Healthcare assistants play a vital role in Europe's health systems, yet their wages lag far behind. A recent report by the European Federation of Public Service Unions (EPSU) exposes significant pay differences that are only worsening with rising living costs. This situation creates a highly unstable environment for workers.

Uncovering the Wage Gap in Europe's Healthcare Sector

International Wage Disparities in Healthcare Assistants

In a comparison of 15 European countries, EPSU's researchers discovered concerning salary variations. In Germany, an assistant's median hourly wage is around €20, while in Romania, it is less than €5. Romania stands out as an extreme example, with the report noting that even degree-qualified nurses earn, on average, 22% less than the national median wage. This wage gap clearly shows why Romania is struggling with health worker brain drain.Healthcare professionals' salaries often fall well below national average and median incomes. In some cases, like in England, Ireland, and Spain, some healthcare assistants are paid as little as the national minimum wage. Despite this, they handle important duties such as assisting with patients' personal hygiene, helping with meals, and monitoring vital parameters.

The Impact of Task Shifting on Healthcare Assistants

Many of these responsibilities were originally part of nurses' workloads but have been shifted to assistants as part of a broader trend. Mainstream health policy analysts view task shifting as a way to redistribute workloads within a depleted workforce. However, for employers and policymakers, it seems to mean expecting workers to take on more tasks with significantly less training and pay. For instance, in England, healthcare assistant training can be completed in as little as one month, compared to the three years needed to become a nurse.According to Can Kaya from EPSU, there is another crucial aspect of task shifting regarding health workers' rights. While presented as a technical solution, in practice, it often leads to cutting corners and costs in health workforce plans. "It means shifting tasks to lower-paid workers to save expenses," Kaya explains. As a result, healthcare assistants are stuck at the intersection of workforce shortages and austerity.

The Role of Trade Unions in Addressing Wage and Workload Issues

The presence of trade unions can make a difference in this situation. Even in the private sector, when unions are present, the wage gap tends to be less pronounced. For example, in select Scandinavian countries with high unionization rates in private institutions, wage gaps are narrower compared to Italy, where trade unions are stronger in the public sector.In some cases, healthcare assistants in the public sector can earn 30% or more than their counterparts in private institutions spreading across Europe. The largest differences between public and private wages are seen in Italy, Ireland, Spain, and Cyprus. This highlights another factor contributing to wage disparities, as Kaya explains: "The private sector is a business focused on maximizing profit, which it achieves by paying workers less. Commercialization drives lower wages."

The Failures in Europe's Health Workforce Strategy

The current staffing crisis is a national and European issue. National governments have a duty to safeguard the health and care sectors. Kaya emphasizes that the European Union must also take action, including revising its fiscal rules. "Austerity will only make the staffing crisis worse," he warns. More decisive action and investment at all levels of European governance are crucial to combat staff shortages and ensure safe staffing levels.People's Health Dispatch is a fortnightly bulletin published by the People's Health Movement and Peoples Dispatch. For more articles and subscriptions, click here.