MINISTER FOR HEALTH & MEDICAL SERVICES HON. DR IFEREIMI WAQAINABETE'S STATEMENT AT THE PRESS CONFERENCE ON NURSES RESIGNATION

Permanent Secretary MHMS Dr James Fong
Chief Medical Advisor Dr Jemesa Tudravu
Acting Chief Nurse and Midwifery Officer Mrs Kelera Soata
Members of the Media
Ladies and Gentlemen
 
Good afternoon to you all,
 
This afternoon’s press conference is intended to give the Ministry of Health & Medical Services, the opportunity to clear the air on misinformation in regards to the resignation or mass exodus of nurses. I would also like to address other developments in the Ministry in regards to the health needs of all Fijians.

As the Minister for Health & Medical Services, I take time to visit, together with my executive team, the Divisional Hospitals, Sub-divisional Hospitals, Health Centres and Nursing Stations around Fiji throughout the year. I talk to the doctors and nurses who hold the fort in these health facilities because they are the eyes, ears, hands and feet of the Ministry.
 
I ensure there is a bottom-up approach as I give out my mobile number and email address to my staff to call or email me directly if there are burning issues that need to be addressed in their area of service. And I do get emails, calls, and viber messages from the Ministry staff. So I am well aware of the concerns and challenges that our staff face in the delivery of health care, and we make every effort to address them as best as we can. This is opposed to some stated allegations that the Ministry has a top-down approach which is why the concerns and needs of nurses are never heard.
 
I am also fortunate to have the support of our Permanent Secretary Dr James Fong, our Chief Medical Advisor Dr Jemesa Tudravu – both of whom are practicing medical practitioners, who also understand the importance of steering the Ministry of Health & Medical Services in the right direction as battled with the COVID-19 global pandemic.
 
A quick review of the resignation data for nurses showed that in 2018, 93 nurses exited the service of which 52 were resignations, 112 exited in 2019 with 80 resignations, 88 exited in 2020 with 66 resignations, and 144 exited in 2021 with 86 resignations. The total number of nurses who exited in the four years from 2018 to 2021 is 437 of which 284 were resignations.
 
In the same period, the Ministry recruited 678 nurses into the Ministry. On average, 65% of nurses exiting the service in the last four years were due to resignation, and the main reason for resignations was migration and pursuing job opportunities abroad.
 
Nurses also grasp the opportunity to further their studies locally with the availability of scholarships like TELS or travel abroad. So the assertion that work stress is causing many resignations of nurses is false and unfounded.
 
Resignations of nurses and other health care workers had existed before the pandemic and will continue after the pandemic. This is all part of a natural employment cycle; employees join, and employees depart. However, the Ministry remains committed to ensuring that shortfalls in the workforce are addressed as quickly as we can, and we continue doing all we can to look after the welfare of all its staff as they deliver health care services to all Fijians.
 
The Ministry abides by the general order for civil servants and therefore pay meal allowance like every other Ministry according to the provisions of the general order. This has not been changed!
 
On the operational front, we have allowed flexibility for our divisional management teams and frontline supervisors on the management of staff under their command to safeguard the welfare of health staff through effective staff rostering, and management of leave accrued.
 
In addition, Government resisted the recommendation of the Opposition in Parliament to cut the salary for civil servants by 20 – 35%.
 
A recent survey conducted in one of our larger divisional hospitals noted that 84% of the close to 300 nurses surveyed prefer the 12-hour shift from the standard 8 hours shifts, for the following reasons:
- There are more staff in each shift to share the workload;
- There was ample time to finish off the work in each shift;
- There were more days off to spend quality time with the family.

This [8 hours shifts] has allowed our management teams to move back from extended working hours to normal working hours, and take official leave entitlements accrued over the past year;
 
The suggestion that an industrial action such as a strike as the means to negotiate better working conditions is shameful and uncalled for. The Government has processes of allowing its staff to dialogue rather than taking drastic actions that would put the lives of Fijians who are in the public health system at risk.
 
There is no doubt that the last two years have been extremely challenging for the health service and health care workers throughout the world and Fiji has not been spared. Images from hospitals overseas show mayhem but thank God we have not endured that level of intensity.
 
I can only stand here today to salute and commend our health workers including our hardworking nurses, and all frontliners, for their dedication, passion, commitment, and sacrifice to stop the disease and turn our nation around quickly in this pandemic.
 
In my visits, and as a fellow health care worker, I have always called on all our staff to remember our oath and our calling to serve the people of Fiji to the best of our abilities.
 
Nurses, like doctors who take their own oath, take the oath of Florence Nightingale, the founder of nursing which is as follows:
“I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully.

I will abstain from whatever is deleterious and mischievous and will not take or knowingly administer any harmful drug.

I will do all in my power to maintain and elevate the standard of my profession and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling.

With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.”
 
I again encourage my fellow health care workers to continue with the good work they are doing so far and not be distracted by commentators who are not really supporting them in their careers.
 
