Hospitals and clinics in rural areas are finding it increasingly difficult to hire nurses on their own, and the amount of referral fees they are paying to private agents are significantly on the rise, a recent research report shows.
To employ a full-time nurse the fees were about ¥870,000 ($8,100) on average in fiscal 2016, according to the report released by the Japan Medical Association Research Institute.
In the year that ended in March 2017, the total amount of fees paid by 844 medical institutions surveyed had ballooned to roughly ¥1.6 billion, compared with ¥1.1 billion in fiscal 2014, it said.
“The results confirmed the costs have placed a heavy burden on hospitals relying on private staff agencies,” said Nobuyuki Tsutsumi, one of the research fellows at the institute who conducted the survey.
The report, released in late December, said there were 36 hospitals spending more than ¥10 million on such fees.
Despite the additional costs, the report also showed that the turnover rate of nurses recruited with the help of the agencies is higher. In recent years an average of 11.3 percent left jobs within one year, while the overall rate — including those employed without using private employment agencies — was just 6.1 percent.
As for the rate of departures within six months, 6.6 percent of nurses hired through the agencies left compared with only 3 percent overall.
The institute conducted the survey between May and June last year, contacting some 4,000 hospitals and clinics across the country of which 844 responded online.
The study found that the lack of nurses is acute in more rural and less-populated areas.
About 50 percent of medical institutions in cities with a population of more than 1 million said there has been a shortage of nurses. For those located in towns with a population of less than 100,000, the percentage experiencing a shortage rises to 75 percent.
In depopulated areas, 83 percent of medical institutions admitted to suffering from a chronic shortage of nurses.
To better address the difficult situation, the report has proposed that hospital officials actively use “nurse centers” that were set up across the country in the 1990s based on a national law. All 47 of Japan’s prefectures have at least one nurse center. The centers, operated by the Japanese Nursing Association, can provide job-placement services for free. But they are not widely known and their use remains marginal.
Masami Kumagai, an executive of the association, said the centers are staffed with veteran nurses, and that she is confident they can provide more detailed advice and information than private employment agencies.
As 94 percent of nurses in Japan are women, she said the centers are willing to help them with how best to continue their careers even after they marry and give birth, for example. She added that the association is also prepared to facilitate the re-employment of middle-aged and older nurses who wish to work.
“The centers are aimed at assisting each individual to find a job,” Kumagai said. “If the employment situation is stabilized, the quality of nursing and medical services will improve in the long run and that is going to be a very good thing for patients.”