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Philippine FTA to reshape health care

Japan Times

Philippine FTA to reshape health care

Trade pact’s labor provisions evoke hope, opposition within industry

By Maya Kaneko, Kyodo News

13 September 2006

The free-trade agreement clinched with the Philippines on Saturday will test whether Japan is serious about opening its labor market, a change that would trade homogeneity for a more youthful workforce.

The FTA is Japan’s first that includes provisions on the movement of labor. It is widely believed that hundreds of Filipino nurses, caregivers and nursing-care trainees will enter Japan in the initial stages of the agreement.

Other countries seeking free-trade pacts with Japan such as Thailand and Indonesia also want their workers — cooks, masseurs and hotel staff, to name a few — to have the freedom to work in Japan.

But liberalizing the labor market ignites controversy and protest in Japan whenever the government negotiates FTAs with other countries.

The nursing sector is split over accepting Filipino workers. Some see them as a ray of light in Japan’s shrinking labor market. Others fear the working conditions of Japanese nurses will deteriorate with a new, cheaper pool of labor close at hand.

Reiko Kikuchi, executive director of the Japanese Nursing Association, urged the government to stick to its pledge to treat Japanese and Filipino nurses equally by requiring Filipino staff to pass national examinations and making sure they speak fluent Japanese to ensure they are able to provide adequate patient care.

"We should not easily accept laborers from abroad," Kikuchi said. "In Japan, there are 550,000 nurses eligible to work."

Kikuchi suggested the government should first improve labor conditions for Japanese workers. She believes many hospitals suffer staff shortages because work rules are inflexible, for example by forcing women to quit when they have children, for example.

Kozo Suyama, chief of the secretariat of the 60,000-strong Nippon Care Service Craft Union, is also critical of the FTA’s labor provisions, saying they amount to "importing a makeshift labor force" from overseas instead of utilizing potential workers in Japan.

"Among unemployed Japanese youth, some may be willing to work as caregivers," he said. "But current working conditions are too bad. They cannot make a living."

Suyama said that with the entry of Filipino caregivers, which will be seen as "cheap labor," employment conditions for Japanese workers will continue to worsen, leaving the sector staffed entirely by foreign workers.

He said that unless Japan ensures proper living conditions for foreign workers in terms of salary, education, medical care and religious services, it is possible that poorly paid workers will cause social unrest.

But Hirohiko Nakamura, a member of the Upper House of the Diet and head of the Japanese Council of Senior Citizens Welfare Service, argues that opponents of foreign workers "will soon feel ashamed" if they continue to advocate a "closed-door policy."

"In strengthening partnership with our neighbors in Asia, we should free up the movement of goods, money and personnel in the region, like the European Union," he said.

"If Japan keeps strict conditions, Filipino care workers may go to South Korea or China instead."

Health care companies, meanwhile, are already looking to the future. They have started training Filipinos who are already permanent residents of Japan, most of whom are married to Japanese.

Avance Life Support, a subsidiary of Aichi Prefecture-based Avance Corp., and Hakubi Health Care Support, a subsidiary of Total Care Support Co. in Tokyo, offer lessons on Japanese technical terminology and training in nursing-care facilities.

About 70 Filipino students have completed courses at the two companies and are working at homes for the elderly. It is hoped they will blaze a trail for their compatriots who will follow once the FTA comes into effect.

Both Advance and Hakubi officials said that Filipino caregivers have difficulty keeping a daily work journal in Japanese, but their respect and compassion for the aged are much appreciated.

"Those Filipino workers may stimulate Japan’s nursing industry," said Shinichi Kawabata, a Total Care Support spokesman.

"Many institutions refrained from hiring Filipino workers because of the negative image associated with bar hostesses," he said. "But after hearing high opinions of (the Filipino staff) from other facilities, some changed their attitude."

About 60,000 Filipinos work in Japan as hostesses or dancers. Avance and Hakubi started the caregiver courses to give those working in pubs or factories new career options, company officials said.

Asian Human Power Networks, a nonprofit organization that has been training Vietnamese nurses at Japanese hospitals since 1997 to help them upgrade their skills and take them back home to Vietnam, began teaching Japanese to Filipino trainees in January after a framework for the bilateral free-trade pact was agreed to in November 2004.

"In reality, Japan is definitely short of nurses despite efforts to recruit retired Japanese staff," said Osamu Nimonjiya of the organization. "I believe it is up to patients to decide who should be their medical service providers."

"Objectively speaking, Japan cannot make up for its labor shortage by itself in the long run," said Motoshige Ito, a professor of economics at the University of Tokyo.

"In the era of economic globalization, domestic manpower will shift to stronger industries, and we need to supply laborers from overseas in weaker industries," he said.

Ito was involved in the government’s efforts this year to formulate a new economic strategy based on globalization. The strategy called for boosting the number of foreign workers in Japan.