Singapore Health Minister Ong Ye Kung told Parliament on Wednesday (5 Oct) that Singapore will need more nurses by 2030 as Singapore ages (‘24k more nurses, healthcare staff needed by 2030 as S’pore ages‘, 6 Oct 2022).

“They number 58,000 now and MOH (Ministry of Health) estimates that this will need to grow to 82,000 by 2030,” said Mr Ong in his closing speech on the debate on the Healthier SG White Paper in Parliament.

This means MOH will need 24,000 more nurses in the next eight years, about 3,000 per year on the average.

The Health Minister “pointed out that by 2030, one in four Singaporeans will be aged 65 and above, and said that nurses, allied health professionals and support care staff are needed to operate hospitals, clinics and also eldercare centres.

Mr Ong took the opportunity to point out that since there simply are not enough local nurses available, Singapore will have to rely on more foreign nurses.

“If we want to take care of our seniors and the sick, if we want to reduce the workload of healthcare workers, we must expect foreign healthcare workers to play a bigger role in the coming years,” said Mr Ong. “This is especially so in areas that are facing a bigger manpower crunch, like aged care or palliative care.”

But he assured the House that there has been no exodus of local nurses, and that efforts are afoot to raise the intake of nursing students locally to 2,300, from 2,100 currently. That is, an increase of 200 more locals per intake.

Nominated Member of Parliament and breast surgeon Tan Yia Swam then suggested giving permanent residency to foreign nurses and Mr Ong said MOH is supportive of this.
Presently, Singaporeans and permanent residents make up about 72 per cent of Singapore’s pool of registered nurses and 63 per cent of enrolled nurses. The rest are foreigners.
In his closing speech, Mr Ong again underlined the urgency to attract foreign nurses, who are critical in making the aged care system work.

In fact, MOH already put up a tender through its subsidiary last month (Sep 2022) looking for recruitment agencies to provide services for a period of two years to hire nurses and nursing aides from overseas. The closing date for the tender is 2 weeks from now:

 

Uphill Challenges For Singapore To Attract And Retain Top Talents Nursing

Similar to issues faced by Singapore in attracting top talents for junior doctors in fierce competition against OECD countries such as the United States, Australia and the United Kingdom, nurses too is a profession much sought for by developed countries, especially in light of the issue of aging population.

As Mr Ong clarified in his speech, there was no mass exodus of local nurses amidst the COVID pandemic but the attrition of foreign nurses has gone up.

“From about 8.9% in normal years, to 14.8% in 2021. This is where there is record high attrition, at least over past few years.” said Mr Ong.

Recognising the heightened international competition, Mr Ong said, “We know the main reason, and Dr Tan Yia Swam talked about it – which is that the pandemic has increased the demand for nurses all over the world, and our foreign nurses are being poached by other countries. They go to New Zealand, Australia, the UK, the UAE etc.”

According to data from OECD for countries such as Australia, UK, New Zealand and US, the top source countries for their foreign-trained nurses come from Philippines and India. One reason being nurses from these two countries would likely be able to communicate in English.

While in Singapore, other than the Philippines and India, it also taps on countries such as Malaysia, China and Myanmar for nurses.

In a 2005 report, each year, about eight per cent of nurses leave, and seven per cent of them enter Singapore based on information from the International Council of Nurses (ICN). This figure corresponds with the figure provided by Mr Ong in his speech on 5 Oct.

The report further notes that the 8 per cent of nurses who leave the country are mostly foreign nurses on employment contracts, not Singaporean nurses.

“Filipino nurses, in particular, tend to move to other countries such as the U.K., the U.S. or Canada upon completion of their employment contracts. According to the Ministry of Health, the attrition rate of foreign nurses in 2005 was 23 per cent. Singapore seems to serve as a stepping stone for these Asian nurses who wish to migrate to other destinations with the expectation of bigger and better compensation packages.”

As to whether such sentiments are still present, a report produced by Lien Foundation in 2019 on Long-term Care workers in Singapore, had interviewees say:


So just how much is the difference in wages between nurses in Australia and Singapore?

On top of differential wages from other developed countries, there is also a difference in work environment and culture. Again we use results obtained from Lien Foundation’s report as a superficial comparison between countries. While the figures used for long-term caretakers are not indicative of the primary care environment but it gives some basis for comparison between countries.

Mr Ong said in response to questions filed by MPs back in August, “Even as we prioritise the well-being of our nurses, we appreciate the reality of their work, which is to deliver timely and quality patient care. The Ministry is working to ensure there are sufficient nurses on the ground. In fact, the registered stock of nurses over the past few years has remained stable, with a slight increase from around 42,800 in end 2019, to 43,000 in end 2021. Local nursing intakes have also increased from around 1,500 in 2014 to around 2,100 in 2021 to ensure that there is a stable inflow of nursing manpower into our healthcare system.”

While Mr Ong is optimistic about the increase of nurses with the figures that he cited, the reality might be far harsher when we consider the number of nurses leaving employment — both local and foreign — against those that Singapore hires on a yearly basis. This is especially so when Singapore intends to hire 3,000 nurses per year to increase the base number of nurses to another 24,000, which is 67,000 if we used the figures in 2021.

If Singapore does not wish to become a nursing ground for potential hires of OECD countries — although it already is in a way — and to retain its new recruits, more needs to be done urgently to ensure that nurses feel well-taken cared for and that they have a career prospect in the country regardless whether they are local or foreigners.

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