Sending Nepali nurses to the United Kingdom will worsen Nepali medical sector, affecting the health services, health experts have warned.  

The shortages of nurses in the country will have an adverse effect in the health sector as patients will face delays in emergency departments and in other health services. 

 Critical care will be affected and there will be scarcity of nurses to take care of patients after surgery. Also it increases the workload of the nurses and makes them fatigued.  

Nepal and the United Kingdom though have signed a bilateral agreement on health partnership opening the door for Nepali nurses to work in the UK. 

There are already international concerns over the UK’s plan to take nurses from developing countries. The International Council of Nurses (ICN), said that such wealthy nations recruiting nursing staff from some of the world’s most fragile health systems was extremely hard to justify and perhaps should be stopped entirely. 

The ratio of nurses to the British population is around 80 to 10,000 while in Nepal it is nearer 20. The government run hospitals where there are a large number of the patients are facing an acute shortage of nurses. 

Consider this case. Recently 245 nurses have been appointed in Bir Hospital and 50 nurses have been appointed to work in federal governmental hospitals. These newly appointed numbers however are still insufficient to deliver quality health care to patients.  The ICN has said seven or eight wealthy countries—notably Britain, the United States, and Canada—were driving around 80 percent of international nurse migration, to try to address their domestic shortages.

Situation of nurses in the country 

The country is already facing an acute shortage of nurses. The shortage of nurses affects health care services, posing a threat to patient’s lives. It affects patient satisfaction rate, increases medication errors and makes them fatigued. 

One nurse should serve only six patients in a general ward, four in a pediatric unit, and one in an intensive care unit with a ventilator, according to the government. It is also ideal to have at least two nurses for a single operation table and during delivery.

Nepal produces around 5,000 nurses per year and this number is insufficient to the country. The number of nurses in the health centers in the rural areas are lesser than the urban areas.  According to Nepal Nursing Council there are 1,352 specialist nurses, 73,889 nurses, 51 midwives, 37,236 auxiliary nurse midwives and 848 foreign nurses registered with the council.

The World Health Organization estimates that at least 2.5 medical staff (physicians, nurses and midwives) per 1,000 people are needed to provide adequate coverage with primary care interventions as per its World Health Report 2006.

There is a need for 70,000 nurses in the country itself. 

The country however has not been able to meet the WHO estimates. Nepal is currently on the red list of countries according to the Code of Practice. The Code of Practice for the ethical international recruitment of health and social care personnel bans active recruitment from countries with the greatest workforce shortages unless there is a government-to-government agreement in place.

“When the government is not concerned about the shortage of nurses in the country and is sending the human resources to foreign countries it’s a shameful situation,” said Sarala KC, president of Nepal Nursing Council.

She said that this decision will be counterproductive as it affects the health care system. “Its effect will be seen in the citizens as they will not be able to get healthcare. When there is a shortage of the nurses the hospitals will be closed,” KC added. 

Who is eligible? 

Though the two governments are still working to prepare an implementation protocol Nepali citizen aged between 20 and 45 and who have completed either Staff Nurse, Bachelor’s Degree in Nursing Bachelor of Science in Nursing (BSc), or Bachelor of Nursing (BN), or Master’s Degree in Nursing, holds an active professional license from the Nepal Nursing Council plus at least two years of experience in a registered hospital in Nepal is eligible for the application. The applicants can fill up an online application on the Department of Foreign Employment’s website. 

Details on the recruitment process, the initiation date for the application process, as well as other related information will be posted on the Ministry’s website. The ICN has said that international recruitment focused largely on experienced, specialized nurses, rather than the “myth” that only newly-qualified nurses were being targeted.

“That creates a serious deficit in expertise in countries that cannot afford to lose their more experienced nurses. That has really been a serious concern,” ICN president Pamela Cipriano, had said during a press conference organized by the UN correspondents association in Geneva. 

British ambassador to Nepal Nicola Pollitt after signing the agreement on 22 Aug last year had then tweeted that the deal will benefit the health sectors of both countries.  Successful Nepali nurses will not need to pay anything for the recruitment and will enjoy the same benefits as British nurses, Pollitt, she had said.

The medical experts however are of the view that sending the Nepali nurses will worsen the condition of the already ill health sector. They say that the number of nurses is already decreasing in the country as the number of nursing colleges and the number of students joining nursing education is declining. “We must increase the number of nursing students if we are to run the medical sector,” said KC. 

Over 250,000 medical resource needed 

The Medical Education Commission (MEC), a national regulatory body for medical education in Nepal estimated that more than 250,000 human resources related to the medical sector will be necessary in the country till the fiscal year 2030/31. The projection has been made on the basis of a study based on fiscal year 2020/21. 

The commission has said that a total of 358,938 human resources including female health volunteers and office assistants in both the government and private health institutions would be needed across the country. It has also said that there is a demand of 257,091 doctors and health workers in the Nepali medical sector. 

“The number of human resources are projected on the basis of the retirement and migration of the health practitioners along with the construction of health institutions in the country,” said Dr Shree Krishna Giri, vice-chair of the commission.