Crisis of Nursing shortage in Health Service Facilities under Office of Permanent Secretary, Ministry of Public Health: Policy Recommendations

Abstract

Today’s nursing shortage in Thailand is a result of not only inadequate production as in the past 30 years, but also a failure to retain qualified and experienced nurses. Healthcare facilities under the Perma-nent Secretary Office (PSO), Ministry of Public Health has been facing high attrition rate of new entrant nurses regarding a lack of civil servant posts. Degree of severity of this problem varies across different facilities. This article aimed to provide policy recommendations based on evidences from the demand and supply projection of nurses during the years 2017 to 2021 and from the literature review on the interna-tional experience in addressing nurse shortage due to aging workforce in Organization for Economic Co-operation and Development (OECD) countries. It was found that healthcare facilities under the PSO required 136,520 Full-Time-Equivalent (FTE) of nurses by the year 2021. In order to maintain ad-equate supply of skilled nurses and to strengthen healthcare system in Thailand, there should be around 112,170 civil servant posts for nurses (equivalent to 90% of FTE requirement). This was contrast to the current situation where there are only 71.87% of the estimated demands. Moreover, approximately 11.34% of the current nurses (around 11,000 nurses) were temporary staffs. Temporary employment of nurses might cause young nurses to leave their career in the next 3 years. Based on the study results, the PSO should urgently request the Cabinet to provide at least 3,600 of new civil servant posts per year during 2017-2019 to prevent the loss of those temporary nurses. Key long-term measures, both supply and demand sides, are needed. Some supply-side measures should include: improving policies in recruiting and retaining qualified nurses, maximizing the efficient use of nurses particularly amongst the seniors, creating positive practice environment and engagement, strengthening collaboration and resource sharing amongst all stakeholders, namely, public sector,-private sector, communities, and civil society. Examples of demand-side measures are: re-orientation of healthcare system in the way that focuses more on disease prevention and health promotion activities, and strengthening capacities of local people in terms of health literacy, self-care capability, and rational use of health services.