Philippine hospitals struggle to retain nurses as rich countries lure them away

Ronald Ignacio began his nursing career in the Philippines during the nursing boom in 2008, quickly discovering that there were not enough jobs available within the health system. Initially unable to find work in his chosen profession, Ignacio spent two years laboring on a farm. In 2010, he eventually secured a nursing position in a private hospital in Manila.

Ignacio recounts that the situation today is markedly different. Filipino nurses now face low pay, poor working conditions, and inadequate nurse-to-patient ratios, all while developed countries are vigorously luring them overseas with lucrative job offers. As a result, hospitals and health centers in the Philippines are battling to retain their best nurses and fill new positions.

In the hospital where Ignacio currently works, several wards have closed due to a shortage of nursing staff. Even emergency patients face extended waits for beds. Ignacio explains that many expert nurses have accepted jobs abroad, citing insufficient salaries in the Philippines compared to the demands of their roles. The absence of experienced mentors means new hires often resign after just a few months, citing overwhelming workloads and low pay or the allure of attractive overseas job packages.

With only 16 nurses per 10,000 people, the Philippines falls significantly short of the World Health Organization’s recommended ratio of 27 nurses per 10,000. The country requires an additional 127,000 nurses to meet this target, according to the Health Ministry. Entry-level nurses in private hospitals in the Philippines earn a monthly wage of between US$271 and US$452, but this pales in comparison to the average monthly salary of US$3,000 and £2,000 (US$2,530) available in the US and UK, respectively.

Since the 1950s, remittances from Filipino nurses working abroad have significantly bolstered the country’s economy. By the end of 2021, approximately one-third of the country’s over 900,000 registered nurses were working overseas, generating roughly US$8 billion in annual remittances. This accounts for around 25% of all remittances, contributing to nearly 9% of the Philippines’ gross domestic product.

However, this overseas employment trend has contributed to a domestic shortage of healthcare workers. Jocelyn Andamo, Secretary-General of Filipino Nurses United, highlights increasingly creative recruitment strategies employed by affluent countries in the wake of the pandemic. For example, German recruiters have offered to sponsor nursing students prior to qualification and relocate their families. The German ambassador to the Philippines has lauded these programs, claiming they consider countries with an excess of highly-trained nurses.

With the Philippines not included on the World Health Organization’s list of countries experiencing healthcare worker shortages, there are no restrictions on foreign employers recruiting local nurses. However, Howard Catton, Chief Executive Officer of the International Council of Nurses, has raised concerns about the impact of continued recruitment on the Philippines’ healthcare sector.

While several governments, including the Philippines, have signed bilateral agreements to facilitate the recruitment of foreign healthcare workers, Jean Franco, a political science professor at the University of the Philippines, notes that these agreements often lack provisions to mitigate the effects of brain drain. Unions representing Filipino nurses are calling for increased salaries and improvements in working conditions; if ignored, more health professionals may choose to go abroad. The proposed annual overseas deployment cap, limiting the number of medical workers permitted to work abroad, has been criticized as a violation of workers’ rights.

Franco emphasizes the importance of the Philippine government supporting nurses like Ignacio who wish to serve the nation’s health system. He urges the government to demonstrate that nursing remains a dignified profession by improving conditions, ultimately enabling nurses to provide for their families without leaving the country reports Channel News Asia.