The Japan Times: Sept. 22, 2004
FTA could exacerbate Philippine nurse drain
By ARLENE BURGOS
MANILA (Kyodo) Even as the Philippines strives to get Japan to allow in Filipino health-care workers under a free-trade agreement now under negotiation, the country itself could be moving rapidly toward a crisis in which patients suffer as health-care professionals move abroad.
Under the FTA talks that began earlier this month, Manila is looking to get Japan to allow Filipino nurses and caregivers to work freely in Japan, even though medical professionals are already packing their bags in record numbers for the United States, Britain and other countries where pay and working conditions are often better, industry experts warn.
"We are really on our way (to a medical crisis)," said Ruth Padilla, president of the Philippine Nurses Association. "In fact, we are already suffering in the delivery of health services especially in the rural areas, so much so that even doctors now are taking up nursing because they want to leave the country."
Padilla said records from the Philippine Overseas Employment Agency, which processes papers for migrant workers, show the agency has processed 34,415 professional nurses in the last three years.
The Philippines produces 8,000 to 16,000 nursing graduates annually, and this may triple or more in about three years when new nursing colleges begin graduating students. However, these numbers will barely meet domestic requirements.
And given that graduates need at least two years of experience and training before they become skilled professionals, a shortage is already foreseen.
Adding to the concern is the reality that many of the students now in college or in training will seek work abroad rather than at home, meaning the Philippines is likely to lose nurses faster than it can graduate new ones, experts say.
Padilla’s PNA, a government-recognized nursing association, is lobbying for better pay for nurses and other medical workers to keep them home because jobs abroad are just too lucrative.
"What can we say as our nurses leave the country? It is primarily for economic reasons," Padilla said.
The 12,114 nurses who work in government hospitals earn an average of $160 a month, a far cry from the $3,000 to $4,000 they can earn in the United States, where many Filipino nurses now work.
And even though Filipino nurses must pass a licensing exam and four other competency tests to practice in the United States or two examinations to get work in Britain, the high pay draws them by the thousands.
Padilla said Japan requires a battery of language-proficiency exams before it will accept Filipino nurses, and even though Japanese can be a difficult language to learn, many Filipinos will still take Japan-sponsored language courses in hopes of getting a job there.
"The Japanese government should shoulder the expense if (Filipino nurses) train here just to learn the Japanese language and the Japanese culture. It will be for the benefit of Japanese nationals," Padilla said.
And she admits the Japanese job market is very attractive to Filipino nurses, noting that on Monday, when news broke that the Philippines and Japan have started negotiating an FTA, two Filipino nurses showed up and asked Padilla’s association for recommendations to work in Japan.
Overseas nursing work is becoming so attractive, several experts said, that doctors are now shifting into nursing careers so they can more easily get jobs abroad.
One study by the Health Department said the Philippines, already with a high patient-to-doctor ratio, may need 18,000 new doctors by 2010.
And the Philippine College of Surgeons has warned that at the rate doctors are leaving, there will be few well-trained and qualified surgeons in the country by 2014, the Manila Standard reported last week.
Rene Ofreneo, an expert in industrial relations and human resources, calls the phenomenon of Filipinos seeking work abroad "the brain and brawn drain."
The new exodus of health-care professionals represents just the latest wave of migration — like the exit of construction workers and engineers in the 1970s, entertainers and maids in the 1980s, and teachers in the 1990s, Ofreneo suggested.
And it is difficult to stop the migration because the domestic economy is "barely surviving," he added.
The economy even depends in considerable part on about 8 million overseas Filipino workers who send home to their families around $7 billion a year.
"The irony and the tragedy of it, because of numerous problems, is that there is still a large portion of the population crying for assistance here," Ofreneo said.