The “double demographic challenge” facing healthcare in Europe: increasingly older patients and staff on the verge of retirement

According to the report, more than a third of doctors and a quarter of nurses in the EU are 55 years old or older, meaning they will retire in the coming years, 35% and 24% respectively. The countries with the highest rates are Bulgaria (54% of doctors), Italy (54% of doctors and 24% of nurses) and Latvia (47% and 39%). Other countries such as Germany or France are above average. Spain, however, is below, although by a small distance, as there are 34% of doctors over 55 years of age and 19% of nurses.

In this sense, the report highlights policies carried out by Spain and other countries such as the Czech Republic, Ireland or Portugal to prolong the working life of doctors either through delaying the retirement age for the entire population or through specific incentives. for healthcare personnel. Likewise, the increase in family doctor positions that has been carried out in our country in recent years to replace those who will retire stands out.

In general, Spain has a number of doctors somewhat higher than the European Union average. However, the report points out that this does not mean that there is no shortage of these professionals in some areas and specific specialties, as it highlights the lack of family doctors – only 22 percent of all doctors in 2022 had this specialty – as well as like geriatricians. In this sense, the OECD highlights measures carried out to contain areas of difficult coverage or medical deserts, such as incentives in rural areas or the increase in nursing skills.

Nurses

The OECD does warn, on the other hand, that the number of nurses, although it has increased in the last decade, is low in Spain compared to the rest of the EU, with a ratio of 6.2 professionals per 1,000 inhabitants in our country compared to one of 8.4 on the European average. But the report also clarifies that in the case of our country, nursing assistants are not counted, whose work is included in the data from other countries.

But the OECD also warns that the interest of young people in studying health careers is decreasing, which is why the replacement of personnel that should occur so that health systems continue to function normally is compromised. Added to this is the fact that the proportion of people over 65 years of age has grown in recent years due to high life expectancy and the decline in birth rates: it has gone from 16 percent in 2020 to 21 percent in 2023. It also expects that in 2050 almost 30 percent of the population will be over 65 years old in countries like Spain. For this reason, it urges planning health personnel when developing health policies.

Worst conditions

The organization insists that it is “primary” to address this lack of health professionals and highlights how it has increased after the Covid-19 pandemic. To those previously mentioned, the report adds one more problem: the shortage of doctors and nurses causes working conditions to be more stressful, with a greater care burden, which leads to abandonment of the profession and, therefore, can further aggravate the situation over time.

Regarding health spending, the report shows that Spain is below average. Specifically, our country invested 2,822 euros per capita in healthcare in 2022, well below the 3,533 euros of the European average and almost 50 percent less than Germany, which invests the most (5,317 euros). The OECD emphasizes that the increase in health spending in Spain is slower than the European average. Public spending on health accounts for 74 percent of total health spending compared to the European average of 81 percent. Coverage, the report says, is especially low in dental health.