The objective of these surveys is to determine the average daily number of patients per nurse or caregiver, but also to collect data on working time and staff feelings.
The “workforce” survey highlights the deterioration of the health sector
Compared to the results of 2018, the 2023 vintage highlights the explosion in daily overtime, going from 30 minutes on average in 2018 to around 1 to 2 hours in 2023. The testimonies of professionals corroborate statistical data: working conditions have deteriorated considerably and staff are in real distress. The “workforce” surveys in health establishments and nursing homes, carried out again in 2024, will be renewed each year.
Working conditions have deteriorated considerably and staff are in real distress”
For the CFDT, several levers must be activated in order to contribute to better attractiveness of health and medico-social establishments, as well as to employee loyalty. This involves increasing salaries, but also ensuring career development, or improving working conditions. Furthermore, this workforce crisis does not only affect France. The European Public Services Union Federation (EPSU) has joined a dozen organizations from across Europe to develop a strategy to tackle the global healthcare workforce crisis.
Resilience of health systems in the face of pandemics
In 2020, almost 100% of French hospitals were filled with patients presenting a single pathology, the SARS-CoV-2 coronavirus. The pandemic resulted in four epidemic waves in France, in the spring and autumn of 2020, at the beginning of 2021, then during the summer of 2021. From the emergence of the virus to the beginning of September 2021, 460,000 people were affected. were hospitalized, of which 116,000 died in hospital or in social or medico-social establishments, including nursing homes.
People who have worked in Covid wards have experienced unusual periods of work overload. However, in the hospital, the intensity of work was already high before the crisis. This assessment is the same for all European countries.
Europe: contaminated by the lack of healthcare personnel
The 2022 WHO report identifies the strengths and weaknesses of health systems that the Covid-19 pandemic has highlighted in the European region. Many Member States managed the state of emergency linked to the pandemic with an insufficient number of health personnel. But the report warns: the aging of staff in the health and social services sector was already a serious problem before the pandemic, but it is even more worrying today. The reason: the aging of nursing staff is compounded by professional burnout, thus contributing to a constant reduction in numbers.
The aging of staff in the health and social services sector was already a serious problem before the pandemic”
Dr Hans Henri P. Kluge, WHO Regional Director for Europe warns: “All these threats represent a time bomb which, if we are not careful, risks causing serious consequences for health everywhere, long waiting times before treatment, many avoidable deaths, even a collapse of systems health. It is time to act to remedy the shortages of health and care workers. »
Women, who make up the majority of health personnel, continue to be penalized by occupying the least valued and least paid jobs, thus exposing them to particularly difficult working conditions. Salaries for women in health are lower than the average for other economic sectors. The gross gender pay gap is 20%, compared to around 12% in all other economic sectors. Furthermore, the largest gender pay gaps are found in the highest socio-professional categories.
The difficulties of replacing doctors when they retire are already a reality”
The pressures linked to the pandemic risk exacerbating long-standing gaps: shortages of health workers; difficulties in attracting and retaining this staff; demotivating working conditions and poor work-life balance. In addition, the increase in the cost of living since 2022 is increasing salary inequalities and the attractiveness of the sector. Many countries in the Europe region report that around 52% of healthcare workers feel burned out.
In a context where the aging of the healthcare workforce remains a major concern across Europe, how can workforce sustainability be ensured? Difficulties in replacing doctors when they retire are already a reality. Italy is in the lead, with almost 60% of doctors over 55 years old. The shortage of nursing staff throughout the world is a recurring problem. Even in Norway, one of Europe’s richest countries, the Norwegian Nurses Organization reports serious faculty shortages in nursing schools.
WHO Europe is urging countries to act now to train, recruit and retain the next generation of health and care workers.
States undertake to act
In March 2023, WHO Europe hosted a regional meeting in Bucharest, Romania, where more than 250 participants from 50 countries adopted the Bucharest Declaration. This calls for action to improve the supply of health and personal assistance personnel, measures to strengthen their recruitment and retention, better strategic planning of health personnel and personal assistance, as well as greater and smarter public investments.
Following the Bucharest declaration, the representatives of the 53 countries, meeting in October 2023 on the occasion of the 73e session of the WHO Regional Committee for Europe in Astana, Kazakhstan, unanimously adopted a resolution
in support of a framework of actions on health and personal care workers in the WHO European region, for the period 2023-2030.
On this occasion, EPSU expressed itself in a press release: “ Staffing shortages, caused by insufficient staffing or inadequate education and training of healthcare professionals, create unsafe conditions. They cause unnecessary additional stress on already overwhelmed healthcare professionals. Therefore, we call for the development of safe and binding staffing levels for healthcare professionals. We demand that members of the WHO-Europe region develop national strategies with unions and professional organizations to address the shortage of health professionals. »
The EU wants to make health a priority
The European Union’s competences on public health are important, but limited to public health issues. The EU health system faces major challenges, particularly in terms of shortage of health personnel.
In June 2024, ministers responsible for Employment, Social Affairs, Health and Consumer Protection from all EU Member States approved draft conclusions on the future of the European Union. health: a Europe that cares, prepares and protects. They also asked the European Commission to make health a priority during its next five-year term.
A Europe that cares, prepares and protects”
The new European Commission, led by Ursula von der Leyen, took office on 1is December 2024, and the European trade union movement intends to continue its work with the new Commission for the Future of European Health.
The CFDT health-social federation presented its “workforce” survey to the EPSU health committee in October 2024. The EPSU, which views staffing levels in the health sector, not simply as a matter of workplace design, but as a potential occupational risk factor. The organization is also asking that a directive on safe staffing levels protect workers, as they would for any other occupational health and safety risk.
