LCQ7: Employment of part-time nurses and agency nurses of Hospital Authority
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Question:
It is learnt that in order to alleviate a shortage of nursing manpower in the public hospitals, the Hospital Authority (HA) at present not only employs part-time nurses, but also hires the services provided by nurses employed by agencies (agency nurses). In this connection, will the Government inform this Council if it knows:
(1) the respective numbers of days for which (i) part-time nurses and (ii) agency nurses worked in the public hospitals under each hospital cluster (cluster) last year, as well as the respective expenditures involved;
(2) of the respective (i) entry requirements (including working experience), (ii) employment terms, (iii) range of salaries (including minimum pay point and maximum pay point) and (iv) duties, of part-time nurses and agency nurses (set out in a table);
(3) the criteria based on which HA determines (i) whether there is a demand for extra nursing manpower, and (ii) whether such demand is to be met by employing part-time nurses or hiring the services provided by agency nurses;
(4) whether HA has (i) provided pre-employment training to part-time nurses and agency nurses to ensure that the care services provided by them are up to professional standards, and (ii) put in place a mechanism to evaluate their performance; if so, of the details; if not, the reasons for that; and
(5) the respective numbers of days for which (i) part-time nurses and (ii) agency nurses worked/will work in the public hospitals under each cluster from March to May this year, as well as the respective expenditures involved?
Reply:
President,
My reply to the various parts of the question raised by the Professor Hon Joseph Lee is as follows:
(1) The number of part-time nurses employed in each cluster of the Hospital Authority (HA) and the expenditure involved in 2017-18 are as follows:
| Cluster | Number of part-time nurses (as at December 31, 2017) |
Estimated annual expenditure on salaries of part-time nurses in 2017-18 ($ million) |
|---|---|---|
| HKEC | 296 | 44.1 |
| HKWC | 371 | 44.2 |
| KCC | 374 | 50.3 |
| KEC | 421 | 42.2 |
| KWC | 214 | 31.7 |
| NTEC | 559 | 63.7 |
| NTWC | 305 | 37.5 |
Abbreviations:
HKEC – Hong Kong East Cluster
HKWC – Hong Kong West Cluster
KCC – Kowloon Central Cluster
KEC – Kowloon East Cluster
KWC – Kowloon West Cluster
NTEC – New Territories East Cluster
NTWC – New Territories West Cluster
Note:
(a) The figures on manpower are calculated on a headcount basis, including permanent staff, contract staff and temporary staff in the ranks of Temporary Undergraduate Nursing Student, Enrolled Nurse, Registered Nurse and Advanced Practice Nurse.
(b) Payroll cost includes basic salaries, allowances, contract gratuities and other on-costs, such as home loan interest subsidy as well as death and disability benefits.
As the salaries of some of the part-time nurses are calculated on the basis of the number of hours worked, the HA is unable to provide information on the number of working days of the part-time nurses employed.
Regarding agency nurses, as their working hours are extremely irregular, the HA does not keep data in this regard.
(2) The entry requirements for full-time nurses, part-time nurses and agency nurses set by the HA are the same, i.e. applicants must hold valid practising certificates issued by the Nursing Council of Hong Kong. The duties of full-time nurses and part-time nurses are similar. They are mainly responsible for providing nursing care to patient and assisting other healthcare personnel in patient care. Given their higher turnover rate, agency nurses are mainly responsible for assisting full-time and part-time nurses in the patient care.
The terms of employment and range of salaries (including minimum pay point and maximum pay point) of part-time nurses are set out in the table below:
| Rank | Terms of employment (for temporary part-time employment) |
Hourly rate for part-time employment (actual hourly rate depends on experience and working time) |
Equivalent to the HA General Pay Scale |
| Enrolled Nurse | In general, annual leave, sick leave, maternity leave and paternity leave are included. |
$91 to $287 | Point 7 to 21 (General) Point 7 to 23 (Psychiatric) |
| Registered Nurse | $144 to $329 | Point 15 to 25 (General) Point 17 to 26 (Psychiatric) |
|
| Advanced Practice Nurse | $243 to $456 | Point 26 to 33A (General) Point 27 to 33A (Psychiatric) |
|
| Temporary Undergraduate Nursing Student | $91 to $119 | Not applicable |
In general, the terms of employment and salaries of agency nurses are set by individual agencies, while the HA sets out the terms in the tenders regarding the provision of services by the agencies, having regard to its service needs. Therefore, the HA is unable to provide information on the terms of employment and salary range of agency nurses.
(3) When compiling duty rosters, the unit or the ward in-charge concerned assesses and estimates the nursing workload and staffing requirements according to factors such as the number of patients, patient dependency and nursing activities in the unit or ward. If it is found that the number of full-time nurses deployed cannot meet the staffing requirement, arrangement will be made for part-time nurses and agency nurses to be on duty.
(4) The HA provides necessary pre-service training for both full-time nurses and part-time nurses before they join the service to ensure they meet the service needs of the clusters. The training covers basic infection control, protection of patients' privacy and safety, fire safety guidelines and knowledge of occupational safety and health. Apart from pre-service training, the HA also provides nurses with in-service training to ensure that they provide care services of professional standards. The HA has developed a Staff Development Review system to assess staff's performance and help staff set their future development goals.
As for the training of agency nurses, the HA incorporates terms and conditions in tenders before they are issued, stating and specifying that agencies are required to provide necessary pre-employment training, and will request agencies to submit relevant training records as and when needed. Moreover, the unit or the ward in-charge concerned provides orientation for agency nurses to ensure that the service needs are met and the relevant workflow followed. The nurse in-charge also provides the agencies with feedback on the performance of agency nurses for appropriate follow-ups.
(5) The HA employs and deploys part-time nurses and agency nurses according to the service demand. The compilation of the statistics on part-time nurses and agency nurses for the period from March this year up to now has not yet been completed.
Ends/Wednesday, April 25, 2018
Issued at HKT 12:00
Issued at HKT 12:00
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