Language sets high hurdle for caregiver candidates


Since the first batch of Indonesian nurses and caregivers arrived in 2008 under a new bilateral economic partnership agreement, 570 have come to Japan, as have 310 Filipinos under another EPA that took effect two years ago.
But just two Indonesians and one Filipino — out of 254 applicants — passed Japan’s nursing qualification exam in February, becoming the first successful candidates to receive the right to work in this country indefinitely.

While 89.5 percent of all exam-takers passed this year, the corresponding number for Indonesians and Filipinos was only 1.2 percent.

In response to the results as well as burdens on their employers, the number of accepting hospitals and welfare facilities in fiscal 2010 dropped by one-third for Indonesians and by half for Filipinos.

As the second batch of Filipino candidates arrived in Japan on Sunday and Indonesia is now selecting the third batch, the government has started to take measures to increase the examination pass rate.

Following are basic questions and answers about foreign nurse and caregiver applicants entering Japan under the EPAs:

Why did Japan start accepting nurse and caregiver candidates from Indonesia and the Philippines?

The acceptance is part of bilateral EPAs, one with Indonesia that took effect on July 1, 2008, and another with the Philippines that started on Dec. 11 the same year.

Under the accords, Japan can benefit from the reduction or removal of tariffs on Japanese goods. In return, Japan agreed to accept nurses and caregivers from the two countries as candidates for certification to work here.

Although the Health, Labor and Welfare Ministry has denied that accepting foreign caregivers is part of efforts to resolve the manpower shortage in health care, about 60 percent of hospitals and about 50 percent of welfare facilities that have accepted Indonesian candidates said they offered them jobs hoping to improve staff levels, according to a survey conducted by the health ministry.

What is required to become a qualified nurse or caregiver in Japan under the EPAs?

Both Indonesians and Filipinos must be qualified nurses in their home countries. Plus, Indonesian nurses must have more than two years of experience. Filipino nurses should have three years of experience.

For caregivers, Indonesians must be graduates of nursing universities or schools that require at least three years of study. Filipinos must be graduates of four-year universities or nursing colleges.

All are required to take six months of Japanese-language training before working for care facilities.

Nurses must pass the annual exam within three years, while caregivers get four years. To be qualified to take the exam, caregiver applicants must have three years of on-the-job training in Japan, which means they have only one shot to pass the exam before they are asked to return to their countries.

What other options for qualifying are available?

Filipino candidates can undergo a caregiver-trainee program that doesn’t require them to pass the national exam.

To qualify for the program, one must be a graduate of a four-year-university in the Philippines.

After completing the six-month Japanese-language course, they are required to graduate from Japanese caregiver schools, a process that takes two to four years.

Under this program, candidates automatically become qualified caregivers upon graduation.

How much are the nurses and caregivers paid?

Both EPAs guarantee the Indonesians and Filipinos will be paid salaries equivalent to their Japanese counterparts.

On average, this would amount to between ¥150,000 and ¥160,000 a month, according to Hiroya Yaguchi, a manager of Japan International Corp. of Welfare Services, an affiliate of and the only placement organization appointed by the health ministry.

Because pay levels differ among hospitals and welfare facilities, there is no set pay standard, Yaguchi said.

Some people are receiving around ¥200,000 per month, while the lowest salary among the accepting facilities is around ¥120,000, according to JICWELS.

However, because living costs vary by region, salaries can’t be compared simply by their amount, Yaguchi noted.

Do the accepting institutions provide accommodations?

Some hospital and care facilities provide free dormitories for employees. There are also institutions that rent out living quarters, and in some cases employees receive housing subsidies, according to JICWELS.

Do candidates get any support to prepare for the national exam?

The accepting institutions are responsible for teaching the candidates Japanese and helping them to prepare for the national exam, but the extent of such support varies between facilities.

According to a health ministry survey in February, about 76 percent of employers said Japanese nurses are helping candidates to prepare for the national exam, and about 30 percent said they are hiring teachers from outside.

Why has the number of hospitals and welfare institutions accepting Indonesian and Filipino candidates sharply dropped for fiscal 2010?

Experts attribute the decline to the employers’ financial and manpower burdens.

Employers pay an initial cost of about ¥600,000 per candidate.

The cost includes part of the six-month Japanese training fees and living expenses, as well as commission and placement fees to pay for JICWELS and its counterparts in Indonesia and the Philippines.

In addition, employers must pay ¥21,000 per person per year to JICWELS as a management fee.

Also, in many cases Japanese staff are helping candidates to study for the national exam. This has become a burden for facilities already suffering manpower shortages.

What are the candidates’ main linguistic problems?

Experts say kanji and technical terms used in the national exam pose a high hurdle for Indonesians and Filipinos. The health ministry is considering using simpler terms in the nursing exam.

Is the government doing anything to improve the situation?

Starting in fiscal 2010, the government will pay a yearly ¥295,000 subsidy for each hospital that accepts one or more nurse candidates and ¥117,000 per candidate a year to cover training expenses, according to the labor ministry.

Facilities that accept caregivers will receive a ¥235,000 government subsidy per person each year.

Also, JICWELS is providing so-called e-learning at all the hospitals that have accepted nurse candidates. The Internet learning system provides exercise books and past national tests in Japanese, English and Indonesian.

In addition, JICWELS is distributing Japanese-language textbooks to hospitals with nurse candidates this fiscal year.

However, these support measures are currently available only to nursing candidates.