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Doctors at the New Territories West Cluster at Tuen Mun Hospital on October 13 year. Hong Kong has had some success in its efforts to lure doctors trained overseas to help ease the city’s doctor shortage. Photo: Xiaomei Chen
Opinion
Lina Vyas
Lina Vyas

Fixing Hong Kong’s doctor shortage needs more than just recruiting

  • Efforts to ease Hong Kong’s doctor shortage by recruiting doctors trained overseas have had some success, but that alone is not enough
  • The government should also address the reasons behind high turnover rates, particularly in the public sector
Lina Vyas
Lina Vyas
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The healthcare sector is among the fastest-growing service sectors around the world. In Hong Kong, the quality of healthcare and patient safety is under scrutiny given its long-standing shortage of doctors.

According to data from the Legislative Council Secretariat released last year, the doctor-to-population ratio was up from 1.8 doctors per 1,000 people in 2011 to 2.1 in 2021. However, the ratio remains below that of Asian economies such as Taiwan, South Korea and Singapore. This trend is a worrying sign for the future.

Healthcare in Hong Kong faces significant challenges. The shortage of medical professionals has been accompanied by high turnover rates because of retirement as well as doctor joining the private sector or leaving the city.

To better discover the reason for the high turnover rate, consider a recent study I did on Hong Kong’s healthcare professionals in 2023. Most healthcare workers perceived systemic staffing shortages. They are under high pressure, which contributes to a higher desire to leave their job.

Comparing the public and private healthcare sectors, people in the private sector were more adequately compensated by their employers and were more satisfied with their jobs. This helps explains the draw for public doctors to go private.

With regard to their motivation to work, the results showed that most enjoyed and were engaged in their jobs. Surprisingly, more than a third said they were likely to seek new employment even though they enjoyed their jobs. Additionally, the participants preferred career achievement over monetary incentives as most of them believed a sense of professional responsibility prevented them from resigning.

However, overwork and heavy responsibilities are pushing healthcare workers to their limits. Half of those surveyed said they experienced moderate to extreme stress, especially amid the Covid-19 pandemic.
In response to this challenge, the Hong Kong government has stepped up efforts to attract non-locally trained doctors by conducting overseas recruitment events. Since 2021, these doctors are allowed to practise and attain full registration without being required to take the local licensing examination.
Despite the eased restrictions, not enough have been willing to come. It is important that the Hospital Authority maximises the city’s appeal to attract as many non-locally trained doctors as possible.
Most of the doctors attracted by this policy are from the UK, where the pay difference is significant. The salary of a doctor of the same level in Hong Kong is more than double that in the UK. Tightened visa practices in the UK potentially provide an opportunity to attract talent back to Hong Kong, but is this enough?

While these policy changes are a step in the right direction, they are only part of the solution. The government’s efforts must not be limited to recruitment but should also address the reasons behind the high turnover, particularly in the public sector.

Factors such as burnout, stress and perceptions of poor compensation are among the reasons for high turnover. To address the healthcare worker shortage, it is worth asking if focusing on policies to attract talent are actually helping to solve the issue.

What Hong Kong needs is a long-term solution that addresses the crucial issues that lead healthcare workers to leave in the first place. These include low salaries, stressful work conditions and heavy workloads.

Hong Kong should ensure its investment into training doctors pays off

A possible solution could be that Hong Kong further enhances public-private partnerships and narrows the gap both in terms of salary, benefits and workload to control the one-sided movement from one sector to another. It is clear from the study that despite doctors receiving handsome compensation, the turnover rate is more than financially driven.

To increase staffing levels, the government should also strengthen support for the mental health of existing healthcare professionals, review compensation packages to ensure they are competitive, explore flexible work arrangements to improve work-life balance and continue to refine these based on their effectiveness and the feedback from healthcare workers.

Offering flexibility and providing meaningful work can improve motivation and job satisfaction, reduce the turnover rate and create a more resilient healthcare system that benefits both healthcare professionals and the patients they serve. It is of the utmost importance that Hong Kong takes this looming health crisis seriously and keeps the healthcare system strong to best serve the people.

Dr Lina Vyas is an associate professor in the Department of Social Sciences and Policy Studies at the Education University of Hong Kong

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