As Singapore prepares to hire nearly 4,000 new nurses by the end of 2023, with more coming from abroad, some CNAs(Certified Nursing Assistants) discuss the factors driving them elsewhere. According to healthcare workers and experts, Singapore has a competitive advantage due to its proximity to source countries and relatively simple application process in the face of rising global demand for foreign nurses.
Singapore is also attempting to replace nurses lost to other countries during the pandemic, including by dangling larger pay packages. Still, retention is an issue, with some CNAs stating that they were considering moving abroad due to difficulties settling in here. According to the Singapore Nursing Board, foreign-trained nurses who wish to work in Singapore must pass a licensure examination and undergo a competency assessment.
However, in other countries, such as the United States or the United Kingdom, foreigners seeking employment may be required to take additional steps, such as an English language test. The cost of each test typically ranges from US$180 to US$325, depending on where they sit for it, which may discourage some applicants from applying to such countries.
“Nurses have many more options today than they did previously because the pandemic has compelled everyone to prioritize nurses,” said Associate Professor Jeremy Lim of the Saw Swee Hock School of Public Health at the National University of Singapore. Another important consideration for foreign nurses, according to him, is being close to their family while working abroad.
“Many of the nurses are from the Philippines or other regional countries, and people leave their home countries to earn money, but they still want to be reasonably close to home,” Assoc Prof Lim explained. “So, frankly, Singapore benefits from our proximity to the Philippines, India, and Myanmar, as opposed to the United States and European countries, and we have an inherent advantage when it comes to recruiting foreign nurses.”
Earlier this month, Health Minister Ong Ye Kung announced that Singapore would hire nearly 4,000 new nurses by the end of 2023. This represents about 10% of the current nursing workforce and is 700 more than the total number of nurses hired last year. To compensate for the two-year slowdown in foreign nurse recruitment caused by COVID-19 border restrictions, a higher proportion of these 4,000 nurses will be foreign, with a ratio of about 60:40 local.
In Singapore, attrition rates among local and foreign nurses in the public sector increased in 2021 compared to 2020. Attrition among locals was 7.4 percent in 2021, up from 5.4 percent the previous year. Attrition among foreign nurses has more than doubled year on year, reaching 14.8% in 2021. The Health Ministry announced in July that over 25,000 nurses would receive a special payment ranging from 1.7 to 2.1 months of their base salary.
“NOT JUST QUANTITY BUT QUALITY”
Despite these efforts to attract and retain foreign nurses, some of those who work here cite the difficulties of making Singapore their permanent home as a factor in their decision to look elsewhere.
Paul (ambiguous), is an Indian national who worked as a nurse in a Singapore public hospital for four years. After working as a nurse in India for three years, the 29-year-old decided to relocate to Singapore.
“I chose Singapore because it is closer to India than other countries,” he explained. “My parents are old and have a lot of medical problems,so if I had gone to a European country, which is quite a distance away from India, it would take too long.
“I have no plans to leave Singapore as of yet because I believe it is a good place to work, and the pay is better than what I would get at home.” Paul wants to settle down with his partner.
In the face of a continuing global nursing shortage and rising demand for care, Assoc Prof Lim believes that providing long-term residency to foreign nurses will help Singapore’s competitiveness and reduce attrition rates in the long run.
“We’re definitely one of the best in Southeast Asia, and our public healthcare system is probably one of the best in the world, so nurses who pass through us do get a sense of credibility,” said Dr. Lim Huai Yang, a public health specialist with interest in organizational health.
“They see us as a place where they can get something on their resume, get good training for a few years, and gain some experience before moving on to another country where the pay is probably better, and the work-life balance is better.”
According to Assoc Prof Lim of the National University of Singapore, the battle to attract and retain nursing talent is increasingly about quality as well as quantity.”We’re in a global market, and if we don’t want them, someone else will,” says the author. “He issued a warning.”We have lost many of our most experienced foreign nurses, and replacing a nurse who has been in Singapore for 15 years is not easy. “We can’t expect to get one nurse who just arrived in Singapore to be like-for-like.”