No shortage of nurses but low salaries, the lack of tenure pushing them abroad

MANILA, Philippines — While it’s nothing new for nurses in the Philippines choosing to go abroad in search of better opportunities, this time the wave of resignations comes just as the country anticipates a new wave of COVID-19 infections.

Amid steady work and pandemic-induced burnout, some nurses are taking advantage of the reopening of overseas economies and the easing of border restrictions to seek employment overseas.

“[It’s] due to the lack of opportunity in our country,” Dr. Anthony Leachon, former adviser to the National Pandemic Task Force, told by phone earlier this month.

“They are overworked, they are overworked but less appreciated and of course they seem undervalued. And there is a discrepancy between payments from private hospitals and public hospitals,” Leachon added in a mixture of English. and Filipino.

Earlier he sounded the alarm that nurses in private hospitals are “resign en masseHe said that nurses from private hospitals would transfer and work for public hospitals instead or end up in other industries before taking the mandatory exams for the country to which they would migrate.

Pay gaps

Private hospital nurses are paid minimum wage or around 537 pesos per day in Metro Manila or more or less around 12,000 pesos per month, but those in the provinces are paid even less.

According to a report by ABS-CBN, St. Luke’s Medical Center is promising more benefits such as a P10,000 signing bonus, free rides and accommodation, among other things in a bid to incentivize nurses to apply in their clinics.

But the groups say not all private hospitals can afford to issue such benefits.

“Only the best hospitals can provide these packages and premiums, but our concern is with private hospitals that may not have the operational revenue,” Melvin Miranda told the Philippine Nurses Association. in a separate phone call.

“They are the ones who will really need help in this regard because they are the ones who have been identified with problems related to the nursing shortage.”

The salary in private hospitals is not enough for some nurses to choose to work for higher education institutions instead.

“We are also experiencing a shortage of clinical instructors in nursing education,” Miranda said.

Meanwhile, nurses working for public hospitals are on the 15th year salary, about 35,097 pesos a month. Filipino Nurses United (FNU) National President Maristela Presto-Abenojar said the implementation of this also varies.

“Not all public sector nurses receive this salary because we know that our healthcare system has also been decentralized since 1991,” she said. in a video call.

In some provinces, nurses in public hospitals receive only 65% ​​of what they are supposed to earn.

“This is the reason why it is difficult for our nurses to support their own families if they are breadwinners because their salary is not enough for themselves. It is not a living wage in done,” Presto-Abenojar said.

She notes that about 50% of the country’s nurses in government institutions are contract workers. This means that half of nurses in public hospitals are not entitled to benefits such as paid holidays and medical leave.

No shortage, many unemployed

Citing data from the Ministry of Health, Presto-Abenojar noted that the total number of nurses in the public and private sectors in December last year stood at 172,589.

“Out of 10 registered nurses, two work in either the public or private sector, which equates to 19% of the total 915,291 registered nurses,” she said, adding that 35% or four registered nurses in 10 in the Philippines have opted to become migrant health workers instead.

The FNU maintains that the country is not short of nurses, but hospitals are experiencing “chronic understaffing”. Some 32% of registered nurses do not practice, either because they are unemployed or perhaps underemployed.

The Professional Regulation Commission has just announced that 6,616 or 68% of 9,729 applicants passed the May 2022 nursing board exams. But the question is, how many will choose to serve the Philippines in the next three to five years? ?

“We call them our frontliners, but are we really giving them enough to be able to name them the heroes of this particular pandemic? I wouldn’t stop them from coming out if there were better opportunities because there are other members of family who would need their help,” Dr. Leachon said in a mix of English and Filipino.

Work abroad

As economies open up and more countries adjust their travel restrictions, healthcare workers can now take advantage of the opportunities available. The exodus does not only concern nurses, but also other health personnel in the country.

Data from the Philippine Overseas Employment Administration, which obtained through the UNF, showed the following as the top destination countries for healthcare workers:

  • Saudi Arabia
  • UK
  • Qatar
  • Germany
  • United Arab Emirates
  • Singapore
  • United States
  • Ireland
  • Oman
  • Kuwait

As of March 28 this year, 8,752 healthcare workers have left the country. This number is expected to increase as the total number of healthcare workers who migrated last year stood at 22,895.

When deployed to the main destination, Saudi Arabia, agency-employed nurses can reportedly earn at least $500 or SR1,875 (just over P27,000) and up to SR3,840 (more of P55,500) per month. If employed under a government scheme, they can earn a minimum wage of SR4,110 or more than P53,000 per month.

Miranda from PNA even said that a junior nurse’s salary abroad could even allow her to earn up to 750,000 pesos per year, which could attract nurses working even for public hospitals here in the country.

Just recently, Germany and the Philippines signed a memorandum of understanding that allows more Filipino healthcare workers to work in the European country. The agreement “will improve the existing private recruitment pathway for nurses and other healthcare professionals such as physiotherapists, radiographers, [and] occupational therapists” for employment in Germany.

The Foreign Office said there were 6,000 Filipino nurses in Germany. POEA data showed that their salary, under the government-to-government scheme, should be at least €2,300 per month, or about P135,700.

“A chronic problem”

Stories of Filipina nurses or other medical professionals who prefer to work overseas due to higher take-home pay and other benefits such as insurance are not new.

“It’s a chronic problem and [it was] heightened due to the COVID pandemic,” Leachon said.

In addition to caring for patients who test positive for COVID-19, they must also care for those with other illnesses.

But when they are paid crumbs here at home, why prevent them from going abroad?

“As much as possible, we don’t want to see in the picture that the Philippines is seen as the main [labor] export,” said Miranda of PNA.

However, he notes that Filipino nurses have the advantage of having a good command of the English language and having competitive training.

“It was recognized that our program here in the Philippines is also universal,” Miranda said.

Data from the POEA showed that the deployment of healthcare professionals decreased during the pandemic. In 2017, this number stood at 106,009 and fell to 75,938 in 2018. The deployment of healthcare workers fell by almost 74% in 2020, from 78,403 to 20,652.

How do you make them stay?

In an report over the weekend, Undersecretary of Health Maria Rosario Vergeire said the exodus of nurses can be solved through a “whole of government approach”. She said the department is trying to find incentives for nurses to stay in the Philippines.

However, Migrante Philippines President Arman Hernando said providing incentives would not be the answer.

“Hangga’t walang sapat and nakabubuhay na sahod at maayos na health system in Pilipinas, patuloy na maghahanap ang ating mga health workers of mga oportunidad in ibang banssa,” Hernando said on June 19.

(Until the country can’t offer a decent, living wage and a proper healthcare system, our healthcare workers will continue to seek opportunities abroad.)

FNU advocates that private and public hospitals in the Philippines pay nurses a starting salary of 50,000 pesos per month. If small and medium-sized hospitals cannot afford it, they suggest the government subsidize salaries for the first three to five years.

With this, they also call on the government to increase its health budget.

Meanwhile, among the PNA’s appeals to government is “the establishment of representation for nurses in national government agencies”. Miranda said it would pave the way for nursing leaders to “be empowered” even at the local level through provincial, city and municipal health boards.

Nine days away from the inauguration of President-elect Ferdinand Marcos Jr., he has yet to name a new health secretary who would lead the country out of the pandemic.

“Health care should be the focus of the new administration,” Dr. Leachon said.

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