Shortage of nursing care workers

A recent Health, Labor and Welfare Ministry estimate serves as a reminder that Japan will face an acute shortage of nursing care workers as the aging of its population accelerates in coming years. The government must redouble its efforts to deal with the chronic labor shortage in the nursing care industry, including steps to improve the working conditions of nursing care staff.

According to the estimate, the nation will need 2.53 million nursing care workers in fiscal 2025, when the youngest members of the postwar baby boomer generation turn 75. The nation had 1.77 million nursing care workers, including part-time staff, in 2013. To meet the target, 800,000 more workers will be needed over the coming decade. But unless the current pace of increase picks up, the number of nursing care workers will fall short of demand by 380,000.

A serious labor shortage is forecast to materialize even sooner. It’s estimated that as early as in fiscal 2017, the gap will reach 120,000 and, unless effective steps are taken to secure more nursing care workers, it will widen to 200,000 in 2020. The estimated shortage will be more acute in some prefectures, including those in the northern Kanto region, which are forecast to face an exodus of manpower to Tokyo.

The number of nursing care workers in Japan has roughly tripled from 550,000 in fiscal 2000, when the public nursing care insurance system for the elderly was introduced. But the chronic manpower shortage continues as the population of elderly people requiring nursing care increases. Recruiting enough nursing care workers has become tough because the vocation has a reputation for being physically demanding but low-paying. According to the health ministry, the ratio of full-time nursing care workers changing jobs annually is 16.8 percent, far above the all-industry average of 12.4 percent, and their average monthly wages stand around ¥220,000 — roughly ¥100,000 lower than the all-industry average (in part because they remain on the job for fewer years).

The labor shortage is reportedly forcing cutbacks in public nursing care services for local residents in many areas. This problem threatens to erode people’s trust in the public nursing care insurance system, and many people might hesitate to pay premiums if they begin to question whether they can receive the services commensurate with the cost.

The government has been taking steps to help secure enough nursing care workers to meet the growing demand. In its latest review of the compensation paid out to nursing care providers, the health ministry bumped up the allowance that can be used to increase the wages of certified care workers. It is also offering support for workers willing to obtain the necessary licenses and trying to lure back licensed care staff who have left the industry.

But these efforts will not be sufficient to close the labor gap. The government should explore other means of dealing with the problem, including the introduction of a new category of licensed personnel that combines the functions of nurses, care workers and rehabilitation experts so that the labor shortage will not erode the foundation of the nursing care insurance system.