Hong Kong seeks prescription for nursing shortage

The city must improve working conditions and offer nurses better pay.

Hong Kong should offer a more attractive compensation package to nurses amidst stiff global competition for healthcare professionals, many of whom are enticed to work in countries that offer better pay and a lighter workload.

Simply standing by is not an option, especially when the region is facing a persistent shortage of nurses, Hong Kong Health Secretary Lo Chung-mau told Hong Kong Business.

“Despite increasing nursing training places from about 2,900 in 2017/2018 to 4,500 in 2023/2024, we still face a shortfall of over 8,000 nurses,” Lo said in an emailed reply to questions. “We need to be realistic and face the keen global competition head-on.”

This shortage is worsened by nurses seeking better opportunities outside Hong Kong amidst high workloads and burnout, said Shin Thant Aung, director at YCP's Thailand office.

“For example, nurses from Indonesia and India are trying to work in Malaysia, and Malaysian nurses in Singapore or Hong Kong,” he said. “Similarly, Hong Kong nurses are aiming to work in the US, UK, or Australia.”

As of March this year, the monthly salary of registered nurses in Hong Kong ranges from $36,570 to $58,843, according to the Hospital Authority (HA).

“To compete globally, Hong Kong must improve working conditions, offer competitive salaries, and create stronger support systems for nurses,” Aung added.

The Hong Kong Legislative Council recently passed a bill allowing non-locally trained nurses to practise in the city without taking the local licensing exam.

The city is also bolstering the recruitment of nurses from nearby countries like Malaysia and Macau “provided they meet the rigorous professional qualification and competency requirements set by the Nursing Council of Hong Kong,” Lo said.

“We must attract the best nurses to come and practice,” he added.

These initiatives are not only expected to ease work pressure and burnout but also bring diversity into the workforce, said Rathanesh Ramasundram, director for Healthcare and Life Sciences at Frost & Sullivan.

“Hong Kong will likely become a more multicultural healthcare hub,” she said.

He said more foreign nurses mean more competition, which could both be a cause for concern and an opportunity for local nursing graduates.

“Local nurses may feel there are fewer job opportunities or slower career progression,” she said. “The situation also presents the chance to enhance professional growth through pursuing specialisations and certifications to remain competitive.”

However, foreign nurses still face challenges related to cultural adaptation, language barriers, regulatory compliance, team integration, and the need for ongoing support, Ramasundram said.

She said recruiting foreign nurses might not be sustainable in the long run. “An overreliance on non-locally trained nurses could delay structural reforms in Hong Kong’s healthcare workforce planning.”

“Filling the increasing requirement of nurses with non-locals will incur rising costs of recruitment and overdependence on non-local resources,” she added.

Aung warned that relying too much on foreign nurses could worsen the loss of local talent, forcing more nurses to seek job opportunities overseas. “This is not sustainable, as it comes with a range of difficulties, including economic and social implications.”

“Locally trained nurses may feel demotivated by perceived favouritism, especially if career progression or job opportunities appear skewed,” Ramasundram added.

Lo said the government policy prioritises the employment of locally trained nurses. “The new admission pathways for nurses are designed specifically in this spirit.”

“For non-local nurses to practice in Hong Kong, they must first secure employment from institutions such as the HA and the Department of Health,” he said. “These institutions are duty-bound to accord priority to employing locally trained nurses.”  

He also said the Hospital Authority has implemented a preceptorship programme, appointing experienced nurses to supervise recruits and help them become familiar with ward procedures and the work environment.

“The Department of Health will also organise orientations, induction training, and peer support schemes,” Lo said. “With more nurses to share the workload, local nurses could dedicate more time and attention to caring for patients.”