The EU health paradox: shortages with surging staff numbers

The European healthcare sector faces a real paradox in 2024: while the WHO estimates that by 2030 staff shortages will reach four million professionals, the number of doctors and nurses has never been so high - so where’s the gap and how to breach it?   

Over the past two decades, the number of doctors and nurses per capita has increased substantially in most EU countries. In 2022, more than one in every ten jobs was in the health and social care sectors on average across EU countries, up from 8.5% in 2002.  

But demographics are worsening the future picture. An ageing population and workforce will increase demand for healthcare professionals, while staff shortages will put further pressure on the system. 

By 2050, there will be 38 million more people aged over 65 and 26 million fewer people of working age, according to OECD estimates. This means “more people with higher needs, fewer people of working age", Gaetan Lafortune, OECD’s Senior Economist and coordinator of Health at a Glance: Europe 2024 report, told Euronews. 

At the same time, interest in health careers among young people is declining, the OECD warned, and healthcare professionals across the EU are taking to the streets to demand better pay and working conditions.   

"The ongoing protests and demands from healthcare professionals highlight the critical challenges they face, including insufficient pay and inadequate working conditions,” MEP Dennis Radtke (Germany/EPP) told Euronews.

For his fellow MEP Romana Jerković (Croatia/S&D), low salaries, political and economic instability and poor working conditions at national level are driving healthcare workers out of the sector or to seek opportunities abroad.  

As a result, European countries are relying on foreign-trained health professionals to fill domestic gaps – a solution that can exacerbate staff shortages in the countries of origin. 

“Without decisive action at EU level, the situation will become even worse, only widening already existing healthcare inequalities in the EU,” Jerković claimed.  

A sector in life support

The health workforce is also ageing: by 2022, more than a third of doctors in all EU countries will be more than 55 years old, with this proportion reaching 40% or more in almost half of EU countries. 

The decision by many doctors to continue working beyond the standard retirement age has helped to prevent a worsening of the staff shortages in many EU countries over the past decade, the joint report by the OECD and the European Commission shows. 

"They had underestimated the fact that many doctors would choose or would be obliged for financial reasons to continue to work, and this has helped greatly mitigating the shortage. But obviously these people will retire,” said Lafortune.  

This poses a dual challenge for the countries concerned, as they will need to train enough new doctors to replace those retiring and, at the same time, implement policies to encourage current doctors to continue working beyond the standard retirement age. 

"We can attract more people possibly into the health workforce, although the jobs will need to be attractive," the OECD senior economist said.  

Making the profession more appealing means addressing the psychosocial risks that lead to burnout, said MEP Jerković, who called on the EU to take further action to protect workers from excessive stress.   

Reducing working hours will be a factor in attracting new recruits. "If doctors or nurses want to work fewer hours because they want to reach a better work in their personal life balance, then you'll need more [staff],” Lafortune argued. 

European countries had an estimated shortage of approximately 1.2 million doctors, nurses and midwives in 2022, according to the joint report.

From reaction to prevention

But will more doctors be a solution alone? The OECD concluded not.  

“Against this background, the EU has a crucial role to play in supporting member states in their efforts to attract, train, and retain a sufficient number of skilled and motivated health workers,” reads the OECD report.  

Consequently, EU health policy is increasingly moving from reaction to prevention, with the 'Beating Cancer' plan being the main pillar of the last mandate and a new plan on cardiovascular diseases in the pipeline for the EU Council.  

The report identifies two areas of work on innovation: a shift in work organisation and the introduction of new technologies.  

Task-sharing was widely discussed during the COVID-19 pandemic, when roles traditionally performed by physicians had to be outsourced due to high demand, such as vaccination, which was then carried out in pharmacies.   

On the other hand, the use of digital tools and AI is increasing in the sector, as innovations are becoming essential to increase the productivity of health workers and allow them to focus more on patient care. 

"But obviously we cannot count on these [AI and robots] to resolve the current shortages. For the time being, we need more humans,” Lafortune concluded.