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Following is a question by the Dr Hon Leung Ka-lau and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (July 9):
Question:
It is learnt that currently there is a serious shortage of nursing manpower in public healthcare services. As a result, quite a number of new and existing services have been affected. Regarding nursing manpower and training of nurses, will the Government inform this Council if it knows:
(1) the number of new healthcare services that the Hospital Authority (HA) plans to launch in each of the coming five years, and set out the nursing manpower required for each service;
(2) whether HA has projected the numbers of vacancies for enrolled nurses and registered nurses in various specialist services in each of the coming five years; if HA has projected, set out a tabulated breakdown of such vacancies by rank and number of service years required; if not, the reasons for that;
(3) why HA plans to close down the schools for training enrolled nurses under the United Christian Hospital, Prince of Wales Hospital and Pamela Youde Nethersole Eastern Hospital this year; the number of nurse training places and the amount of expenditure reduced as a result of such a plan;
(4) in each of the coming five years, (i) the respective numbers of places of Bachelor of Nursing programmes and Higher Diploma in Nursing programmes to be offered by various publicly-funded tertiary institutions, (ii) the respective numbers of places of enrolled nurses and registered nurses training programmes to be offered by the nursing schools under public hospitals, and (iii) the respective numbers of nursing graduates that will be recruited by public general and psychiatric services; and
(5) the respective current unit costs for public hospitals to train enrolled nurses and registered nurses?
Reply:
President,
The Hospital Authority (HA) is responsible for managing the public hospital system in Hong Kong and providing quality and affordable public health services to the public.
"The Strategic Plan 2012-2017" is an overarching document for service and development planning of HA, outlining the objectives and strategies to be pursued by HA in the coming five years. It also provides directions and guidelines for its annual planning so that clinical and executive staff may align their programme initiatives in the process of service planning.
My reply to the various parts of the question is as follows:
(1) and (2) Starting from 2012-13, "the Strategic Plan 2012-2017" guides the development of the HA's annual plans for the following five years. The aim is to steer HA towards achieving its common vision and mission.
Every year, HA follows the annual planning process in formulating the work plan for the next year. During the process, it will review the overall supply and demand of resources and manpower, and allocate funds and manpower to hospitals in various clusters in accordance with the annual work plan.
HA will seek annual funding through the Government's Resource Allocation Exercise to meet the needs of daily operation and new services of the hospitals. In formulating the resource allocation (including nursing service and manpower distribution) to various clusters, HA will consider the following factors:
(1) the resources needed to sustain the operation of existing services of various clusters;
(2) the new services and priority initiatives that have been approved in the annual planning process;
(3) the resources required to address the needs of other specific pressure areas/service gaps;
(4) replacement for manpower wastage of hospitals in various clusters in the previous year; and
(5) nursing manpower requirement estimated according to a workload assessment model.
The targeted number of nurses to be recruited each year by HA is set having regard to the turnover rate and the manpower required for providing new services. On the operational front, HA will flexibly deploy nursing staff to provide existing and new medical services. Therefore, HA has not maintained statistics on the vacancy of nursing staff in respect of each medical service programme and specialty.
In general, HA has strengthened the recruitment of nurses in recent years to relieve the pressure on nursing manpower. The increase in the number of nurses is mainly for the provision of new medical services. The net increase in the number of nurses each year is listed in the following table:
Year Number of nurses Net increase
2009-10 19 866 --
2010-11 20 102 236
2011-12 20 901 799
2012-13 21 816 915
2013-14 22 759 943
Total 2 893
HA estimated that there was a shortfall of about 600 nurses in 2013-14. HA has implemented various measures to attract and retain staff, including strengthening recruitment, enhancing promotion prospects and supporting career development of enrolled nurses, with a view to relieving the manpower shortage of nurses. HA will continue to monitor the manpower situation and make appropriate arrangements in manpower planning to cope with the service demand.
(3) To ensure a sufficient provision of nurses to meet service demand, HA re-opened the four Enrolled Nurse (General) training schools at the Pamela Youde Nethersole Eastern Hospital, the Grantham Hospital, the United Christian Hospital and the Prince of Wales Hospital in 2008. The number of nursing students trained for HA by these schools in the last five years is set out as follows:
Year Number of nursing students
2009-10 320
2010-11 320
2011-12 100
2012-13 100
2013-14 100
In addition, the Social Welfare Department (SWD) has collaborated with the HA to organise a two-year Enrolled Nurse (General) Training Programme for the welfare sector since 2006 to alleviate the shortage of nurses in the welfare sector. The number of nursing students admitted in the last five years is set out as follows:
Year Number of nursing students
for welfare sector
2009-10 220
2010-11 190
2011-12 160
2012-13 260
2013-14 260
Since starting from 2014-15, SWD no longer designates HA as the collaborating partner on organising enrolled nurse training programmes for welfare sector, and having considered the cost-effectiveness to maintain the three enrolled nurse training schools for training 100 nurses each year, and in view of the redevelopment works of the United Christian Hospital and the planned redevelopment project of the Prince of Wales Hospital (Phase 2), the two hospitals will cease to admit new students for enrolled nurse training with effect from 2014-15. Since the accreditation given to the Enrolled Nurse Training Programme of Pamela Youde Nethersole Eastern Hospital by the Nursing Council of Hong Kong was valid up to 2012-13, the hospital's nursing school has ceased to enroll students in 2013-14 and will close in October 2014. Nevertheless, the number of places for the enrolled nurse training programme of HA will remain unchanged in 2014-15, maintaining at 100 annually. The Enrolled Nurse Training Programme of the HA will continue to be conducted in the training school of the Grantham Hospital. Since the number of places for the HA's enrolled nurse programmes remains at 100 in 2014-15, there is no reduction in programme expenditure.
(4) Nursing is a discipline which is subject to the Government's specific manpower requirements. At the beginning of each triennium of the planning of student number targets, the University Grants Committee (UGC) will inform the institutions offering the manpower-planned programmes of the respective student number targets advised by the Administration. For the 2012-13 to 2014-15 triennium, the first-year-first-degree and senior year intake places for nursing programme increased from 590 and 100 respectively in the 2011-12 academic year to 630 and 125 respectively in the 2014-15 academic year. UGC-funded institutions do not have plan to offer UGC-funded Higher Diploma in Nursing programmes in 2014-15 academic year. As regards the next triennium (i.e. 2015-16 to 2017-18 academic years), planning is under way and the student number targets of the manpower-planned programmes (including nursing programmes) will be determined in due course.
HA's nursing schools plan to continue to enroll 300 Registered Nurse students and 100 Enrolled Nurses students in 2014-15. HA will assess the demand for nursing manpower on a yearly basis in order to confirm the number of nursing students to be enrolled each year before making further projection on the respective number of nursing graduates to be recruited by general and psychiatric units of hospitals each year.
(5) The cost of providing training for nursing students by the HA's nursing schools includes staff expenditure and other operating costs, and the training of nurses is mainly provided through nursing schools and on-the-job training. Since the training of nurses forms part and parcel of the HA overall service provision, the requested cost breakdown is not available. Moreover, HA does not calculate costs with students as units. Hence, figures about the unit cost per Registered/Enrolled Nurse student are not available.
Ends/Wednesday, July 9, 2014
Issued at HKT 15:33
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