Private hospitals turning increasingly to India for skilled staff

At least two private city hospitals have turned to India to fulfil their need for registered nurses and skilled medical personnel saying that the move was necessitated by the drain in the sector caused by migration to other parts of the world.

Patients visiting the Woodlands and Dr Balwant Singh hospitals would have noticed the numerous Indian medical staff, especially nurses.

This is because there are not enough trained Registered Nurses here say the Director of the Woodlands Hospital (WHL) Deonarine Memraj and Administrator of Balwant Singh Hospital Dr Madhu Singh.

“Our primary reason for bringing nurses was because of lack of qualified RNs [Registered Nurses] in Guyana… there has not been an improvement in the availability of these certified nurses,” Memraj told Stabroek News in an interview.

“I would love to have local nurses but right now we only have five, including midwives because the migration has affected us severely…all our trained nurses are gone,” Singh said. She explained that the five locals and all other nurses on staff are RNs.

She explained that over the last 8 to 10 years the depletion of registered nurses here has hit the medical sector very hard and as such prompted her hospital to turn to India to fill the void.

According to the World Migration Report of 2010 Guyana is one of the leading Caribbean countries in terms of nurses’ migration to the United States and United Kingdom.

Nurses from Guyana have also migrated to Caribbean countries as not only are wages better there but so are other fringe benefits.

India has one of the highest emigration rates of nurses globally, but also has the highest number of trained medical personnel.

The Woodlands Hospital manager explained that while nurses were being trained locally they did not reach the criteria set by the WHL. As such the hospital turned to India where there are “more than enough RNs.”  “All of the nurses from India that you see here are RNs – every single one of them. It’s a standard we have and [are] maintaining because we see quality patient care as a very serious issue,” Memraj said.

Only recently Leader of A Partnership for National Unity (APNU) David Granger called for a complete re-evaluation of nurses’ training to improve patient care and expressed concern about the high failure rate of nurses at the October sitting of the nursing examination finals.

It was reported that of the 120 students enrolled at the Georgetown School of Nursing who wrote the examination, only 19 were successful.

In addition, at the start of the three-year programme, 255 students had entered the Professional Nursing Programme in April 2010 but only 120 of them persevered to write the final examination.

The Guyana Nurses Association stepped in and its President Norma Semple said that her organization will work with the Ministry of Health (MOH) to ensure that recommendations made to help alleviate the high failure rate of nurses are instituted.

The Woodlands Hospital Manager informed this newspaper that their trained RNs are given three-year contracts and these were subject to renewal; monetary payment, he said, was based on their certification. “The scale of pay is about the same based on certification. It doesn’t matter which country our medical staff is from they are paid according to their qualifications and years of experience …we are not biased in this regard at all,” he said.

Stabroek News understands that a registered nurse in Guyana works for a net salary of  about $140,0000-$160,000 or US$700 $800 per month with a private institution, while government pays a gross of between $75,000 -$110,000 or US$325 or US$550.

In the Caribbean they are paid anywhere between US$2500 -$6500 per month, while in the United States the range varies depending on the state and whether a private, government-owned or specialty medical facility is involved. Years of experience is also taken into consideration and salaries range on average between US$45,000 and US$95,000 per year.

It is believed that poor wages and salaries are the main reason for the migration of trained medical personnel in Guyana, and World Bank and Pan American Health Organization studies among others have pointed to this fact.

Singh agrees with this view and adds that in addition to salaries perks are also a contributory factor. “I would like to say wages is key but there are also things that can be done to attract back our nurses like bringing down the vehicle taxes. In Trinidad for example every nurse has a car, but here they would then counter and say, well the streets would be crowded,” she observed.

However, she said that she doubted that Guyana would ever be able to compete with North American countries for medical staff employment: “No matter how high, we can’t reach the North American salaries, we just can’t.”

Singh explained that contracting the Indian nurses was a very expensive undertaking as the hospital has to stand airfare and accommodation for them although the hospital has a nurses’ hostel of its own. “ It’s very expensive hiring from India because you have to stand the airfare and you have to give them a place to live…that’s a part of their contract…but I wish that we could have hired… [locally] but that’s not the reality,” the Balwant Singh Administrator stated.

Some persons have raised concerns about the language barrier between medical personnel and patients but both hospitals gave the assurance that to date this has not been a problem for them.

The directors of the two hospitals say that during interviews knowledge of the English language is evaluated and that some staff take refresher courses while on the job here.

The hospitals said that they thrive on being the nation’s premier medical facilities, so the staff’s performance is continuously monitored and evaluated. The administrators also noted that there has been no complaint by patients about the service they receive from the hospital staff both foreign and local.

As such they will continue to contract qualified Indian nurses until the void is filled.