SPEECH BY MR ONG YE KUNG, MINISTER FOR HEALTH, AT THE NATIONAL UNIVERSITY HOSPITAL LUVING NURSES FORUM, 20 FEBRUARY 2024, 3.30PM, NUH

Professor Yeoh Khay Guan, Chief Executive, National University Health System (NUHS)

Professor Aymeric Lim, Chief Executive, National University Hospital (NUH)

Professor Quek Swee Chye, Chairman, Medical Board, NUH

Dr Karen Koh, Chief Nurse, NUH

Ladies and Gentlemen,

Nurses

Today, we gather here to recognise the dedication of our nursing workforce as the backbone of the healthcare system, and the extraordinary impact you have on your patients and their families.

2.             As we all know, post COVID-19, like many countries around the world, we are experiencing a tight bed situation in all our hospitals. We are redeveloping existing facilities and building new ones to expand our healthcare capacity. For example, the Woodlands Health Campus will add a total of 1,000 more acute and community beds, and almost 400 beds in its long-term care facility this year. Further capacity will come on stream in the coming years. Alongside with expanding capacity, we also need to build up our healthcare workforce.

Our Nursing Manpower

3.             As frontline healthcare staff, nurses play a pivotal role in providing quality patient care. Nurses are often the first touchpoint for patients, and provide round-the-clock care, comfort and support to patients and their families.

4.             Nurses make up the single largest share in our healthcare workforce. Of the 65,000 strong healthcare workforce in the public healthcare clusters, about 24,000 or one-third are nurses. You are also of greatest shortage, especially after the higher-than-usual attrition of foreign nurses during the COVID-19 pandemic years, but we have made up for it since then.

5.             Hence MOH Holdings (MOHH) as well as  our public healthcare institutions devoted a lot of significant effort last year to recruit more nurses into our healthcare system. We have exceeded our target, and achieved more than 5,600 acceptances to job offers made to nurses since end-2022. About 4,500 have been newly registered and many have started work. I would like to thank MOHH, our healthcare employers and the Singapore Nursing Board for working tirelessly to reinforce our nursing bench strength. Well done, everybody.

6.             Overall, we have made up for the high nurse attrition experienced in 2021 and 2022. We will continue to sustain the strong recruitment momentum for both local and foreign nurses this year, and beyond. Now, we have to focus on inducting the new nurses into our teams, training them and integrating them into our system. I encourage all of you to lend a helping hand to all the new nurses, show them around, induct and integrate them into your teams.

Making Nursing an Attractive Career

7.             Last year’s tremendous recruitment effort is part of a long-term strategy to make nursing an attractive career. Over the years, we have implemented many new initiatives to attract and retain nurses.

8.             It starts with building a healthy flow of nursing graduates from our Institutes of Higher Learning (IHLs) – at the Institute of Technical Education (ITE), Nanyang Polytechnic, Ngee Ann Polytechnic, Singapore Institute of Technology (SIT) and National University of Singapore.

9.             We grew the nursing intake numbers by about 30% from 2013 to 2023. This means that if you look at students today, for every 25 students, one becomes a nurse. For every Primary 1 class with maybe 30 to 40 people, there is probably at least one, if not, two nurses in one class. That is how many we are taking into our healthcare workforce as nurses. It is worth pointing out that with falling birthrates, fewer babies, and shrinking student cohorts, just keeping these intakes stable is a very encouraging outcome.

10.          ITE recently transited the Nitec in Nursing course to Higher Nitec in Nursing from January this year. This will better equip our Enrolled Nurses with the necessary skills to take on enhanced job roles. ITE is also working on a new Work-Study programme to be launched later this year, for Enrolled Nurses to upgrade to a Registered Nurse. What this means is that they may not need to go back to full-time further studies. Instead, they work and study at the same time, like an apprenticeship programme, and they can upgrade from an Enrolled Nurse to a Registered Nurse.

11.          SIT will be starting a new integrated programme for nurses to obtain both a Bachelor and Master of Science in Nursing, that will equip nurses with the skills to embark on career pathways to become nursing specialists and leaders.

12.          Last year, we worked with the public healthcare clusters to enhance sponsorships for locals studying nursing in our IHLs. MOH also introduced a sign-on bonus for fresh nursing graduates last year. With these efforts, our public healthcare clusters hired 12% more local fresh nursing graduates in 2023, compared to 2022.

13.          For local mid-career switchers, we enhanced the Nursing Career Conversion Programme pathways. For the accelerated diploma level conversion programme, we introduced a second intake from 2017. We introduced an accelerated degree level conversion programme too in 2018. We also increased the training allowances to attract more mid-career locals into nursing.

14.          To augment our local nursing workforce, we have been recruiting foreign nurses from regional countries. Healthcare employers have set aside supervisory bandwidth to onboard and train new foreign nurses because you need to get used to working in Singapore, and we integrate you into the working environment and culture of our local hospitals.

15.          Through MOHH, we have been converting several existing buildings in Singapore into lodging facilities, and started to provide accommodation support for our new foreign healthcare workers hired by our public healthcare institutions. For foreign nurses coming into Singapore, the foreign nursing dormitories help them settle down in Singapore much better.

