Hot Topics: Hong Kong raises retirement age of doctors and medical staff to 65 in efforts to solve manpower shortage

The Hospital Authority announced the scheme on September 23, effective immediately. It will cost an additional HK$5.9 billion in the next decade. The measures aim to encourage staff in the public health care system to stay on. It will also create a new associate nurse consultant position, to give nurses another career path.

The authority estimated about 1,000 doctors, 5,000 nurses and 10,000 support staff would reach retirement age in the coming 10 years. It predicted a shortage of more than 1,600 doctors by the end of the decade.

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The authority said it would “actively and constantly” negotiate with staff to extend their retirement age once they reached age 55. Flexibility would also be provided if staff wanted to work part-time rather than full-time, or change job position and hospital.

On the other hand, more than 140 associate nurse consultant positions would be made available from next year. This promotion pathway for nurses is an alternative to the existing clinical management stream.

The new position gives nurses the chance to develop a career in specialty nursing. The salary would be the same as for a ward manager. In a general ward, the new position’s salary would range from HK$59,283 to HK$88,327 a month, and for psychiatric nurses, from HK$62,049 to HK$88,327.

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Hospital Authority chairman Henry Fan Hung-ling said the retention of medical staff was “deteriorating”. The rate of doctors leaving rose from 4.1 per cent in 2020 to 4.9 per cent this year. The exit rate for nurses was even higher, increasing from 5.8 per cent to 6.7 per cent.

Fan believed some leaving staff were moving to the private sector, reaching retirement age or leaving Hong Kong. He stressed that the two measures were not the only ways to keep staff from leaving.

“The government also has other multipronged plans such as opening the door to foreign-trained doctors, but distant water cannot put out a nearby fire. The new measures allow us to persuade retiring staff to stay immediately,” he explained.

The authority also added that the measures would not affect employees’ promotion prospects. But it would provide more manpower and lessen the burden on frontline staff.
Staff writers and Sue Ng

Question prompts:

• Explain in your own words why the Hospital Authority is extending the retirement age for its medical staff and adding a new nursing career path.

• Henry Fan Hung-ling said, “The new measures allow us to persuade retiring staff to stay immediately.” To what extent do you think this will work? Explain using Context and your own knowledge.

Question prompts:

• Describe TWO major features of the chart.

• How does the number of doctors in Hong Kong compare to that of other places on the chart? Using your own knowledge, explain the effects of having a shortage of doctors.

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The government revealed in early September that more than 1,000 Hong Kong medical students educated overseas would be allowed to intern in the city under proposed changes to medical registration.

The amendments to the Medical Registration Ordinance, proposed in February, at first only centred on allowing permanent residents to skip the local licensing exam, if they had graduated from a recognised medical school and were already registered to practise outside Hong Kong.

But the government later announced that it would propose further changes, including expanding the hiring scheme to cover non-permanent residents, including those from mainland China, but limiting eligibility to specialist doctors.

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Graduates of foreign medical schools who are permanent residents and able to pass the local licensing exams will be allowed to intern in Hong Kong.

The city currently has a ratio of two doctors for every 1,000 residents, compared with Australia’s 3.8 and Sweden’s 4.3. Secretary for Food and Health Sophia Chan Siu-chee said in September that a failure to adopt the new framework would result in 1,610 fewer doctors than needed by 2030, with that figure rising to 1,949 by 2040.

“This is for public interest, and we hope to solve the shortage of medical and nursing staff – that is our only goal,” she told a radio programme.

Permanent Secretary for Health Thomas Chan Chung-ching sought to address concerns over communication problems and a possible influx of mainland doctors. He said candidates would need to be largely trained in English so as to integrate into the local public health care system.

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“Languages shouldn’t become a barrier for hiring. It would depend [on] which post the candidate is applying for,” he said.

Hong Kong received just a few dozen foreign doctors under the limited registration scheme each year, and they were mostly professors and researchers working at universities and public institutions, he added.

“They are required to work in the public sector and must gain approval from the Medical Council to practise in Hong Kong,” he said.

So far, officials have not been able to allay concerns raised by local doctors, such as whether amendments would make the system unfair for medical students in the city.

After the government’s announcement, the Hong Kong Academy of Medicine said officials should focus on “maintaining the level of professionalism ... [and] guaranteeing training and job opportunities for local medical students”.
Staff writers

Question prompts:

• List TWO concerns people have about the foreign-trained doctors scheme.

• Thomas Chan Chung-ching said the amendments were needed to compete for medical talent in a globalised world. To what extent do you agree with his reasoning? Explain using News and your own knowledge.

In response to the Hospital Authority’s recent announcement raising the retirement age of medical staff, David Chan Kwok-shing, acting chairman of the Hospital Authority Employees Alliance, said the new measures did not go far enough to address long-term grievances staff had brought up.

On September 23, the Hospital Authority announced it was extending the retirement age of its doctors and health care workers for five more years until age 65, to cope with a long-standing manpower shortage.

Health authorities have long warned of the staffing crunch facing Hong Kong, predicting a shortfall of 1,610 doctors by the end of the decade, rising to 1,949 by 2040.

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Representing the union that had emerged from the anti-government protest movement in 2019, Chan said: “There are many reasons for people leaving, including the working environment and manpower ratio, as well as the current sociopolitical environment ... I don’t think the new measures really address the root problem of Hong Kong’s manpower shortage in public hospitals.

“Issues such as increasing resources for primary health care services and better coordination between long-term manpower planning and local training have been talked about for many years, but the Hospital Authority still has not taken these concerns seriously.”

The shortages could be worsened by an exodus of Hongkongers from across wider society. Some 89,200 people had left the city in the 12 months since Beijing imposed a national security law on Hong Kong last June, according to the Census and Statistics Department.

The net migration figure – coupled with demographic statistics that show the city’s deaths outstripping births – contributed to a 1.2 per cent drop in the population, which now stands at 7.39 million.

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Under the new scheme, the authority estimated about 1,650 medical workers could be retained in the coming five years, accounting for 43 per cent of retiring staff.

While announcing the new measures, Hospital Authority chairman Henry Fan Hung-ling said the authority had carried out a consultation but had yet to get reaction from staff.

“We understand that it is hard to persuade some staff, especially those who are younger, to stay ... Whether the new measures are effective or not, we can only try our best.”
Staff writers

Question prompt:

• Do you agree with David Chan Kwok-shing that the government’s new measures do not go far enough to address long-term grievances staff have brought up? Why or why not?

• Apart from the schemes to bring in foreign doctors, raise the retirement age for medical staff, and create a new career pathway for nurses, list ONE other thing the Hong Kong government could do to solve the shortage of medical staff in the city.

Retirement age of medical staff: refers to the age that Hong Kong’s medical staff must retire. On September 23, the age was increased from 60 to 65 to tackle the manpower shortage in public hospitals. In Hong Kong, there is no statutory retirement age.

Foreign-trained doctors scheme: a scheme proposed by the Hong Kong government to allow doctors trained outside the city to gain full registration without passing a local licensing exam. Applicants must fit one of the following criteria: permanent Hong Kong residents; graduates of recognised foreign medical schools who are already registered as doctors; or holders of specialist qualifications outside Hong Kong after they have worked for five years under the limited registration scheme and have served another five years at a public health institution.