At the heart of health

It’s a small enough territory geographically. But with seven million people residing there, Hong Kong represents a big and diverse challenge for those driving the local health system. The Hong Kong Hospital Authority administers 41 public hospitals across the special administrative region; on top of that there are 118 specialist and general outpatient clinics also under its management. The authority’s 58,000-strong staff handle some 1.3 million patients a year, with a total capacity of 27,000 beds. David Rossiter, Head of HR, says it all adds up to a busy and dynamic organisation – with plenty of HR challenges facing it. In this exclusive HR Insider, he outlines the top four – and how the authority is working to solve each one.

Recruiting in volume

The labour market for medical staff in Hong Kong is very different to talent markets elsewhere. It’s underlined by a perpetual shortage of key roles including nurses and doctors and many other allied health professionals.

“That (shortage) is different to pretty much every developed country.”

Elsewhere, hospitals may be able to compete on price terms. They are also able to take advantage of international markets for professional talent. But Hong Kong’s unique position in the world makes both of these a difficult task. Rossiter says the organisation looks to recruit locally wherever possible, particularly for professionals such as nurses.

“We produce our own nurses since they have to be able to speak Cantonese,” he says, that important criteria ruling out much of the rest of the world’s nursing workforce. Rossiter says that makes things challenging during the continuing shortage.

He and the HR team are addressing the issue in a number of ways. In the first instance, they are working to increase the total supply of nursing skills available within territory. Through a strong advocacy programme, the authority is encouraging both the Hong Kong Government and local universities to create more nursing training places. At the same time, it has opened its own nursing schools to supplement the intake of students.

The team is also working on some internal factors to make the job more appealing, both to school leavers considering career options and those already-trained nurses who may have previously left the profession.

“We are working to reduce the workload of nurses,” Rossiter says. These strategies include training other staff, to handle some simple nursing tasks (such as blood taking) and making a strong effort to reduce the amount of non-clinical work in a typical nurse’s day. “Nurses are Degree-qualified people and we are working to support their continuing professional development.”

Rossiter says the authority is also investing in better technology and equipment to help nurses in their jobs. Even seemingly simple resources, like electrically-adjustable patient beds, can help ease the burden on nursing staff and, importantly, improve retention among their ranks.

While competitive salaries are certainly important, Rossiter says compensation is not the biggest attractor of nurses into the Authority’s hospitals. It is also a less significant driver of retention once they have been hired.

“People don’t become rich by being a nurse,” he says, praising the 20,000 currently employed by the authority. “They each have an inherent desire to help people and the community. and they expect the support of their employer.

“It’s a 24/7 service industry – the ultimate role for someone who cares about others.”

Getting strategic

The Hospital Authority is organised into seven geographic clusters of health facilities, with a central headquarters in Kowloon where policies and the strategic direction are developed. Each of these clusters has an HR team led by an experienced professional that drives policy and manages the day-to-day challenges. A key part of Rossiter’s tenure is to lead the HR function into a much more strategic role, rather than simply keeping up with the daily demands of such a large organisation. In particular, he is focusing on modernising HR policies and procedures, talent management, and leadership development.

That first goal is a key enabler for the remaining tasks, and Rossiter admits it’s a big job. Even just implementing a modern, more automated HR and Payroll system requires significant attention from the central HR team. “We have 58,000 staff,” he notes. “But we’re still paying using a mainframe in-house system - which while very efficient, does not provide us with meaningful workforce data for analysis and strategic planning.”

The second task will help to build the organisation from the ground up. Rossiter says talent management all starts with getting the best people into the hospital system, and then keeping them there.

“The most important thing that the HR team can do is to help the organisation select the right people,” he says. That’s not just nurses and doctors, but staff of all levels and functions; everyone needs a strong, positive attitude and the ability to work as part of a much larger team.

The commonly used phrase of “people are our greatest asset” applies equally in HA but Rossiter insists that it’s much more about the right people being the greatest asset.

But the longest term, and most profound, gains will come through leadership development within the authority and ensuring it develops the next generation of leaders. “This applies equally to clinical leadership as it does to organisational leadership,” he said. “We have made great leaps forward in the last few years in developing leaders from all parts of the organisation.”

A winning culture

Rossiter is confident all that, and more, can be achieved in the coming years, largely because of the organisational culture that has already developed within the Hong Kong public hospital system. “Hong Kong people are like no others with their ‘can do’ attitude and their spirit of community within the Hospital Authority is a great example,” he says. “The Authority is a great organisation to work in with truly wonderful and committed people who, of course, challenge the HR function every day – all in the name of providing quality patient care to our community.”

At the unit-level, Rossiter says his HR team has come a long way since he first stepped into the role over seven years ago, and some accolades are now beginning to come through. The authority won the HRM Award for Leadership Development in Hong Kong last year, something its HR leader says is a “great recognition” of the drive and passion of the many people involved.