(HA Recruitment, 2012)
Morale of nurses
Morale can be affected by the working environment, welfare system and workload capacity.
According to a research from Association of Hong Kong Nursing Staff, it interviewed 3512 nurses who are working in the public hospital in 2012. It shows various factors which affect the morale of nurses.
Firstly, the proportion of nurses and patients is imbalance. According to the report, a nurse had to take care 14 patients in the morning shift which means the proportion is 1:14. On the other, nurse had to take care 24 patients in the overnight shifts which mean the proportion is 1:24. According to the international standard, a nurse is more suitable to take care 4 to 6 patients during a shift. Nurses have to suffer great pressure under this situation. The report also mentioned that the nurses who are working in public hospital have to work overnight every 5 days which will affect the personal health of the nurse and the risk of patients will be enhanced. The pressure index of nurse is 9 and the job satisfaction index of nurse is 3 which illustrate the nurses are not enjoy on their work. The indexes have mentioned above reflect that the pressure of nurses have met the tipping point and nurses are not enjoy and be satisfied under this working environment which means these nurses are likely to leave Hospital Authority. Finally, system of promotion is lack of transparency and the welfare for nurse are not enough as private hospital which lower the morale of nurse in public hospital.
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Closure of nursing school (http://www.leekoklong.org.hk/c4_09.htm)
Since 1999, Hong Kong Hospital Authority discontinued programs of enrolled nurse and registered of nurse because the manpower is saturated. Also, Hospital Authority encouraged nurse to obtain degree level by this way which leads to the shortage of manpower. According to the report from Food and Health Bureau of t Hong Kong, it shows that there are only 336 registered nurse and 0 enrolled nurse graduated in 2004. However, the demand of nurse in 2004 is 400 nurses which show the demand of nurse is unsatisfied because the closure of nursing school.
It is not essential to import nurse from outside Hong Kong
Actually, Hospital Authority can solve the shortage problem in various aspects instead of import nurse from outside Hong Kong.
Firstly, in order to persuade more nurses to stay in Hospital Authority, salary rate must be raised to the similar level as private hospital. Salary is a main factor which affects the wiling of employee so that this strategy is appropriate.
Secondly, recruitment is indeed to balance the proportion between nurses and patients. And the promotion system has to be more transparency and additional studies chance should be provided to nurses which can satisfy their want of knowledge. Also, government can provide more welfare for nurses such as subsidy for body check. These strategies can increase the morale of nurse and reduce the pressure of them.
Finally, the government has already realized the shortage of nurses, so that Hospital Authority opened the nursing school again in 2002 and increased the quantity of high diploma courses to solve the shortage problem. Also, government provided financial support to universities such as Open University to set up high diploma and degree course to solve the shortage problem. According to the report, the nursing degree quantity has increased from 624 to 721 during 2008 to 2011 and the quantity of enrolled nurse has also increased.( Education of nurse, 2007)
Since the shortage of doctors in Hong Kong cannot be solved immediately and the imperfect education system in doctor cannot be improved within a short period of time so that recruit doctors from outside Hong Kong is essential.
On the other hand, since the government has already realized the shortage of nurse and adapted different strategies to improve the situation so that the nurse shortage can be solved instead of import nurse from outside Hong Kong.
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