Rising number of healthcare freelancers prompts call for better support

SINGAPORE — The number of freelance healthcare workers has soared in recent years, based on figures from industry players.

Caregiving portal CaregiverAsia, for example, started out with about 20 active freelance caregivers in 2015. The number has grown to more than 1,000. Home-care provider Jaga-Me has also seen the number of freelance nurses on its books jump from between 20 and 30 to more than 200 over the past year.

While the growing freelance pool is helping to ease the perennial manpower crunch in healthcare, providers and Members of Parliament (MPs) cited the lack of support in providing freelancers with training and the need to ensure quality of care as among the issues that must be tackled.

The freelance roles that had the largest increases are among nurses, counsellors dealing with family, mental health and other issues, as well as care companions.

At home-care and nursing provider Homage, its caregiving pool has grown from 50 in July last year to more than 300, co-founders Gillian Tee and Lily Phang said.

Comfort Keepers’ pool of part-time and full-time caregivers has also risen from 200 to 250 two years ago to between 250 and 300 now, said Ms Joy Soh, case management director at its Queenstown and Clementi office.

A study of the healthcare sector, released last month by the National Trades Union Congress’ (NTUC) Future Jobs, Skills and Training (FJST) department, found that there was a rising use of mobile applications and platforms that match providers to patients, enabling them to age in place.

This “gives rise to freelance opportunities for healthcare workers”, said NTUC assistant secretary-general and the FJST department’s director Patrick Tay.

The sought-after freelance roles include caregivers, confinement nannies, doctors and medical companions, the study showed. By 2020, the Republic is projected to require another 4,200 nursing home beds and 4,700 centre-based care and home-care places.

As the pool of freelancers grows, MPs said the need to ensure quality of care, basic competence in caregiving and build awareness cannot be ignored. Dr Chia Shi-Lu, who chairs the Government Parliamentary Committee (GPC) for Health, said the question is how to ensure quality and recourse for users should things go awry.

As such services become more prevalent, he believes some form of licensing or regulatory framework governing providers would take shape.

Just as the Government has put in place a licensing regime for the private-hire car industry, and mulls over new rules on short-term rentals in a nod to home-sharing providers such as Airbnb, so will caregiving “see the same trend” once demand reaches a critical mass, said Dr Chia, who is also an MP for Tanjong Pagar GRC.

MP (MacPherson) Tin Pei Ling, who also sits on the Health GPC, said awareness of such services offered by freelance caregivers, which is “not very high yet”, needs to be drummed up by providers and in the community.

Saying that all for-profit caregivers should have the “basic competence” to carry out their duties, she noted that the Government could consider a training road map or support under the SkillsFuture movement for such freelancers.

Providers, too, could devise training maps for freelancers. Since they have “scale”, they are more well-placed to negotiate better training packages compared with individual freelancers, who may “lose sight” of this, Ms Tin added.

Right now, care providers and portals offer various forms of training for their part-time and freelance workers.

For instance, Comfort Keepers’ caregivers undergo formal training of about a week before they are deployed. At Homage, those who are not trained in nursing receive certified caregiver training.

Jaga-Me recently also teamed up with HCA Hospice Care to hold a workshop on palliative care for its nurses – at no cost to them.

However, Mr Julian Koo, Jaga-Me’s chief executive, said there is a lack of support for freelance nurses to tap training subsidies outside the confines of public and community healthcare, making it difficult for them to receive training.

Caregivers TODAY spoke to said they were drawn by the flexibility of freelance work.

Registered nurse Ong Lay Ching, 43, joined Jaga-Me in February. Formerly a full-time nurse at places such as a gynaecology specialist clinic, Ms Ong said she was worn out by “constant fatigue” and did not get to see her elderly mother on weekdays because of her working hours.

Now, she occupies herself with cases four or five days each week, and earns more than S$3,000 each month, which is “sufficient”. “I don’t want to go back to full-time nursing… Clinics are very hectic.”

For many, freelance or part-time healthcare work is steadily becoming a financially viable option. At Homage, for instance, its part-time care professionals who often work “after hours” can earn between S$1,000 and S$2,500 monthly, compared with its full-time workers, who often receive between S$2,000 and S$5,000.

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