{"id":17319,"date":"2022-12-21T09:33:01","date_gmt":"2022-12-21T05:33:01","guid":{"rendered":"http:\/\/geworld.ge\/en\/?p=17319"},"modified":"2023-01-22T09:36:17","modified_gmt":"2023-01-22T05:36:17","slug":"a-ticking-time-bomb-healthcare-under-threat-across-western-europe","status":"publish","type":"post","link":"https:\/\/geworld.ge\/en\/a-ticking-time-bomb-healthcare-under-threat-across-western-europe\/","title":{"rendered":"\u2018A ticking time bomb\u2019: healthcare under threat across western Europe"},"content":{"rendered":"\n

For decades, western Europe\u2019s national healthcare systems have been widely touted as among the best in the world.<\/strong><\/p>\n\n\n\n

But an ageing population, more long-term illnesses, a continuing recruitment and retainment crisis plus post-Covid exhaustion have combined, this winter, to create a perfect healthcare storm that is likely to get worse before it gets better.<\/p>\n\n\n\n

\u201cAll countries of the region face severe problems related to their health and care workforce,\u201d the World Health Organization\u2019s Europe region said in a report earlier this year<\/a>, warning of potentially dire consequences without urgent government action.<\/p>\n\n\n\n

In France<\/a>, there are fewer doctors now than in 2012. More than 6 million people, including 600,000 with chronic illnesses, do not have a regular GP and 30% of the population does not have adequate access to health services.<\/p>\n\n\n\n

In Germany, 35,000 care sector posts were vacant last year, 40% more than a decade ago, while a report this summer said that by 2035 more than a third of all health jobs could be unfilled. Facing unprecedented hospital overcrowding due to \u201ca severe shortage of nurses\u201d<\/a>, even Finland will need 200,000 new workers in the health and social care sector by 2030.<\/p>\n\n\n\n

In Spain<\/a>, the health ministry announced in May that more than 700,000 people were waiting for surgery, and 5,000 frontline GPs and paediatricians in Madrid have been on strike for nearly a month in protest at years of underfunding and overwork.<\/p>\n\n\n\n

Efforts to replace retiring workers were already \u201csuboptimal\u201d, the WHO Europe report said, but had to now be urgently extended to \u201cimprove retention and tackle an expected increase in younger people leaving the workforce due to burnout, ill health and general dissatisfaction\u201d.<\/p>\n\n\n\n

In a third of countries in the region, at least 40% of doctors were aged 55 or over, the report said. Even when younger practitioners stayed despite stress, long hours and often low pay, their reluctance to work in remote rural areas or deprived inner cities had created \u201cmedical deserts\u201d that were proving almost impossible to fill.<\/p>\n\n\n\n

\u201cAll of these threats represent a ticking time bomb \u2026 likely to lead to poor health outcomes, long waiting times, many preventable deaths and potentially even health system collapse,\u201d warned Hans Kluge, the WHO regional director for Europe.<\/p>\n\n\n\n

In some countries the worst shortages are among GPs, with France in particular paying the price for previous planning errors. Back in 1971, it capped the number of second-year medical students through a so-called numerus clausus<\/em> aimed at cutting health spending and raising earnings.<\/p>\n\n\n\n

The result was a collapse in annual student numbers \u2013 from 8,600 in the early 1970s, to 3,500 in 1993 \u2013 and while intakes have since climbed somewhat and the cap was lifted altogether two years ago, it will take years for the size of the workforce to recover.<\/p>\n\n\n\n

Even though 10% of France\u2019s GPs now work past retirement age, older doctors leaving the profession outnumbered newcomers entering it last year, when numbers were still 6% down on what they were even a decade ago. It could be 2035 before the country reaches a satisfactory ratio of doctors to inhabitants nationally.<\/p>\n\n\n\n

Local provision, however, is another matter: GP ratios range from 125 or more per 100,000 people in some wealthier neighbourhoods to less than half that in remote rural France or deprived suburbs such as Seine-Saint-Denis.<\/p>\n\n\n\n

