To meet the demands of a rapidly ageing population, Japan has loosened its notoriously strict immigration and nursing regulations to accept foreign caregivers. But new evidence indicates deep cracks in those piecemeal gestures.
This month, in a surprise move, two qualified Indonesian care workers who had arrived in 2008 to obtain Japan’s difficult caregiving licence, left the country. They were among 35 Indonesians who had passed the exam and found employment here.
In an interview with Japanese television, one of the workers, Peramono, cited family concerns before he left Japan. “My wife is asking me to return to the family,” he explained simply.
The Indonesian caregiver had entered Japan under a bilateral economic partnership agreement (EPA) between the two countries. Japan has signed similar EPAs with the Philippines and Vietnam, unique agreements that officially aim to boost economic ties and under which Japan has agreed to accept foreign nationals for healthcare training.
The Indonesian immigrants’ decision to leave, though it represented only a very small percentage of foreign workers, shocked Japanese officials, policy makers and caregiving companies, all of whom are grappling with the daunting prospect of supporting a graying society with inadequate help.
Twenty-three percent of Japanese citizens are over 65 years, making the country home to the world’s oldest population. Japan already needs 200,000 nurses and is projected to lack 1.27 million caregivers by 2025.
Worst of all, records indicate a growing number of “lonely” deaths among the elderly (people over 65 years of age), who die alone and whose bodies are not found for several days. That number has now reached 15,600 annually, according to the Nissey Research Institute, an insurance company.
In an effort to tackle the problem, the Japanese government has rushed to implement new regulations over the past two years. For instance, companies that hire foreigners are required to pay wages equal to those earned by local employees.
Under the various EPAs, foreign caregivers are also given three-year visas to prepare for the state exam and, if they pass, are offered the chance to stay in the country indefinitely.
“But,” pointed out Waka Asato, associate professor at the prestigious Kyoto University, “the Indonesians’ decision to return home even after passing the national test is a clear indication that Japan is not tackling the situation properly.”
Asato, an expert on foreign caregivers, said Japan lacks the proper social and economic infrastructure to accept newcomers, especially Asians, into the growing caregiving market.
Some of the main obstacles, he explained to IPS, are the extremely difficult national licence exam, which foreigners are expected to take in the Japanese language.
Thirty-five out of the 94 Indonesians that took the test passed in March this year. It was the first time that Indonesian and Filipino caregivers, arriving under EPAs, had taken the test.
Norio Tokunaga, head of Kuwaoen, a large nursing company, explained the toughest issue is Japanese laws that do not permit foreign trainees second chances if they fail the national test.
“After three years of gruelling work and study, they have to take this test, which even the Japanese find difficult. When they fail they have to leave. This is a key reason for the lack of motivation among foreigners,” he said.
Yet another problem is laws that do not recognise foreign trainees as regular staff during their training period, even though they have basic skills and are learning on the job.
“The Indonesians who apply have basic nursing licences in their home countries, skills which they deepen while on the job in Japan. But when they are not permitted to take on duties like the regular employees, they feel left out,” Tokunaga told IPS.
He explained Japanese laws require three caregivers per resident in the nursing facility. But when foreign trainees are not included in this system they become ” invisible” in the company and at risk of missing out on economic merits such as annual bonuses.
Experts contend these issues prove that the caregiving legal system does not meet the needs of the industry.
“They are not treated as individuals with residential rights of their own. It is an illustration of official discrimination against foreigners that is deep-rooted in Japan,” said Manabu Shimasawa, an immigration expert at Akita University.
Japan is debating introducing a new welfare tax to meet the country’s expanding medical and social needs. It is also considering increasing payments to nursing and care service companies. New technology for the elderly is booming, including multi-functional robots that can talk and feed the infirm.
“Still,” says Asato, “the bottom line is that the elderly need a loving hand extended by a professional caregiver to help them lead emotionally and physically stable lives. This basic need is ignored by the government.”