16.          Most recently in December 2023, the Tripartite Workgroup for the Prevention of Abuse and Harassment against Healthcare Workers launched its Tripartite Framework. We set out a common definition of abuse and harassment, and standardised protocols to respond to incidents of abuse from patients or their families and visitors.

17.          Since its launch, we observed that healthcare workers have been more forthcoming in seeking support and reporting abuse and harassment incidents. Patients and their family members have become more conscious of their words and action. We need to keep up the effort. We hope that with these steps, healthcare workers, including frontline nurses, will get to work in an abuse-free environment.

ANGEL

18.          Last year, I announced that MOH is working on a retention incentive scheme for nurses. It is not a new idea, to be honest. Major schemes of service in the government, such as the Singapore Armed Forces, Home Team and teachers, already have retention incentive schemes and they have become an important component of the total remuneration of these officers.

19.          The purpose of retention schemes is to recognise the commitment of officers who have served for many years and developed a career in their respective schemes of service. Such retention schemes also recognise that for very valid personal and family reasons, officers at certain ages or years of service, are particularly susceptible to contemplate leaving the scheme of service. They do so start a family, further their studies, take care of aged parents, or just to try out a new opportunity that came along. These are very valid reasons.

20.          A retention scheme signals to these officers – please think twice and give yourself and give us a chance. As employers, we can help address these dilemmas and trade-offs in life, and help you stay in a career that you will find meaning and continue to make a very positive impact. On your part, if you stay on, perhaps after a while, things do work out after all.

21.          It is in this spirit that we developed the retention incentive scheme for nurses. It is called the ANGEL scheme. ANGEL stands for Award for Nurses’ Grace, Excellence and Loyalty.

22.          Under the ANGEL scheme, each nursing officer can potentially receive up to $100,000 over a 20-year period, or up to the prevailing retirement age, whichever is earlier.

23.          For newly recruited nurses and nurses aged below 46, you will have at least a 20-year runway before you, given that Singapore intends to raise retirement age to 65 by 2030. For this group, every four to six years, you will receive an award of $20,000 to $30,000.

24.          What about nurses who have already stayed many years with us? You have already contributed significantly, and some may have fewer than 20 years before retirement.

25.          We have two considerations for this group, and I need to be absolutely honest with our considerations. First, for your many years of service, we should rightly recognise you under the ANGEL scheme, immediately. Second, we still hope to incentivise you to serve even longer. So, we do need to strike a balance between the two.

26.          Hence, for nurses who have served several years and are aged 46 and above, you will get an immediate award of $5,000 to $15,000, for those who already have 5 years of service. Whether it is $5,000 or $15,000, the range depends on how many years you have served. If you have stepped out of school and served until now,  chances are you will get $15,000. Thereafter, you will be on an accelerated payout path, where you will be awarded $15,000 every three years.

27.          Some of you may be from a foreign country. You will be asking if this is only for Singaporeans. I should add that the ANGEL scheme is applicable to foreign recruited nurses too. However, we must recognise this – for foreign nurses, integrating into the Singapore system and society takes time. The majority successfully does so, but some, a minority, will not work out and they leave. We will therefore effect the ANGEL scheme for foreign nurses after you have served four years of service in our public healthcare sector. If you have already served continuously for four years or more, you are immediately eligible.

28.          There are nurses outside of the public hospitals who serve in Voluntary Welfare Organisations and community facilities, and are part of our community care organisations. Social service agencies will be wondering if they are included too. These organisations  can apply to participate in the ANGEL scheme. They will need to co-fund the awards, with the majority of the funding coming from the government. More details will be shared with these organisations.

29.          This means that some 29,000 nurses in the publicly funded healthcare system, and newly recruited nurses every year from henceforth, can benefit from the ANGEL scheme. Long serving nurses aged 46 and above will get your first retention award by before end of this year, which is the year zero payout. For the younger nurses, you will get your first payout in 2028 when you reach your first milestone. So, please stay.

30.          MOH and cluster HR officers worked hard to get the scheme designed and approved, so that we can announce before Chap Goh Mei. I hope it brings some cheer to you this Chinese New Year. More details will be shared by your HR departments.

31.          I am sure many other healthcare professionals who are not nurses will be asking ‘What about me?’. We will not forget you. We set up the ANGEL scheme because nursing is the largest healthcare profession in our system, and competition for nursing recruitment has become more intense. Please be assured that if you are not a nurse, we will review the competitiveness of all the professions within healthcare, and make the necessary adjustments to the remuneration package wherever necessary.

Serving With Heart and Passion

32.          Remuneration is an important and a practical consideration for everybody, but we know it is not everything. Ultimately, healthcare professionals serve with heart and passion. Care for patients is what drives the entire healthcare sector.

33.          That is why we are doing far more than just reviewing remuneration packages and implementing retention incentives. We are strengthening training and development, putting in place a policy of zero tolerance against abuse, and improving the career prospects of nurses.

34.          We want to support our nurses to do a good job. We see this especially during Nurses’ Day, where everyone in the healthcare sector comes together to celebrate and recognise the achievements of nurses. The management will sing and dance and for a day, laugh heartily at themselves. This is what a family does for each other.

35.          Nursing is no easy job as it is a commitment to care for others in their most vulnerable moments. So, thank you for choosing to make a difference in the lives of others. All the best, and Happy Chinese New Year once again.