Universal Health Coverage
In spite of the challenges of the pandemic, the Ministry is pursuing its effort to extend the accessibility of health services to all Fijians to achieve the Govt’s intentions under the principle of Universal Health Coverage (UHC).  We continue to carry out outreach services into hard-to-reach communities in rural and maritime Fiji, for disaster response, for the vaccination campaign, and for general and specialist medical care.

In our effort to elevate health care provision in our rural communities, we have also identified nursing stations throughout the country that we wish to elevate to have Nurse Practitioner service level, and be able to deliver services beyond the scope of what a registered nurse can do.  This move will mean more health care service available to our rural population, and the promotion of nurses in this specialized area of public health. We are also at the early stage of formulating a plan that will establish new doctor positions in existing health centers and nursing stations.
 
Training and Upskilling Health Care Workers
The Ministry has made every effort to provide the opportunity for health care workers to access continuous professional development (CPD) and postgraduate qualification relevant to their area of expertise. 
 
Our health workers are endorsed for training opportunities that come up, and the Ministry continues to collaborate and engage with development partners and funders to support the development of health care workers.
 
As an example, with the support of the New Zealand Medical Treatment Scheme, 20 registered nurses completed the Foundation of Management Course at FNU in 2019, while 38 registered nurses are into their 2nd semester of the Postgraduate Certificate in Child Health Nursing course from the TISI Sangam School of Nursing in Labasa after successful completion of the 1st semester in 2021.
 
From 2018 to 2021, the Australian Department of Foreign Affairs and Trade (DFAT) through the Facility has funded the training of 179 Fijian midwives at the Fiji National University and the TISI Sangam School of Nursing.
 
The Fred Hollows Foundation of NZ has sponsored 37 eye doctors and nurses from 2017 to 2021, while SPC sponsored 10 registered nurses in 2020 – 2021 for PGC in Critical Care Nursing, 6 registered nurses for PGC in Perioperative Nursing, and 8 doctors for PG courses.
 
The Ministry has also sponsored the following HCWs for post graduate training:
- MMED – total of 79 doctors, at FNU from 2016 to 2019;
- Master in Radiology – 3 doctors, at PNG & China from 2019 to 2021;
- Procurement Course – 4 FPBS staff, online US course;
- Basic Prosecution Course – 4 HIs, DPP office
- Masters of Nursing – 2 registered nurses, China and Australia
 
The Ministry firmly believes that a well-trained and competent workforce is crucial in achieving the UHC target that the Ministry and the Govt have put in place.
 
Equipment, Medicines, and Medical Supplies
The Ministry is committed to supporting our staff at the frontline with the correct equipment, medical supplies, and medicines to carry out their work.
 
While the global supply chain for medicines and medical equipment have been severely disrupted in the last 2 years, the Ministry continues to pursue avenues and opportunities to obtain the medical supplies our staff need for their work.
 
The Ministry has spent $28.9million from its $403.3million for the 2021-2022 Budget allocation for the procurement of oxygen supplies and other essential medical equipment to all medical facilities around Fiji in the 5 months period from October 2021 to January 2022.
 
We are also grateful to our development partners and donors who have assisted us in the last 24 months with medical equipment and supplies that have helped our staff.
 
Health Infrastructure
The Ministry is committed to upgrading our health infrastructure as quickly as our circumstances allow us. The last two years have been challenging with the COVID-19 outbreak and the multiple tropical cyclones we have faced.
 
 We are working with the Ministry of Infrastructure and the CIU to address the health infrastructure issues for the Ministry. I led a team to Rotuma last week to review the progress of the new Rotuma hospital and wish to reassure the community that the Ministry is committed to completing this project as soon as we can.
 
COVID-19 Update
I will conclude by providing some update on the COVID-19 response. The Government has announced the relaxations of COVID restrictions as announced by the Acting PM on Sunday 06 February 2022.
 
While the requirement for checking of careFIJI app and Vax Check have been removed at businesses and venues, unvaccinated individuals are not allowed to enter a house of worship - houses of worship can operate at 100% capacity or attend a sporting event - which operate at 80% capacity must allow only those who are fully vaccinated - in other words they have had two vaccine shots.
 
Unvaccinated individuals are also not allowed to enter high-risk businesses such as cinemas, bars, taverns, gyms, hair salons, tattoo parlours and gaming venues.
 
Therefore, those who are in charge of these venues, businesses and houses of worship must ensure that they check the vaccine status of all those who enter their premises.
 
These measures are in place in recognition of the fact that COVID-19 is still here, and we hope we will soon reach the stage where the disease is at low and safe levels for us to remove all the remaining restrictions.
 
Meanwhile, we have continued our vaccination campaign. As of 10th February 2022, we have 93% full vaccination of adult population aged 18 years and over while 98% have had one dose.
 
We continue to discuss with the MEHA on the vaccination of children. We have re-started the vaccination of children aged 12 to 14 years as of yesterday, but the current adverse weather conditions is limiting the roll out for now.  Vaccination of children aged 15 to 17 years continue, and so is the Booster vaccination. To date, 88320 individuals have received their booster jabs.
 
So I again encourage everyone to be fully vaccinated and to get their booster dose when it is due. Vaccines save lives!
 
Vinaka vakalevu, Dhanyavaad, Thank you.