Data on Nurses' Shift Rosters in General and Intensive Care Wards

34 Mr Louis Ng Kok Kwang asked the Minister for Health (a) whether the Ministry has annual data in the past five years on the average number of times when nurses in public hospitals are rostered for an afternoon shift that ends in the evening and is immediately followed by a morning shift the next day in the (i) general wards and (ii) intensive care units; (b) if so, what are they; and (c) if this data is not available, whether the Ministry intends to collect it and, if not, why not.

The Senior Parliamentary Secretary to the Minister for Health (Ms Rahayu Mahzam) (for the Minister for Health): Mr Speaker, Sir, with your permission, may I address Question No 34 together with queries on related matters filed by Mr Seah Kian Peng¹ and Mr Louis Ng² scheduled for future Sittings?

Mr Speaker: Please proceed.

Ms Rahayu Mahzam: The rostering of nurses for shifts is managed by the hospitals which MOH does not and should not interfere. Hospitals are operational environments, which have to address patient needs on a day-to-day basis. Generally, healthcare workers understand and embrace this, and will cover for each other occasionally when there is an operational need, even if it means a heavier workload. A rigid system will result in compromising on patient care.

On Mr Ng's suggestion in respect of the MOE Connect Plan, we would highlight that MOH regularly reviews and adjusts the compensation and benefits for healthcare workers to ensure that they remain competitive. Our most recent review saw the base salaries of nurses in the public healthcare sector enhanced between 5% and 14%, which was implemented over two phases in July 2021 and 2022. We can study Mr Ng's suggestion along with other options in future reviews.

We will continue to work on various ways to support, develop and retain our healthcare workers. We have to take a multi-pronged approach including ensuring staff well-being, regularly reviewing compensation, attracting foreign nurses to augment our local workforce and working with families and caregivers to alleviate the load on healthcare workers.

Mr Speaker: Mr Louis Ng.

Mr Louis Ng Kok Kwang (Nee Soon): Can I just ask again, specifically, how does MOH look into the workload of our nurses? I ask this because, the nurse-to-patient ratio that we shared previously in Parliament of one is to four or five, seems quite far from the reality on the ground. Many nurses are sharing that they are looking after way more patients.

Second, I do agree with the Senior Parliamentary Secretary, maybe we should not be that prescriptive. But a lot of nurses are now sharing that they only have five hours of rest between shifts and I fear not just for the nurses, but also the level of care that patients would get for someone that is overworked. And so, I hope MOH can again review the rostering system of the hospitals and also the nurse-to-patient ratio.

Ms Rahayu Mahzam: Mr Speaker, I thank the Member for his questions and I appreciate the concerns he has for the nurses and the healthcare workers in general. He has raised many questions in this House relating to their workload and the things that they have to address in the realities on the ground today. But I am sure he also appreciates and understands that it is a pandemic situation that we are dealing with, and these are the realities on the ground. We have to be cognisant that we not only have to ensure that the nurses are taken care of, we also need to ensure that the patients are taken care of.

So, in the light of the context that we are facing today, these are the realities on the ground that we have to acknowledge and learn how to manage. We have accepted that there are some difficulties and I have explained in previous Sittings in response to Mr Louis Ng's questions about the efforts that we have been taking. There is a staff well-being committee that has been set up to look into different areas and different aspects of the work and to see how we can improve and fill in some of these gaps. We have set up a task force, looking at issues relating to abuse of healthcare workers. We also have the workgroup looking into the issues relating to the junior doctors. This is the holistic effort and we are taking into account.

So, one aspect of it is the managing of their workload. This is something that we need to leave to the hospitals and public healthcare institutions to manage. It is an operational setting and setting too much rules does not help. It will be counter-productive. The reality is, even if we set the rules, the professionals, even if they are going to leave their shift, if they see a patient who is unwell, they would also still stay and still want to take care of the patient. I think this is the reality that we have to accept of the nature of the work in the healthcare sector.

Notwithstanding that, we appreciate that it is a challenging time. I have explained just now and also in earlier Sittings, that we are looking at this from a multi-pronged approach. We are looking to see what are the areas where we can augment the work with regard to, maybe, having technology, employing more people to help with the administrative load, looking at how we can augment the workforce with foreign nurses, looking at how we can get families and caregivers to understand where they can alleviate the load of the nurses.

So, these are all the efforts that are being put in place. We appreciate the concern and care, issues that Mr Louis Ng has raised, are issues that we are cognisant of and we are taking steps to try and address them.

Mr Speaker: Mr Seah Kian Peng.

Mr Seah Kian Peng (Marine Parade): I just want to ask the Senior Parliamentary Secretary, the war for talent is felt in all industries and the healthcare industry is certainly not spared. In the review of our current policies, I want to ask Senior Parliamentary Secretary whether it includes what other countries are offering because, as I said, nurses are in short supply worldwide amongst other things. So, I hope our review takes into account who we are up against and how we can deal with them.

Ms Rahayu Mahzam: I thank Mr Seah for the question. And actually, he has hit the nail on the head. These are some of the issues that we are facing because we are facing competition from other countries. We are watching closely and trying to see how we can come up with strategies where we can overcome and make jobs more attractive and for healthcare workers to want to come and work in Singapore.