\u201cIn fact, about 87% of France could be called a medical desert,\u201d the junior health minister Agn\u00e8s Firmin Le Bodo said last month<\/a>, pledging a \u201ccomplete rebuild\u201d of GP services through more multi-function health centres and remote consultations \u2013 but no obligation, as yet, on doctors to set up in poorly provisioned areas.<\/p>\n\n\n\n

This winter\u2019s flu epidemic, coming on top of Covid-19, had exposed the system\u2019s failings, creating \u201ca crisis not just for France\u2019s hospital sector but for all of French healthcare\u201d,\u00a0said Arnaud Robinet<\/a>\u00a0of the French Hospitals Federation, warning that the service was \u201cno longer capable of responding systematically\u201d to emergencies.<\/p>\n\n\n\n

\"\"
An oximeter is arranged on a baby\u2019s foot in Germany, where human respiratory syncytial virus (RSV) is pushing some hospitals to their limits.\u00a0Photograph: Filip Singer\/EPA<\/figcaption><\/figure>\n\n\n\n

In Germany<\/a>, which spends more on healthcare than almost any other country in the world, hospitals are a greater concern, with this winter\u2019s wave of respiratory syncytial virus (RSV) in young children triggering alarm across the country.<\/p>\n\n\n\n

Amid reports of overcrowded casualty departments and parents forced to sleep in hospital corridors or travel hundreds of kilometres for a child\u2019s treatment, the S\u00fcddeutsche Zeitung said the country was witnessing \u201cwhat it means when a system implodes \u2026 in scenes which for a long time might have seemed unimaginable\u201d.<\/p>\n\n\n\n

In a petition to parliament titled: \u201cAlert level red \u2013 hospitals in danger\u201d, the German Hospital Society (DKG) again highlighted a chronic lack of staff as the main problem, noting that many hospitals had had to temporarily close casualty departments due to a lack of doctors and nurses.<\/p>\n\n\n\n

More than 23,000 posts remain unfilled in Germany\u2019s hospitals after several years of low recruitment and recent mass resignations, particularly in intensive care and operating theatres, by staff citing a workload so extreme that some were unable to take even a short break or go to the toilet.<\/p>\n\n\n\n

The health minister, Karl Lauterbach, has announced a \u20ac300m (\u00a3260m) aid package for paediatric clinics and an as yet unspecified \u201crevolution in hospital care\u201d putting \u201cmedicine first rather than the economics\u201d, plus a plan to move nurses and doctors around to match demand that was dismissed as \u201cabsurd\u201d by leading medics.<\/p>\n\n\n\n

\u201cThe problem is we have no wards that could do without staff, because they\u2019re all already only able to offer the minimum level of care,\u201d said Christine Vogler of the German Council of Nursing (DPR). \u201cThis can only be called an act of desperation.\u201d<\/p>\n\n\n\n

Christoph Spinner, a consultant in infectious diseases at Munich\u2019s University Clinic, said the country\u2019s health system was \u201cwithout doubt facing enormous challenges\u201d, while a paediatrician, Nina Schoetzau, said the state of Britain\u2019s NHS was \u201ca taste of things to come\u201d for Germany.<\/p>\n\n\n\n

In Spain, the winter has already prompted overstretched frontline staff to take strike action. The healthcare crisis, laid bare during the Covid pandemic<\/a>, follows decades of under-investment, competition between regions for medical staff, and the lure of better pay and conditions abroad.<\/p>\n\n\n\n

Much of the discontent has focused on the Madrid region, where in mid-November at least 200,000 people took to the streets<\/a> to defend public healthcare against creeping privatisation and to express concern over the regional government\u2019s restructuring of the primary care system.<\/p>\n\n\n\n

\u00c1ngela Hern\u00e1ndez, a surgeon and general secretary of Madrid\u2019s AMYTS medical association<\/a>, said the situation in paediatric services was \u201cpractically desperate\u201d, adding that it was also \u201cabout demand: no one is telling people that if resources are limited, services have to be used wisely\u201d.<\/p>\n\n\n\n

