Philippines: Top provider of nurses to the world, now facing a shortage?
Manila: Husband-and-wife team Edward and Janice Manalo are both medical doctors in the Philippines — but both work as nurses in the US. He’s obtained his local license as a surgeon; she’s an anesthesiologist.
In 2010, Janice (who took up nursing for her undergraduate degree, before she passed both local and US board exams, and then passed the Philippine medical board exams) moved to America with her doctor-husband after her work visa application was approved first. Theirs is not a rare story.
For many Filipino nurses, working overseas is a lifeline — a shot for a better life, especially for their families.
What are the perks?
In the US, the Manalos (name changed) drive a Tesla, live in a four-bedroom house, and get paid at least 10 times their Manila counterparts.
For the Philippines, this poses a problem — as well as an opportunity. Where the problem ends and opportunity begins is a rather dicey question.
How many Filipino nurses work abroad?
In the UK alone, more than 18,000 Filipinos are said to be working for the National Health Service (NHS), third only to the numbers from Britain and India.
One study found that the Philippines also provides more nurses and clinical support staff than any other country outside the UK. The Philippines tried to cap the exit of its nurses in 2021, but the cap didn't last long and was lifted.
Since the 1960s, over 150,000 Filipino nurses have migrated to the US. In 2019, one out of 20 registered nurses in the US was trained in the Philippines.
Angie L., a nurse from the Philippines’ Bicol region, worked in the Middle East for five years, before moving to Frankfurt. She’s one of the 600 Filipino nurses recruited through a government-led headhunting scheme for Germany's hospitals and elderly care homes. Angie left after hurdling the German language and career tests.
Among the offers for qualified applicants: free travel expenses, language training, a bonus for passing exams on the first try and help finding accommodation.
In September, Singapore and the Philippines also opened talks last month on hiring more Filipino nurses and other health care workers.
Sara works as a nurse in Japan, and does vlogging on the side. Among her perks, half of her apartment rent is subsidised by her employer.
In July, the Philippines News Agency reported that the 14th batch of Filipino nurses and caregivers have arrived in Japan to work in local hospitals and care homes.
Is there really a shortage of local nurses?
This year, 2022, the Philippines is reporting a shortage of nurses. Many local hospitals are also reporting a staff crunch. It’s an increasingly bitter irony: the country that is among the top providers of nurses to many developed, is itself facing a shortage for their leading “export”.
About 106,000 posts open for medical-related jobs, mostly nurses in public and private hospitals nationwide, according to a senior health official.
Dr Maria Rosario Vergeire, officer-in-charge at the Department of Health (DOH), told said in a recent media briefing that in addition to nurses, the country also needs other healthcare professionals — doctors, dentists, midwives, medical technicians, pharmacists, and radiologic technologists.
What are plantilla positions?
“Currently, we have plantilla positions that still need to be filled up in our hospitals and we have around 624 plantilla positions for our nurses. We have 1,332 midwives, plantilla, and we have around 63 dentists that we needed,” she told local media in Filipino language.
A plantilla (service personnel) position refers to a job post whose primary duties and responsibilities contribute to the delivery of services and achievement of agency outcomes.
What are the effects of migration of nurses?
Dr. Vergeire blames the "shortage" in nurses nationwide on emigration of healthcare workers. During the height of COVID, The government tried to impose a cap, but it didn't work.
And while the demand for nurses has gone up during the COVID pandemic, but so is the burnout, which explains a high turnaround.
This is true even among those relatively better-paid nurses working in the US, where pay could average $40-$50 per hour — more than the daily wage of nurses back home.
How much do nurses get paid in the Philippines vs US?
An entry-level nurse in the Philippines at a private hospital gets a salary of about $500 a month, though senior positions could go up $800 to $1,000.
Pay is one thing, but working conditions is another. Long, unholy working hours could mean higher income even in the Philippines, but that could lead to early burnout.
In February 2022, McKinsey estimates that 32% of registered nurses in America are considering leaving their current direct-patient-care role, citing a survey conducted in November 2021.
In the survey, 32 per cent of registered nurses (RNs) said they may leave their current direct-patient-care role. That’s a 10% points jump in under 10 months.
Many, like Angie, would rather move outside than stay close to family and friends, face the same work-related risks, but with less pay.
Due to higher demand, the number of nursing education institutions increased — from 40 universities/colleges during the 1980s to 470 in 2006.
The UK’s Nursing and Midwifery Council (NMC) said stated in an annual report that 48 per cent of the 48,436 new nurses and midwives were from other countries, with 66 per cent from India or the Philippines.
How do you solve the skills gap?
One solution is to incentivise them to stay back home, a challenge given that the Department of Health (DOH) budget accounts for only 1.18% of the countrys GDP.
Health officials have sought for higher budget allocation from Congress. They also try to work out other non-budget solutions with other agencies of government, as well as with labour-receiving countries.
“We’re coordinating closely and we have a scheduled meeting, hopefully, with the Department of Migrant Workers (DMW) headed by Secretary Toots Ople, and of course, with DOLE [Department of Labor and Employment] with Secretary Laguesma,” Vergeire said.
Providing incentives, too, is easier said than done given the budget crunch the country's health sector faces.
> On Wednesday (October 5), the Department of Budget and Management (DBM) approved the release of about Php11.5 billion ($195.23 million) for the distribution of “One Covid-19 Allowance” (OCA), more than two years after the pandemic turned the world upside down.
> It covers claims by more than 1.6 million eligible recipients under the Health Emergency Allowance (HEA) from public and private healthcare facilities.
> On Monday (October 3), the DBM granted the DOH's request to release Php1.04 billion ($17.6 million), earmarked for the distribution of the special risk allowance (SRA) of 55,211 public and private health workers.
> The health department, however, states it still needs about Php64 billion ($1.086 billion) in back pay for health workers, covering June to December 2021, the Philippine News Agency reported.
What's the solution?
As a stop-gap measure, Dr Vergeire is also proposing that the Philippine government should work with countries that absorb Filipino nurses to help foot the bill for their training back home and encourage more young people to take on the career.
“In countries where we deploy our healthcare workers, what can they provide us?” she asked.
It’s a complex question that's part-suggestion, part-solution and part-demand.
In one discussion, Dr Vergeire brought up arrangements like “scholarships, exchange programs, and others so we can have more benefits from this migration”.
One program suggested is for countries recruiting Filipino nurses to partly bankroll the training of nurses in local schools.
In the changing tides of global skills marketplace, however, it’s not clear how such a solution would pan out, as the Philippines must also compete with other sending countries.
News of the event had an larger-than-life impact on Filipino nurses around the globe. For her act, Parsons received the prestigious George Cross Award on behalf of the UK National Health Service from Queen Elizabeth II, one of the monarch’s last public appearances before she died.
‘Go for what is best for you’
Before she landed her UK job, May Parsons worked for three years in the Philippines. She has been in service for the last 26 years.
For Parsons working in the Philippines is a good starting point, and no one should be prevented from leaving the country to work elsewhere if it gives them and their families a better life.
“I would not stop anybody who’s trying to get a better life, cause [going abroad] changes lives,” she said. “If it’s for a better life for you, then absolutely, you have to go for what is best for you.”