By Patricia B. Mirasol  

THE HEALTHCARE staffing shortage can be addressed through ethical and sustainable recruitment practices, according to Connie B. Dela Cruz, co-founder and chairman of Health Carousel Philippines, a POEA (Philippine Overseas Employment Administration)-licensed staffing firm.  

Ethical recruitment refers to the hiring of workers in a way that protects the rights of each stakeholder in the recruitment process. Sustainable staffing, meanwhile, refers to how both the home country and the country of work benefit from the talent exchange.   

“For us, ethical recruitment means that we reinvest in the sustainability of the nursing profession in our source countries,” she told BusinessWorld in an e-mail interview. “We do this in a variety of ways, including faculty educational programs, nursing scholarships, and local hospital recruitment partnerships.”  

Health Carousel Philippines assists in the nurse upskilling efforts of its partner hospitals, like Southwestern University Medical Center and De Los Santos Medical Center, by sharing its knowledge on nursing best practices.  

It also partners with nursing schools, such as University of Santo Tomas and Trinity University of Asia, and provides skills training to their nursing faculty. The staffing firm also ensures that nurses referred to it by partner hospitals are retained by the latter for at least a year for proper manpower management.  

Filipino healthcare professionals are deployed to the US by the staffing firm through PassportUSA, a POEA-accredited, international staffing program partner. PassportUSA is operated by Health Carousel, LLC, a healthcare staffing company in the US.  

The Philippines is the second largest exporter of human labor in the world, according to a 2017 Human Resources for Health study, and healthcare professionals are one of its biggest groups of migrant labor. Professional development, a higher living standard, and economic need are the reasons often cited behind the decision to migrate.   

This June, Malacañang issued a memorandum increasing the salary of nurses to P36,628 from P33,575

In comparison, registered nurses in the US receive a mean annual wage of $80,010 (or P4,065,548.13, at an exchange rate of $1: P50.813), per the US Bureau of Labor Statistics (BLS)’ 2020 Occupational Employment Statistics Report.  

The US BLS predicts that 11 million additional nurses are needed in the country to avoid further labor shortage. Employment opportunities for nurses in the US are also expected to grow at a faster rate than all other occupations from 2016 to 2026.  

The World Health Organization projected in 2016 that by 2030, there will be a shortfall of 18 million healthcare workers in low- to middle-income countries. 

Because upper middle-income countries cannot supply the healthcare workers they need from within their country, they will exert a demand pressure on the supply of healthcare workers from low- to middle-income countries, thus challenging these countries that cannot afford to compete financially to retain their healthcare workers.  

The conversation on nursing shortage is quite nuanced, said Ms. Dela Cruz. The settings in which nurses choose to work in the Philippines also influences the available workforce at the bedside, she added.   

“The pandemic arguably magnified the problem of maldistribution, where many Filipino healthcare workers choose to work in different industries instead of hospitals due to the higher wages offered in those settings — such as BPOs, banks, hotels, and resorts,” Ms. Dela Cruz said.  

The solution, according to Ms. Dela Cruz, is working toward win-win practices that benefit all the parties involved, from the recruitment process to the professionals’ deployment in their country of work.  

On a global level, the High-Level Commission on Health Employment and Economic Growth recommends the following priority actions to address the healthcare worker shortage are the following:  

  • In low-income and some lower middle-income countries, investments in healthcare worker education should be accompanied by an expansion of the fiscal space to fund positions in the health sector.  
  • A shared financing model between countries to finance all these new jobs is likely required if low- and low-middle income countries are not able to pay for the healthcare workers they need — even with moderate domestic fiscal space growth.  

The said commission acknowledged that changing the status quo also requires political will and tough negotiations. Why would high-income countries address their shortfalls in domestic supply, it asked in a 2018 Human Resources for Health paper, if the recruitment of international healthcare workers is cheaper?   

From Health Carousel Philippines’ perspective, a mindful recruitment model is a step in the right direction. Ms. Dela Cruz said her staffing firm created a framework with its aforementioned partner hospitals that helps manage the demand and supply of healthcare staff.  

“Through this program, we help the hospitals retain their nurses for at least two years while their US application is in process,” she added. “We also provide opportunities for nurses to engage in a two-year employment program to gain the local hospital experience required [for their overseas applications, which then] sets them on a course to a brighter future in a premium healthcare facility in the United States.”  

She hopes that an expansion of such practices will eventually stabilize the demand and supply of all the countries involved in the talent exchange.  

That more Filipino healthcare workers opt to work abroad to advance their careers and build a brighter future for their families is understandable, Ms. Dela Cruz said, as the country is rooted in a family-oriented culture.  

“I like to believe that, given the choice, most healthcare professionals would prefer to practice their profession in the Philippines if their career will give them the opportunity to have a comfortable and meaningful life,” she added.