MoH proposes to hire 100 foreign nurses for JDWNRH

The Health Ministry has put up a proposal to the Cabinet to hire 100 foreign nurses to meet the growing shortfall and high attrition rate in the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) hospital.

The Health Minister Tandin Wangchuk said that as of January 2024 the attrition rate for nurses had already reached 25%.

He said this is expected to cross 30% in March 2024 as many nurses had given their 6-month notice period six months ago and it comes to an end in March.

The former government had come up with this 6-month notice rule to give the health system time to make arrangements.

The minister said, “First we have to solve the nurses’ shortage issue because quality of service at JDWNRH could get compromised which is dangerous and another thing is the existing nurses are burning out and are under pressure and may resign if nothing is done.”

The minister said that there are a lot of issues. He said after the nurses things like lab technicians and doctors needed to be looked at.

He said the doctor attrition rate has already reached 13%.

The minister said given the attrition rate he went on a tour of the referral hospitals in Gelephu and Mongar and to see the health facilities in the east.

He said there is some attrition problem in Gelephu too but it is not as bad as JDWNRH and Mongar is comparatively okay.

The plan is to hire the nurses from India given the language compatibility of English.

Currently, to incentivize JDWNRH nurses they are being paid Nu 1500 for addition 6 hours shift beyond their normal working hours. The fund is not being taken from the Ministry of Finance but JDWNRH’s own funds from cabins, after hours consultation etc. is being used.

The minister said that when other hospitals cannot handle patients they refer them to JDWNRH and he said he personally observed that the wards are all packed and even the emergency is packed to the point that people are being put in the corridors. The minister said the crowding has gone up since he was last the minister.

Lyonpo said that other recommendations were about a career path for health professionals and an opportunity to upgrade their skills.

He said this proposal came about as the PM met the health staff and asked the ministry to come up with a proposal. With the proposal ready, the PM out of a grading of good, bad, critical and dangerous for the situation in JDWNRH graded it critical.

If the grading goes to dangerous then it means the implosion and collapse of health services in JDWNRH.

Given the critical situation the PM asked for it to be forwarded to a one time sitting committee of Ministry of Finance, MoH and RCSC which has to take the final decision in one meeting.

The committee will then forward the matter to the cabinet for a final decision on all the recommendations including the hiring of foreign nurses.

The minister said they need to tackle JDWNRH first given its importance and will get to the other regional hospitals later.

The minister said that for nurses who left abroad and want to join back they can do so on contract.

Lyonpo said if the nurses in India are hired via agents then they will cost around USD 1,000 per month. Currently Bhutanese nurses get Nu 40,000 to 74,000 depending on seniority.

However, the MoH will also see if they can bypass the agents and recruit them directly to get them for a cheaper rate which may be possible.

The minister said that to study this matter the MoH sent a team to Kolkata to study the 11 empanelled private hospitals there that get Bhutanese patients to find out what the nurses there are paid and from where they recruit nurses and at what rate.

The minister also said that apart from this the team was also given the task to find out and see from where these private hospitals bought their drugs and its quality.

The minister said he heard about concerns on the quality of drugs supplied to JDWNRH and so he would like to compare the two and see. The minister said this way they can find out if local suppliers are overcharging or what quality is being provided.

Meanwhile, the Prime Minister Dasho Tshering Tobgay said that within a month, he has been to the JDWNRH five times. He said he particularly visited the national hospital as everyone is aware of how many challenges the health workers as well as the citizens are facing. 

Lyonchhen mentioned four recommendations.

He shared that the government has asked the health workers to propose the necessary measures. 

However, in addressing the shortage of doctors and nurses, the health workers are doing off hour works that requires extra allowance and discussions with RCSC have already taken place.

Another strategy put forward is to recruit Bhutanese doctors who have retired.

Lyonchhen also emphasized the significance to open canteens organized by Desuups for the staff whereby Lyonchhen asked them to not sell the products at an expensive rate, especially for the health workers.

The doctors and nurses at JDWNRH also mentioned about the need for a crèche for their children as most of them has no one to look after their children who are still infants.

 For this Lyonchhen said, “I have talked with Save the Children and they have agreed. We have already recognized a place to establish crèche and ECCDs at JDWNRH to take care of children until they attain the age to go to school.”

As there is a greater number of patients and very limited rooms for them, the PM said the plan is to call renowned doctors in thromde health centers which can help the patients to trust the health worker’s service and by doing so it can naturally decongest the number of patients in JDWNRH.

He mentioned that the need to decongest patients is very important as even the Emergency Room (ER), is filled with patients. “When I examined the Emergency Room, I found out that even the patients who are not supposed to be in ER are placed there due to more patients not fitting in a specified room. If in case there’s a very big emergency, this could lead to disaster.”

He said one of the solutions could be the full completion of Gyaltsuen Jetsun Pema Mother and Child Hospital in Thimphu, so they can shift most of the patients there and the ER can only have emergency patients.

Another approach the PM mentioned is by focusing on the establishment of a bio medical hospital which can help in shifting some of the wards, contributing in decongesting the national hospital.

Furthermore, there are proposals to construct private medical dental and diagnostic services.

The PM mentioned the need to buy CT scan and MRI machines. “However, the machines that are already in our hospital needs to be repaired at the earliest. To solve this problem, technicians have to come from Singapore. For this it is not only about the budget, but also the connection our country needs to have.”