Politicians had a responsibility to \u201cexplain the situation to people\u201d, Hern\u00e1ndez said. \u201cBut because they do the exact opposite in Madrid and in Spain, they raise people\u2019s expectations.\u201d<\/p>\n\n\n\n

The Metges de Catalunya<\/a> (Doctors of Catalonia) union also plans a two-day strike next month to protest against \u201coverload, disdain and precariousness\u201d. Xavier Lleonart, its general secretary, said the pandemic was \u201cthe icing on the cake\u201d but the current situation was as foreseeable as it was depressing.<\/p>\n\n\n\n

Some Spanish doctors were so burned out they were taking early retirement, despite the hit to their pensions, he said, adding that the chief imperative was to make the profession more attractive to stop the \u201chaemorrhage\u201d of professionals.<\/p>\n\n\n\n

\u201cPeople say the best capital a company has is its human capital,\u201d Lleonart said. \u201cThe problem is that in health the human capital has been systematically mistreated until it has said: enough\u2019s enough.\u201d<\/p>\n\n\n\n

Italy\u2019s public health service, too, faces serious staff shortages, compounded by the pandemic, which triggered an exodus of staff from the profession, taking early retirement, or switching to roles in the private sector.<\/p>\n\n\n\n

Regional governments have signed contracts with freelance medics to cover hospital shifts where needed, highlighting the low salaries of Italy\u2019s public health sector.<\/p>\n\n\n\n

\u201cThere are holes that need to be filled everywhere, especially in emergency units,\u201d said Giovanni Leoni, vice-president of an Italian doctors\u2019 federation. \u201cThe issue is that freelances earn two to three times more \u2013 up to \u20ac1,200 for a 10-hour shift.\u201d<\/p>\n\n\n\n

Many medics had left public sector roles \u201cbefore their time\u201d, Leoni added. \u201cThey have found other types of jobs in the private sector \u2013 roles that mean they don\u2019t have to do night shifts, or weekends.\u201d<\/p>\n\n\n\n

Italian medics are holding a demonstration of \u201cthe invisibles\u201d later this week. \u201cWe\u2019re invisible for the government,\u201d said Leoni. \u201cSalaries for Italian doctors need to be at the same level as those in Europe. Currently, they\u2019re among the lowest.\u201d<\/p>\n\n\n\n

\u00a0This article was amended on 19 December 2022 to make it clear that the 200,000 figure needed in Finland by 2030 includes social care workers as well as health care workers.<\/p>\n\n\n\n

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https:\/\/www.theguardian.com\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

For decades, western Europe\u2019s national healthcare systems have been widely touted as among the best in the world. But an ageing population, more long-term illnesses, a continuing recruitment and retainment crisis plus post-Covid exhaustion have combined, this winter, to create a perfect healthcare storm that is likely to get worse before it gets better. \u201cAll […]<\/p>\n","protected":false},"author":2,"featured_media":17321,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6],"tags":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/geworld.ge\/en\/wp-json\/wp\/v2\/posts\/17319"}],"collection":[{"href":"https:\/\/geworld.ge\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/geworld.ge\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/geworld.ge\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/geworld.ge\/en\/wp-json\/wp\/v2\/comments?post=17319"}],"version-history":[{"count":1,"href":"https:\/\/geworld.ge\/en\/wp-json\/wp\/v2\/posts\/17319\/revisions"}],"predecessor-version":[{"id":17322,"href":"https:\/\/geworld.ge\/en\/wp-json\/wp\/v2\/posts\/17319\/revisions\/17322"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/geworld.ge\/en\/wp-json\/wp\/v2\/media\/17321"}],"wp:attachment":[{"href":"https:\/\/geworld.ge\/en\/wp-json\/wp\/v2\/media?parent=17319"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/geworld.ge\/en\/wp-json\/wp\/v2\/categories?post=17319"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/geworld.ge\/en\/wp-json\/wp\/v2\/tags?post=17319"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}