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People at a vaccination centre in Kobe, western Japan, in 2021. A high number of elderly people is part of the reason why there is a shortage of healthcare workers. Photo: Kyodo

Japan needs ‘1 million’ more healthcare staff amid dire shortage, government report says

  • Medical profession’s pandemic burnout, falling birth rate, fewer young people working, and longer lives have brought intense pressure
  • Better pay and conditions, more effort to retain workers, more tasks being automated, and more overseas workers may alleviate situation
As it emerges from the coronavirus pandemic, a crisis that at times threatened to overwhelm its capability to meet the nation’s health needs, Japan’s healthcare sector is already staring down the barrel of an even larger risk, with a government report warning that it will have a shortage of nearly 1 million staff by 2040.

Healthcare workers who complained of becoming burned out during the peak of the global pandemic have been leaving the sector and are not being replaced by newcomers due to the well-publicised conditions in which they have to work, including long hours, stressful tasks, low pay and the likelihood of catching the virus.

By far the bigger problem, however, is the falling birth rate and a smaller population of young people entering the workforce at the same time that improved healthcare and medicines mean Japanese are living longer than ever before.

According to government statistics, the total population of Japan will stand at 110.9 million in 2040, down 12.7 per cent from the 125.8 million recorded in 2020.

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At the same time, the median average age of a Japanese person will rise 7.5 years to 54.2 years in 2040 and the ratio of the working-age population will decline nearly 7 percentage points to 5.39 per cent. The figures also show that people aged 65 and over will account for 35.3 per cent of the total population, an increase of 8.7 percentage points from the present figure.

The crisis facing the health sector was spelled out by the Ministry of Health’s annual report presented to the cabinet in September, with attracting sufficient workers to the care sector identified as “one of the most important agenda items facing social security services”.

A sharp increase in demand on health services is expected as soon as 2025, the year the “baby-boomer” generation turns 75. Just 15 years later, when a second wave of people hit the 75-year-old threshold, the nation’s health services will require 10.7 million workers.

Given birth rates and other factors, the report suggests that only 9.74 million workers will be available, a shortfall of 960,000 people, the Asahi newspaper reported on October 19.


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Yoko Tsukamoto is a professor of nursing at the Health Sciences University of Hokkaido and charged with preparing a new generation of healthcare professionals – and she admits she is concerned.

“We have definitely seen more people leaving the healthcare sector, due largely to the pressures that people have been under for the last couple of years,” she said.

“This is a very pressured career and it’s certainly not for everyone, with a drop-out rate among first-year students at about 20 per cent before the pandemic,” she said, pointing out that one-in-five quitting before the end of the first year is a far higher rate of attrition than in other jobs.

And while there are no firm figures about the drop-out rate since the coronavirus emerged in the first quarter of 2020, Tsukamoto is confident it is “noticeably higher” than in the past.

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“Young people now want a work-life balance, but that has been impossible during the pandemic,” she said. “Health workers could not go out and meet their friends on an evening or weekend, and many could not even go home to their families after working a shift on a coronavirus ward.”

But that short-term problem is going to become more acute soon, she agreed, with the already high density of elderly people and shortages in workers affecting virtually every sector.

As well as better pay for healthcare workers, Tsukamoto said more robots and automation can be introduced into hospitals to take on simple tasks that would otherwise fall to nurses or other staff. Equally, more qualified health workers from abroad should be permitted to work in Japan, she said.

The crisis facing the health sector was spelled out by the Ministry of Health’s annual report presented to the cabinet in September. File photo: Reuters
Limited numbers of nurses and care staff from the Philippines and Indonesia are already working in Japan, although the language barrier has proved to be something of a hindrance. And now the yen is so weak, Tsukamoto said more nurses from Southeast Asia are choosing to take better-paid positions in the US instead.
Kazuhiro Tateda, president of the Japanese Association of Infectious Diseases and a member of the advisory panel set up to advise the Japanese government at the outset of the coronavirus crisis, echoed that assessment.

“We need more workers in this sector even now because there are so many elderly people who require treatment and assistance and the shortages that we are seeing now are only going to get worse in the years to come,” he said.

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“Another reason for the shortages is the relatively low pay for many people at the lower end of the sector as the ministry tries to reduce budgets so that the limited amount of funds that it has can be put to the best use,” he said. “Unfortunately, that money does not always go on people and employees will leave because of poor rates of pay.”

The pandemic has, however, woken the authorities up to what could happen if an even more dangerous pandemic should break out in the future, Tateda said. And he said steps need to be taken to attract people into the profession – and retain them.

“People need better conditions and better wages, it’s really that simple,” he said. “But I also think that they need pride. If they have pride in the job, if they feel appreciated and respected for what is a very difficult job, then I think they will stay.”