Europe: Will there be sufficient health professionals to meet future needs?

OMS Europa – According to the latest WHO/Europe core health indicators for 2015, the number of physicians and nurses in the Region may not be sufficient to cover the future health needs of an ageing population, despite an increase of around 10% in the past 10 years. The report also points out that physicians in Europe are getting older: almost every third physician is over 55 years old. In addition, the skills-mix of health professionals needs to change: for example, the proportion of general practitioners (GPs) among all physicians should be increased.

“Human resources are the cornerstone of the health system in any country, and the planning, regulation and management of the health workforce requires extensive intersectoral collaboration – both topics are at the heart of the Health 2020 policy,” said Zsuzsanna Jakab, WHO Regional Director for Europe.

The report, entitled “Core health indicators in the WHO European Region 2015, special focus: human resources for health”, is available in both printed and online formats. It is the third annual document in a series that was devised to provide basic country and regional information for Member States, in order to help monitor trends and evaluate the Health 2020 policy.

Key findings on human resources for health

Notable findings from the document include:

  • Health workforce imbalances and shortages are a major concern in the European Region. Although the number of physicians and nurses has increased in general in the Region by approximately 10% over the past 10 years, it is unlikely that this increase will be stable and sufficient to cover the needs of ageing populations. Simultaneously, inequalities in the availability of physicians and nurses between countries are large: there are 5 times more doctors in some countries than in others. The situation with regard to nurses is of even greater concern, as nurses play a significant role in the care of the elderly; however, the data show that some countries have 9 times fewer nurses than others.
  • In order to strengthen primary health care in the Region, the proportion of general practitioners (GPs) among all physicians should be increased. However, the majority of physicians in Europe are specialists: the specialist to GP ratio is 1 to 3.2, a relation that has been constant over the past decade.
  • The right skills-mix of health workers is indispensable for effective and efficient health care delivery. Although there is no standard for the optimal composition of a health workforce, the nurse to physician ratio varies considerably across the Region, from below 1 nurse to every physician in Georgia and Greece and between 4 and 5 nurses per physician in Finland and Ireland.
  • The age and gender structure of the health workforce in Europe is changing. Physicians are getting older, with almost every third physician more than 55 years old, which is an increase of 6 percentage points over the past 7 years.  In order to guarantee at least the same availability of physicians, the number of medical graduates must increase in the future. The proportion of female physicians has increased by 4 percentage points over the past 10 years, up to 52%. This has important implications, as women tend to work shorter hours and have slightly shorter careers.

Information about human resources for health includes statistics such as the numbers of doctors, nurses and dentists per 100 000 population and the gender and age of physicians. The document also shows trends over time.

Data are collected and disseminated under the umbrella of the European Health Information Initiative, a multimember WHO network that is committed to improving the health of the people of the European Region by enhancing the information on which policy is based. Joint data collection by the Regional Office, the Statistical Office of the European Communities (EUROSTAT) and the Organization for Economic Cooperation and Development (OECD) is part of this initiative.

The health statistics short list

The document also covers a broader list of key health statistics, highlighting the Health 2020 indicators for the health status of the population, risk factors and health system resources. These statistics include:

  • demographic and socioeconomic contexts, with statistics on population growth and death rates, as well as information like unemployment rates and GDP;
  • health status, including mortality data, which shed light on what causes people to die, and morbidity data, which show the incidence of diseases like cancer and HIV infection;
  • health services utilization and health expenditure, which show the rates of use of health services and the amount of money spent on health, including two core Health 2020 indicators: the total percentage of GDP spent on health and private households’ out-of-pocket expenditure, the latter being an important sign of whether people are being plunged into poverty because of the cost of being unwell; and
  • risk factors, including the prevalence of alcohol and tobacco use and of obesity.

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