Singapore's Reliance on Nurses from Philippines and Impact on Local Nursing Workforce Numbers Following Recent Suspension

6 Ms Foo Mee Har asked the Minister for Health (a) whether the Ministry can quantify the current extent of Singapore’s reliance on Filipino nurses; and (b) what is the impact on the Singapore healthcare system by Philippines’ move to suspend permits for nurses to work overseas.

The Senior Minister of State for Health (Dr Koh Poh Koon) (for the Minister for Health): Sir, according to the Singapore Nursing Board’s 2019 report, about 7,600, or 18%, of our nursing workforce are Filipino.

The Ministry of Health (MOH) is closely monitoring the impact of the Philippines’ suspension of permits. We are working with healthcare employers to ensure the adequacy and sustainability of our nursing workforce. Healthcare employers should also diversify their recruitment sources.

Meanwhile, our local supply of nurses has grown. In 2020, there were around 1,400 new registrations from locals, compared to around 1,200 in 2019. This is a result of our past efforts to grow the nursing intake in our Institutes of Higher Learning. We will continue to enhance the attractiveness of the nursing profession and I hope more Singaporeans will join this noble profession, especially those who are considering a mid-career switch.

Mr Deputy Speaker: Ms Foo Mee Har.

Ms Foo Mee Har (West Coast): Thank you, Deputy Speaker. I have two clarifications for the Senior Minister of State. First is that when COVID-19 is regarded as endemic and restrictions are eased, infections are expected to increase and more vaccinated patients – vaccinated, that is the new protocol that was mentioned – will be at the care facilities. So, I would like to ask: will this new health protocol put more demand on nurses, as we evolve our health protocol with COVID-19 being endemic? That is the first question.

The second question is: how can Singapore ramp up our own supply of nurses to reduce our reliance on foreign nurses? I think the number that the Senior Minister of State mentioned, in terms of yearly intake, it looks like it is a small number, if you ask me. How successful has our Professional Conversion Programme been in increasing the number of local nurses and how can this programme be further enhanced to accelerate the pace? If we are producing 1,400 per year, having put in a lot of effort, how can we accelerate that?

Dr Koh Poh Koon: Sir, I thank the Member Ms Foo Mee Har for raising these two clarifications. On how we would want to deploy our medical manpower should there be more cases during the endemic phase that requires community care monitoring, I think it is important to understand the differences between acute hospital care requiring more intensive nursing care and community care that does not require the intensiveness of care monitoring. We have a few options.

One is, of course, we do have a ramped-up plan for nurses to be deployed into some of these Community Care Facilities (CCFs). We experienced that during the earlier phase of the COVID-19 crisis last year, when we had a lot more foreign workers who were being cared for in the CCFs. There, we have a complement of nurses providing more medical supervision as well as doctors, but there is also a series of other care providers, volunteers, who are trained to actually use technology, for example, automatic blood pressure reading machines and oximeters, to also help to monitor the health status of those in those community care facilities. In that way, we actually stretched the role of the nurses through partnership with other care partners.

For the second question on how we can ramp up our local supply of nurses, Singapore's stock of registered nurses increased by about 19% from 36,000 in 2013, to more than 42,000 in 2019. This translates to almost 7.5 registered nurses per 1,000 population, which is a good number compared to many other Asian economies like Hong Kong and Taiwan.

But as the Member said correctly, as our population ages, there will be an increased demand for healthcare services and the manpower will have to increase commensurately. Members may remember that, earlier this year, in the Budget, we announced several measures to increase attraction of our locals to join the nursing profession. One is in the salary review, which was announced in the Budget this year. Public sector healthcare nurses will have an increase of about 5% to 14% in their monthly base salaries from July this year. It just kicked in this month and this will be phased in over the next two years. For publicly-funded community care organisations which require nurses, MOH will also increase funding support for wages to ensure that salaries in the community care settings are also competitive to attract locals to join this sector.

We also encourage more flexible work arrangements. So, all healthcare clusters now have flexible work arrangements to help their workers strike a balance between their work and personal demands. These include part-time employment, compressed work week, flexible work schedules and hours. To facilitate the scheduling of work shifts, e-rostering will be scaled across the public health clusters by the end of 2021.

There are also efforts to enhance professional development, such as through the launch of the Skills Framework for Healthcare and the National Nursing Academy, so that nurses can continue to upskill themselves and advance in their careers.

It is through a multi-pronged approach. First, making sure that the work environment is much more conducive, much more flexible, but also creating different skill pathways for different entrants into different care roles to progressively go up into taking more advanced nursing roles. In that way, we create a more attractive environment for different people of different capabilities to join the healthcare sector and, especially, to attract the mid-career entrants.