Editorials

Fill the gap in nursing care workers

Japan will have nursing care workers to fulfill only 86 percent of demand in 2025, when the youngest of the nation’s postwar baby boomer generation will have turned 75 and the need for care services will significantly increase, a recent government estimate shows. Efforts need to be accelerated to bridge the gap so that elderly people can get the services they require. While working conditions for nursing care workers need to be improved to secure sufficient manpower, efforts to contain the surge in nursing care demand through preventive measures that help people stay fit should also be explored.

The nation had roughly 1.9 million nursing care workers as of 2016. A Health, Labor and Welfare Ministry estimate shows that to meet the growing demand of the rapidly aging population, that number needs to rise by 550,000 to 2.45 million by 2025. At the current pace of increase in the care staffing, however, the nation expects to face a shortage of 337,000 nursing care workers seven years from now.

By sheer numbers, it’s estimated that Tokyo — whose large population will similarly age — will face the biggest shortage of some 34,600 nursing care workers. But in terms of the ratio of the estimated supply of workers to demand, other prefectures will face an even severer shortage. In Fukushima and Chiba, there will only be enough nursing care workers to fulfill 74 percent of demand in 2025. While the projected nationwide average is 86.2 percent, several other prefectures such as Kyoto, Okinawa and Hyogo also expect to face a tight supply.

In Fukushima, the supply of nursing care workers is not expected to match the increase in elderly people requiring care due to the impact of the 2011 Great East Japan Earthquake and the nuclear disaster, which left many elderly residents living away from their homes and families. Chiba’s proximity to Tokyo exposes the local nursing care business to tight competition with other sectors to secure a shrinking labor pool.

The nursing care sector faces a severe labor shortage even today. People tend to shun care worker positions due to their low wages — the average monthly pay is lower than the all-industry average by more than ¥100,000 — despite the physically demanding work. The turnover of nursing care workers remains higher than in other sectors, and in fiscal 2017 there were as many as 3.5 nursing care positions available for each job seeker — more than double the all-industry figure of 1.54.

The manpower shortage is set to worsen as the number of elderly people requiring care is projected to increase. According to the health ministry, it’s estimated that the number of people 65 and older who subscribe to the nursing care insurance program will grow from 34.75 million in fiscal 2017 to 36.1 million in 2025. Of the elderly population, those recognized as eligible for nursing care services due to their ailing conditions are forecast to rise from 6.29 million to 7.71 million — accounting for 21 percent of the total elderly population. Since the public nursing care insurance system was introduced in 2000, the average monthly premium that mandatory subscribers pay into the program has nearly doubled and it’s estimated that it will rise further in coming years, reflecting the growing ranks of the elderly population requiring care services.

The shortage of hundreds of thousands of nursing care workers in coming years will not be easy to fill given that the nation’s total working-age population is projected to continue its downtrend — falling to 70.8 million in 2025 compared with a peak of 87 million in 1995. Since 2015, the government has been taking steps to increase the wages of nursing care workers to narrow the gap with other industries. It also plans to promote the use of IT devices and robots to alleviate the burden on the nursing care workers, as well as to accept more workers from overseas for the nursing care sector. The sector, along with agriculture, construction, shipbuilding and lodging service, are among the industries facing an acute labor shortage — a situation that has prompted the government to decide to create a new term-limited visa status for foreign workers.

Efforts to increase the supply of nursing care workers and improve their working conditions should continue. What should also be pursued are measures such as preventive care that help people stay healthy in their golden years. Yamanashi Prefecture — which in 2016 had the highest healthy life expectancy (expected years of life in good health) in this country among male residents and third-highest among female residents — expects to have nearly 97 percent of its nursing care staffing needs met in 2025, according to the health ministry. We should explore how Yamanashi Prefecture will accomplish this so other prefectures can adopt similar policies.