Proposal to alleviate pressure on public healthcare system in an aging society

This Sept 5, 2017 photo shows healthcare professionals at the Queen Mary Hospital in Hong Kong. (PHOTO / HKSAR GOVERNMENT)

The Hong Kong Special Administrative Region government is seeking to remove institutional barriers for nonlocally-trained nurses and dentists to work in the city in the face of a manpower shortage in the city’s public healthcare system.

In a proposal submitted to the Legislative Council Panel on Health Service, the Health Bureau sought to amend the Nurse Registration Ordinance, allowing nonlocally-trained nurses to register in Hong Kong, in some case without taking the licensing exam.

In the proposal, a “special registration/enrolment” would allow qualified nonlocally-trained nurses to work within the much-strained public healthcare institutions, such as labs run by the Department of Health and hospitals and clinics managed by the Hospital Authority. They would become fully registered and exempted from taking the licensing exam if they perform satisfactorily during their full-time service period in public healthcare institutions. Currently, the licensing exam is a compulsory requirement for nonlocally-trained nurses seeking registration.

In the meantime, nonlocally-trained nurses, whether Hong Kong permanent residents or not, could also be admitted to work in qualified nurse training schools, residential care homes, nursing homes, and social welfare services via a “limited registration/enrolment” pathway.

The proposal also seeks to establish a temporary registration system to allow nurses from other jurisdictions to perform academic exchanges and clinical demonstrations in Hong Kong for a short period of time.

The Health Bureau said the proposed legal changes are aimed at addressing the city’s acute shortage of nurses and enhancing the professional development of nurses. The government aims to submit a draft of the amendments to the Ordinance in mid-2023.

Welcoming the move, Grace Li Fai, a member of the city’s Elderly Commission, on Thursday said on a radio program that the wider adoption of nonlocally-trained nurses can alleviate pressure on the public medical sector as well as help meet the medical requirements of the elderly in care homes.

Alex Lam Chi-yau, chairman of Hong Kong Patients’ Voices, said that the arrangement should make sure that the nonlocally-trained nurses are up to local standards.

Hong Kong’s public healthcare sector has been facing a brain drain over the years, with the attrition rates of registered nurses and enrolled nurses reaching 11.2 percent and 14.8 percent respectively in the Department of Health, and 9.1 percent and 12.8 percent respectively in the Hospital Authority for 2021 and 2022.

However, as the bedrock of the city’s healthcare workforce, local nursing manpower has met its training cap.

In 2020, the University of Hong Kong projected that the gap in general nurses in the HA would reach 3,020 in 2030 and 4,480 in 2040.

A similar relaxation of the threshold for introducing nonlocally-trained dentists is also tipped to be considered by the government.

The preliminary proposal, which suggests revising the Dentists Registration Ordinance, includes importing nonlocally-trained dentists and requiring locally-trained nonspecialist dentists to serve in designated institutions for a specific period of time, believed to be two years. Local dental graduates will also be required to practice for one year before they can be formally registered. The Health Bureau expects to submit the proposal to the legislature within this year.

In 2021, Hong Kong made a similar move to loosen its threshold for introducing eligible nonlocally-trained doctors to work in public healthcare institutions. By December, 75 medical qualifications from overseas training institutions were recognized in Hong Kong. Seven out of 11 applications had been approved for special registration by November.