Wednesday, July 27, 2016
Vietnam - The mystery of the vanishing Vietnamese nurses
It’s one of the policy aspirations touted during the Labor decade that prompted early sound and fury but has since disappeared into the ether.
In the days since SA Police announced it had scrapped its decade-old recruitment policy targeting British bobbies, InDaily has sought to find out what became of a long-ago-reported recruitment drive targeting nurses from Vietnam.
It sounds like the name of some forgotten Agatha Christie potboiler – the mystery of the vanishing Vietnamese nurses – but it is a mystery made all the more perplexing because the department that orchestrated it now officially denies it ever existed.
Intermittently between 2008 and 2011, headlines would appear suggesting the then-Rann Government was proposing to pay to train nurses in Vietnam, with the intention of bringing them over to South Australia to help fill a looming nursing shortfall, amid concerns there may not be enough recruits to care for the state’s notoriously ageing population.
But SA Health insists the program was only ever designed in the interests of cross-cultural philanthropy.
Acting Chief Nurse and Midwifery Officer Julie Brown told InDaily in a statement that “SA Health has not implemented a program aimed at recruiting nurses from Vietnam”.
Rather, she says, in 2013 the department officially partnered with Da Nang University of Medical Technology and Pharmacy to support local nurses by funding two education workshops each year until 2017.
“The workshops aim to assist nurses in the Vietnamese province of Da Nang to become champions for clinical teaching, which enables them to support and build the capacity of local nurses to provide nursing care to their communities,” Brown said.
“A Memorandum of Understanding between SA Health and Da Nang University of Medical Technology and Pharmacy was signed in 2011 prior to official arrangements being put in place.”
But John Hill, who was the state’s Health Minister from 2005 to 2013, remembers things differently, insisting the intent of the relationship was to train nurses with the aim of bringing them to SA to live and work.
“At that time we were doing projections, and there was a real concern about shortages of nurses in the coming 10 to 15-year timeframe, because of the age profile of nurses,” he recalled.
He said there was a concerted effort to “prepare for it in a systemic way”, by establishing ties with “a poorer country which has a demography that’s complementary” to SA’s health needs.
Vietnam fit the bill because of a large number of young people wanting to go into nursing, and Hill sought to “create an arrangement where they can come and do some of their training in Australia, and some who were wanting to could come and work here as migrants”.
“We thought the Vietnamese Government might have their noses put out of joint, but they thought it a was fantastic idea and were really keen to make it happen,” he said.
“I thought they’d be hostile to Australia because we bombed the crap out of them for so long, but they love Australia – mostly because of Gough Whitlam, because his was the first western government to recognise the new regime.
“They saw Australia as good friends.”
John Hill (far left) during his time as Health Minister
Hill saw the plan as “an insurance policy, I suppose”.
“It seemed like a good thing to do, as there were benefits for us in the longer term and for them from a welfare point of view,” he said.
He argues that even with direct overseas aid, “there’s a lot of hands that touch that money before it actually gets spent in a community”.
“What I discovered when I went over and talked to them was that nurses in Vietnam make [the equivalent of] 1500 Australian dollars a year, while nurses in Australia were on $60,000 – so 40 times as much.
“So the nurses would come and work in Australia and earn $60,000, and send back 10 per cent of their income to their family, and that’s the equivalent of four jobs in Vietnam, funded by 10 per cent of the income of these nurses.
“And it wouldn’t go through any bureaucracy, any government system.”
Australian Nursing and Midwifery Federation state secretary Elizabeth Dabars recalls there were “a number of visits to the place”.
“The minister went, representatives from our organisation went, I went on one occasion,” she said.
“It was seen as a potential win-win for Vietnam and Australia because [they thought] nurses working here could return home and bring knowledge and expertise back as well, but nothing ever happened… it’s never gone anywhere.
“The only thing that came of it as I understand it was that some assistance in English language provision was offered and some proposed assistance with curriculum development maybe.”
In the end, there were several stumbling blocks, with language and cultural barriers a significant hurdle.
“English is not widely spoken in Vietnam… I had some feedback later on that it was pretty problematic [training the nurses in English],” Hill recalled.
Dabars also emphasises issues with “cultural expectations”, highlighting “significant differences in the way in which health systems operated”.
“Over in Vietnam, family members provide most of the basic care… it’s not really the nursing staff doing that. They assist with other activities,” she recalled.
“So it does operate in an entirely different way.”
But the primary event that killed off the Vietnamese nursing influx was the Global Financial Crisis.
“The need diminished, probably in the same way the British bobbies’ did,” Hill explained.
The high attrition and retirement rate that had spooked authorities in SA fell away, as nurses opted to keep working longer.
“After the GFC, nobody was giving up their job, so there wasn’t any wastage – and in fact we were having trouble finding jobs for all the nurses,” Hill said.
“It changed so quickly.”
Dabars said five years on, the looming shortfall “to a certain extent still exists, because of the age profile of our nursing and midwifery workforce”.
“It’s a training issue… we’re looking down the barrel over the next five to 10 years of a shortage, but in the meantime we have a virtual surplus or oversupply,” she said.
“That’s why graduates aren’t getting jobs… our message to the Government has consistently been, ‘You need to employ graduates and not get rid of staff now, because you’re looking at that shortfall in the future and you need to make sure you don’t end up in a terrible predicament where you don’t have enough staff to meet the needs of the community’.”
The Opposition is bemused about the entire situation, with Health spokesman Stephen Wade telling InDaily: “With policies like this, it’s little wonder the Government has entrenched SA as the unemployment state.”
“The State Government’s focus should always be ensuring that South Australians are first in line for jobs as nurses in our health system,” he said.
But Hill still sees merit in the scheme.
“I don’t know if they’re still pursuing it,” he mused.
“I hope so, because I thought it was a good social thing, creating a friendship with a country I always felt we’d done wrong by.
“It was a good thing to have a connection with them.”