Following is a question by Dr the Hon David Lam and a reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (January 21):

Question:

     It has been reported that the Hospital Authority (HA) has long faced a severe shortage of nursing staff, and there are no mandatory requirements for the nurse-to-bed ratio in public hospital wards. Furthermore, some frontline nurses are concerned that over the past year, HA's gradual reduction in the number of locum nurses, personnel whose employment has been extended beyond retirement, as well as clinical preceptors, all of whom possess valuable clinical experience within the nursing grade, will have a significant impact on the training and clinical competence of newly recruited nurses, thereby increasing patient risks. In this connection, will the Government inform this Council:

(1) of the respective numbers of locum nurses, personnel whose employment has been extended beyond retirement, and clinical preceptors within HA's nursing grade at the end of each of the past two years;

(2) of the respective ratios of nurses with over five years' experience and those with three years' experience or less in HA at present, and whether HA has formulated the relevant standard ratios; whether HA has plans to increase the ratio of nurses with over five years' experience; if so, of the details of the plans; if not, the reasons for that; and

(3) of the ratio of HA's clinical nurses to the number of hospital beds at present; whether HA has plans to formulate a target ratio and implementation plan; if so, of the details; if not, the reasons for that?

Reply:

President,

     With our high-quality healthcare professionals and highly efficient healthcare system, Hong Kong boasts a number of world-leading health indicators. We are among one of the regions with the longest life expectancies (Note 1) and lowest infant mortality rate in the world (Note 2). The public current health expenditures in Hong Kong only accounted for 4.3 per cent (Note 3) of its Gross Domestic Product in 2023-24. Compared with other economies with a similar degree of population ageing, Hong Kong's related expenditure ratio is among the lowest. On the other hand, we were able to provide over 90 per cent of the city's healthcare services and achieve a high service quality on par with international standards, demonstrating the remarkable efficiency of our public healthcare system.

     Nevertheless, Hong Kong's healthcare system is facing various structural challenges. With an ageing population and a surging prevalence of chronic diseases, quality and highly subsidised public healthcare services have attracted huge service demand, exerting immense pressure on the healthcare system. In light of the above, the Hospital Authority (HA) is actively implementing various measures to attract, train and retain manpower, while leveraging information technology to enhance efficiency.

     My reply to the question raised by Dr the Hon Lam is as follows:

(1) First of all, healthcare professions are the cornerstone of the local healthcare system. The Government has consistently invested heavily in enhancing the training quality, including increasing government-funded training places based on manpower situations and projections to meet the rising demand for healthcare services. To enhance manpower of local nurses, the number of relevant training places in institutions has steadily increased by nearly 60 per cent from about 3 200 in the 2016/17 academic year to about 5 000 in the 2024/25 academic year.

     As for human resources management, the HA introduced the policy of Extending Employment Beyond Retirement (EER) in 2021, allowing serving healthcare staff to extend their service up to the age of 65 after reaching the retirement age of 60. This enables the retention of experienced healthcare professionals to continue taking up clinical duties in public hospitals, thereby alleviating manpower pressure and supporting training and knowledge transfer. On the other hand, the HA has also established the Locum Office to actively recruit part‑time healthcare staff and adopt more flexible hiring strategies. In addition, to nurture junior nurses, the HA has strengthened its preceptorship programme by recruiting experienced nurses as preceptors to provide clinical guidance for junior nurses, facilitating them to get familiarised with the ward procedures and environment.

     Following the passage of the Nurses Registration (Amendment) Ordinance on July 26, 2024, the HA has launched a series of promotional activities to attract non-locally trained nurses (NLTNs) to join the HA. Moreover, the HA has also been actively collaborating with various non-local partners to roll out nurse exchange programmes. As at the end of October 2025, a cumulative total of 170 NLTNs had practised or participated in exchanges in the HA under Limited Registration or Special Registration pathways.

     These measures have begun to yield results. The attrition rate of full-time nurses has improved, with the 12-month rolling figure falling from a peak rate of 10.9 per cent as at end-March 2023 to 6.0 per cent as at end-October 2025. The number of HA nurses counting on full-time basis has increased from a low level of 28 865 as at March 2024 to 30 533 as at October 2025, recording an increase of 5.7 per cent in one and a half year. 

     With the gradual decline in the attrition rate and the increase in the number of full‑time nurses in recent years, the number of locum nurses, whose role is to fill short‑term vacancies, has therefore decreased. For the past two years (i.e. from end-October 2023 to end-October 2025), the numbers of locum nurses, EER staff and clinical preceptors in the HA's nursing grade are set out in Annex 1. While the number of locum nurses slightly decreased from 1 450 to 1 372 in two years, the numbers of EER staff and clinical preceptors did not decrease as indicated in the introduction of the question, in fact, they increased. The number of EER staff increased from 729 to 1 090 and that of clinical preceptors rose from 149 to 181. In contrast with temporary or locum arrangements, full‑time nurses are able to provide more stable and continuous services within clinical teams, which is conducive to the continuity of patient care plans. The HA will continue to arrange temporary or locum nurses to support designated specialties having regard to service needs.

(2) As at end‑October 2025, the distribution of HA's nurses by years of service is set out in Annex 2. The data shows that among the 33 683 nurses in the HA, 9 463 nurses were working for less than three years, representing 28.1 per cent of the overall nursing manpower; while 20 049 nurses had five years of service or more, representing nearly 60 per cent of the overall nursing manpower. There were 12 878 more experienced nurses with ten years of experience or more, representing 38.2 per cent of the overall nursing manpower. Most of these nurses serve on the frontline and assist in training less‑experienced nurses to facilitate professional succession. The Government is particularly thankful to nurses of public healthcare system who embody the spirit of Nightingale for their commitment, dedication and professionalism in taking care patients in the frontline amidst manpower pressure in the past. The HA will continue to implement various measures to recruit and retain nurses, with a view to ensuring service quality and facilitating professional succession. Meanwhile, the HA will also provide nurses with diversely structured and innovative training programmes, including providing more opportunities of simulation and specialty trainings, to enhance the development of professional nursing services.

(3) In order to meet clinical service demand and operation needs, the HA has also recruited 19 106 nursing supporting staff including ward assistants, patient care assistants and so on to support nurses for providing clinical care of patients. 

     As at end‑March last year, the HA had a total of 30 824 hospital beds. As healthcare staff supporting inpatient services in the HA also undertake other duties (such as specialist out-patient services), the demand for nursing manpower varies across different hospitals and inpatient specialties. Therefore, computing a ratio of number of staff supporting in-patient services to that of overall hospital beds separately is not appropriate. 

     Apart from closely monitoring manpower situations, the HA will continue to actively leverage information technologies, including areas like artificial intelligence, smart wards, smart clinics, smart support and digital workplaces, with a view to enhancing clinical and administrative workflows, and the effectiveness of resource utilisation.

     Thank you, President. 

Note 1: Average life expectancy at birth in 2024 is 82.7 for male and 88.2 for female.
Note 2: Infant mortality rate in 2024 is 1.7 deaths per 1 000 registered live births.
Note 3: Excluding expenditures relating to COVID-19.

Ends/Wednesday, January 21, 2026
Issued at HKT 16:15

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