Nursing crisis in care homes for elderly

PUBLISHED : Tuesday, 07 February, 2012, 12:00am
UPDATED : Tuesday, 07 February, 2012, 12:00am


A chronic shortage of nurses in private homes for the elderly is behind huge waiting lists for places at the facilities, a service group says.

At least 400 more nurses are needed in the homes to cope with demand, said Grace Li Fai, chairwoman of the Elderly Services Association of Hong Kong.

Li was responding to yesterday's report in the South China Morning Post on the plight of Ng King-yin, 100, and his wife, Lam Sau-king, 95, who have waited two years to get into a home. Ng has finally been offered a place in a regular home, but he would have to leave his ailing wife behind.

For many of the facilities, it is simply not possible to find enough nurses - especially given competing public and private hospitals also face a shortage of nursing staff.

'Aged-care homes are always the lowest priority for those who choose nursing as their career,' Li said.

The government shut down the Hospital Authority's nursing training programme in 1997 in a bid to raise nursing education to university level. The number of nursing graduates dropped by 70 per cent under the new system - from 1,391 in 2001/02 to 416 the next year. Just 300 graduated in each of the following two years.

Health sector legislator Dr Joseph Lee Kok-long said Ng and Lam's case showed a short-sightedness in meeting the needs of the city's greying population.

There has been little improvement in aged care since the Welfare Department introduced its enhanced bought place scheme in 1998 in a bid to shorten waiting lists. The system aims to bring all private facilities in line with its 'EA1' standard, which stipulates the best ratio of staff to residents.

Fourteen years on, there are just 31 private aged-care homes graded EA1. These are regular 'care and assistance' homes with some nurses.

But the city also has 100 homes classified 'EA2', meaning a greater ratio of staff to residents, with no nurses. The main reason they have been unable to upgrade is because there are not enough nurses.

These homes must hire two to five registered or enrolled nurses to meet EA1 classification, depending on their size. Li estimated 400 nurses were needed across the city to fulfil the government target of having all facilities at the EA1 standard.

The Social Welfare Department said many subsidised care homes had 'a staff ratio greater than the basic requirements'. It has been working with the Hospital Authority on a two-year full-time course since 2006, training nurses specifically for the welfare sector.

'Working in these aged-care homes is always seen as the least desirable option for nurses. We are competing with the lure of private and public hospitals and some NGOs to find the nurses we need,' Li said.

Legislator Peter Cheung Kwok-che agreed the shortage was a problem but it 'doesn't mean the government can't first sort out the basics - like renovating care homes so that they can accommodate elderly people with greater medical needs'.

Public and private hospitals are also coping with a shortage. The Hospital Authority says it needs 1,000 nurses. It is the city's biggest employer of nurses, hiring 20,000 of the 40,000 nurses working in Hong Kong. The public system last year lost 5.3 per cent of its nursing staff, or 1,010 nurses, to private hospitals.

But private hospitals say they still need more nurses. 'It is really hard to find nurses, especially experienced ones,' said Dr Alan Lau Kwok-lam, chairman of the Private Hospitals Association.

Married for more than 70 years, Ng and Lam must make an agonising choice. A place in regular care is available for Ng, but his wife's health has deteriorated and she must wait for a place in a nursing home. So they either separate or Ng waits for two places to come up in one of the few facilities that can care for them both.

The Society for Community Organisation and several lawmakers will visit the couple today. The group said they would press the legislature for follow-up action.