Choki Wangmo

Despite recent talks about pay hikes, Bhutan continues to witness an attrition rate of 4.4 percent for health professionals, which, according to the health minister, is a national concern.

During the question-and-answer session at the National Assembly yesterday, Bartsham-Shongphu MP Passang Dorji (PhD) said that the attrition rate among health professionals in Bhutan is one of the highest. The MP expressed concerns over the detrimental effects this will have on service delivery and said that hiring health professionals on contract may pose sustainability issues.

Health Minister Dechen Wangmo acknowledged the challenge and said that the situation was bad, but not dire. According to international standards, she said that an attrition rate beyond 10 percent was a major cause for concern, sometimes leading to system collapse.

“But as we do not have many human resources, the current attrition rate is concerning,” Lyonpo said.

The highest attrition rate is observed among nurses at 4.6 percent. The attrition rate is 1.7 percent among doctors, 2.5 percent among dentists and specialists, 4 percent among lab technicians, 2.4 percent among health assistants, and 1.5 percent among pharmacists.

The National Referral Hospital in Thimphu experiences the highest attrition.

According to the National Referral Hospital’s management, approximately 70 nurses resigned between 2021 and 2022, and close to 50 nurses are reportedly on extraordinary leave. As of April, the hospital has 136 doctors (general and specialists) and over 500 nurses.

The minister said that the pay hike might help retain the health professionals.

If the attrition rate crosses 5 percent, the ministry plans to bring in professionals on contract while also considering human resource remobilisation among the current health professionals in the country.

If the rate reaches 8-9 percent, the ministry has short-term plans like eliminating service expansion, meaning the services provided in the hospitals will remain the same.

The ministry is also exploring sustainable long-term measures. One example is the introduction of the Bachelor in Medicine and Bachelor of Surgery within the country. The nursing quota in private colleges within the country has also seen a drastic increase to address the shortage. The vision for the health plan aims to secure the health sector, Lyonpo said.

Despite these issues, the minister denied claims that the quality of services at the National Referral Hospital has degraded. Kengkhar-Weringla MP Rinzin Jamtsho expressed concern over the declining quality of services at JDWNRH Hospital as reported by people visiting the hospital.

Lyonpo Dechen Wangmo said that basic services have reached rural areas of the country, while some chronic cases are referred outside the country. She also claimed that access to health facilities such as X-rays has improved.

Comparing the outpatient waiting time with the US and the UK, Lyonpo said that Bhutan’s waiting time is comparatively shorter, with an average of 18 minutes per patient.

Furthermore, once the national hospital is accredited, the services will see further improvement, she added.