******************************************************
Following is a question by the Dr Hon Joseph Lee and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (January 19):
Question:
The Government's introduction of medical reform to balance the public and private health care services, as well as its efforts to promote the development of medical services, have made the development of private healthcare services a major trend, coupled with the demands for nursing services generated by community-based rehabilitation, the elderly care policy of ageing in place and psychiatric services, etc., hence the manpower of nurses is very tight. In this connection, will the Government inform this Council:
(a) of the overall demand for nurses in each of the coming 10 years, together with a breakdown set out in Annex 1;
(b) of the anticipated number of places for the training of nurses in each of the coming 10 years, together with a breakdown set out in Annex 2;
(c) whether it knows the breakdown of the turnover figures of nurses in the Hospital Authority (HA) in each of the past five years (set out in Annex 3);
(d) given that for the purpose of achieving savings, HA formulated in 2002 a policy under which newly recruited nurses will not be granted any increment within the first two years of their employment, whether it knows the number of HA nurses who were not granted any increment within the first two years of their employment each year since 2002; of the amount of savings achieved as a result; whether HA will consider removing the requirement that newly recruited nurses will not be granted any increment within the first two years of their employment, in order to reduce the wastage of nursing staff; if HA will do so, of the details and the time to remove the requirement; if not, the reasons for that;
(e) given HA's indication that it will offer nursing staff better opportunities for promotion in order to retain nursing staff, whether it knows the breakdown of the number of HA nurses who were promoted to the ranks listed in Annex 4 in each of the past five years; and
(f) given HA's indication that Nurse Consultant positions have been created since 2008, whether it knows if HA will plan to create more Nurse Consultant positions in the coming five years; if HA will do so, of the specific timetable for creating such positions, as well as the specialties and hospital clusters involved (set out in table form); if not, the reasons for that?
Reply:
President,
(a) & (b) It is the practice of the Food and Health Bureau to conduct assessment on the manpower requirements for healthcare professionals (including nurses) in tandem with the triennial planning cycle of the University Grants Committee (UGC). The Government also gives advice to UGC on the number of publicly-funded places in future for reference by the tertiary institutions in making their academic planning.
In projecting the long-term manpower requirements, we will take into account the projections on manpower needs of major healthcare providers, who in their projections would have regard to the trend of retirement and wastage of healthcare personnel, the assessment on population ageing, demographic changes, special needs of the community for particular areas of services, etc. The Government will also take into account the implications on manpower requirements arising from the healthcare service delivery model and other related policies such as the development of primary care services, promotion of private hospital development, the Health Protection Scheme, etc.
Manpower assessment and planning is an ongoing process subject to adjustments from time to time in light of changes of demand in the community. We in general expect a substantial increase in the demand for healthcare practitioners in future. As announced in the 2010-11 Policy Address by the Chief Executive, the Government will ensure an adequate supply of healthcare personnel (including enrolled nurses and registered nurses in the general and psychiatric streams) for the provision of services through various measures, which include encouraging tertiary institutions to increase student places and strengthening training programmes provided by the Hospital Authority (HA).
We will continue to closely monitor the manpower requirements for healthcare personnel.
(c) Annex 5 is a breakdown of the turnover figures of nurses in HA (including retirees and other departed staff) in the past five years.
HA has all along filled the vacancies of nurses (including turnover vacancies and newly created nurse positions to cope with service and operational needs) through external recruitment and internal promotion. On the whole, the number of vacancies filled exceeds the turnover. From April 2010 to the end of November 2010, HA recruited a total of 997 nurses whereas the number of departed nurses was 684. As at the end of November 2010, the nursing manpower of HA showed a net increase of 784 as compared with that of three years ago (i.e. at the end of March 2007), representing an increase of 4.1%.
Meanwhile, in order to train more nurses, HA re-opened its nursing schools in 2008 and organised a three-year Registered Nurse (RN) High Diploma Programme and a two-year Enrolled Nurse (EN) Programme. The number of enrolled nursing students increased from 580 in 2008-09 to 650 in 2009-10 and 2010-11.
(d) The policy of not granting any increment to new recruits within the first two years of their employment applies to all HA staff who joined HA on or after June 15, 2002, including doctors, nurses, allied health practitioners and staff of other grades. The number of newly recruited nurses in each of the financial years from June 2002 to March 31, 2010 is shown in Annex 6.
Given that the abolition of this policy will bring substantial and long-term financial burden to HA and that in the allocation of resources, the first and foremost priority of HA is to enhance the provision of services to its patients, it is the strategy of HA to improve the working environment of staff, enhance promotion prospects and increase the manpower for nurses and supporting staff in an effort to retain staff and address the staff shortage problem.
To strengthen the retention of nurses, HA has implemented various measures to improve the working arrangements of nurses, including reducing the non-clinical work handled by nurses, improving the equipment frequently used by nurses to alleviate their workload, as well as increasing the flexibility in recruitment and employing more part-time nurses, etc.
HA has introduced a new career development structure for nurses by phases from June 2008 to broaden their promotion pathway. The relevant initiatives include the creation of the post of Nurse Consultant to broaden the clinical career development pathway of nurses; adjustment of the management duty allowance granted to Department Operations Managers; establishment of additional Advanced Practice Nurse positions in clinical departments to provide more supervisory support; provision of more flexible terms of employment; extension of the contract period of Registered Nurses to six years; and provision of permanent employment terms to eligible full-time contract Registered Nurses, etc.
(e) Annex 7 is a breakdown of the number of nurses who were promoted to different ranks in each of the past five years.
(f) HA launched a Nurse Consultant Pilot Scheme in 2008 with the creation of Nurse Consultant posts in five areas of specialty, namely, diabetes, wound care, nephrology, continence and psychiatry. Upon evaluation of the effectiveness of the pilot scheme, HA plans to create additional Nurse Consultant posts in 2011-12, and will determine the actual number of posts and the areas of specialty having regard to the assessment on the service demands.
Ends/Wednesday, January 19, 2011
Issued at HKT 16:54
NNNN
