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Monday, Sept. 1, 2008
Japanese nurses blocking skilled help from overseas
The Japanese Nursing Association is doing more harm than good to the nation's health care as it steadfastly puts up barriers to nurses and care workers from other countries wishing to work in Japan. What's worse, the association is supported by the health ministry.
Japan and other industrially advanced countries today face an acute shortage of nurses and care workers. While most of these countries are endeavoring to "import" qualified medical staff from newly emerging nations, Japan is closing its doors to such workers from abroad.
The government has long failed to work out strategic immigration policies, and JNA, which represents most nurses in the country, thinks it's more important to protect the jobs of its members than to promote the health of the nation's residents.
In the Philippines, Japan has become the least attractive country for those seeking to work in the medical and nursing fields abroad, despite the fact that Japan has a geographical advantage and the study of the Japanese language has long been popular among Filipinos.
Bilateral economic partnership agreements usually serve as tools for liberalizing the flow of people, goods and money between nations. Japan has so far entered into such agreements with Singapore, Mexico, Malaysia, Chile, Thailand and Indonesia. Similar pacts have also been signed with the Philippines, Brunei and the Association of Southeast Asian Nations (ASEAN), but they have not taken effect.
As for the Philippines, a difficult problem has arisen with respect to the free flow of people. Manila insists that Filipino nurses and care workers be allowed to work in Japan as a condition for entering into the agreement.
Under pressure from JNA and the health ministry, Tokyo came up with a series of conditions that must be met for Filipino nurses and care workers to be employed in Japan. One condition for nurses, for example, is that they pass the state examination within three years. Failure to do so would result in repatriation. The conditions, in fact, are so difficult for Filipinos to meet that they constitute a de facto ban on Filipino nurses coming to Japan to work.
Angered by this high-handed attitude, the Philippine Senate refused to ratify the bilateral economic partnership agreement in 2006. Japan countered with a threat to cut off direct investments in the Philippines unless the pact was ratified.
A female Filipino medical doctor said that although she had a reasonable command of Japanese, she could not get a job with any medical institution in Japan. Yet she passed examinations in the United States to become a registered nurse. Her salary as a physician in the Philippines was about $400 per month; she now makes 10 times that as a nurse in the U.S. This shows how welcome highly qualified Filipino nurses are in advanced countries — except Japan.
In London, four nurses from the Philippines said they were making the equivalent of about ¥400,000 per month, that they were working with nurses from India and African countries, and that they had not felt discriminated against.
Asked if they would like to work in Japan, their unanimous answer was an unequivocal "no": "If we could no longer work in Britain, we would look for jobs in the United States and Canada. If that didn't work, we would work at a hospital in the Middle East."
The 600,000-strong JNA opposes accepting nurses and care workers from abroad for three reasons: The acceptance of Filipino nurses is a bilateral trade issue; its purpose is not to alleviate the nursing shortage in Japan. Japan should not receive foreign nurses solely for the purpose of resolving the shortage problem. Some 550,000 residual nurses who have left their jobs or who are on leave could fill vacant nursing positions.
It is utterly unrealistic to rely on "residual nurses." In the first place, how many of those who have left the nursing field would volunteer to come back to working conditions characterized by the "three D's": dirty, dangerous and demanding. And who would seem more reliable as nurses — Filipinos who have recently been active in first-class hospitals or former Japanese nurses who have been away from their jobs for years or decades?
The unrealistic attitude on the part of the nursing association could push Japan's medical services into an even more serious plight than ever. The JNA may be a wealthy and powerful lobbying body, but how many of its members can demonstrate world-class skills comparable to those of Filipino nurses with the dedication and pride to save lives.
As one Japanese nurse confided, "The influx of nurses from the Philippines would deprive us of our jobs." That perhaps represents the true feeling of the association she belongs to. Japanese hospitals as well as the patients treated there cannot hope for help from highly qualified nurses from abroad as long as the JNA remains interested only in protecting its vested interests, builds insurmountable barriers against foreign immigrants and applies pressure on the government.
By the time Japan realizes why it cannot attract nurses from the Philippines, the competition among advanced nations to secure human resources in Southeast Asia will likely be so intense that this country will probably be left out.
The selfish attitude of the nursing association poses a threat not only to the long-term future of the nation but also to the health of tomorrow's citizens.
This is an abridged translation of an article from the August issue of Sentaku, a monthly magazine covering Japanese political, social and economic scenes.