World Health Day 2023: workers call for urgent action to improve working conditions

World Health Day 7 April 2023 EPSU banner

(4 April 2023) On World Health Day 2023, health and social care workers represented by the European Federation of Public Service Unions (EPSU) call for urgent action to improve working conditions, reminding policymakers that there is no healthcare without healthcare workers.

The last year has seen an unprecedented action from EPSU unions in health and social services. In December 2022 workers from across Europe marched in Brussels to call on Europe’s health ministers to take action to address staff shortages in a demonstration organised by EPSU. The discontent is continuing into 2023 with health and care unions from Germany, the Netherlands, the UK, Greece, Austria, Portugal, Belgium and Georgia taking action in the first three months of the year. The movement is growing, with the Irish Nurses and Midwives Organisation recently sanctioning a campaign of industrial action to call attention to the staffing crisis. Health unions in Latvia, Finland, Austria, Bulgaria, the Netherlands and Lithuania have negotiated pay increases – a key tool to address staff shortages.

The rise in industrial action underlines workers’ frustrations over the forgotten promises made by policymakers three years ago. The cost of living crisis has led to real term pay losses and post-COVID patient backlogs place a continued burden on workers and systems, impeding workers’ ability to safely deliver high quality care.

Staff shortages are a “ticking timebomb”

Urgent improvement of working conditions are needed to address staff shortages in Europe. Short staffing is not a new issue – it is a long-term issue that was exposed and exacerbated by the COVID-19 pandemic. More than a decade of austerity, low investment and commercialisation of health and care services led to the crisis faced three years ago. Circumstances are once more being aggravated by the cost-of-living crisis – and workers are fed up.

WHO/Europe in September last year called growing staff shortages a “ticking timebomb” threatening health systems in Europe and central Asia. The recent Bucharest Declaration – signed by representatives from 50 WHO/Europe Member States - highlights the growing crisis by calling for political action to improve the recruitment and retention of health and care workers. This call echoes a recent EPSU survey which reports moderate to acute shortages of nurses in all twenty unions studied across twenty countries. Healthcare workers in almost all surveyed countries report feeling extreme stress and exhaustion due to staff shortages. These factors contribute to a vicious cycle where workers leave or contemplate leaving the sector due to unaddressed shortages, further contributing to stress and exhaustion.

Health is not a commodity

Europe’s for-profit care system is continuing to put both workers and care recipients at risk. Care providers have filed for bankruptcy in 2023, and French multinational care company Orpea had to be saved with public money. EPSU has long warned of the negative consequences of the commercialisation of care and continues to call for an end to profit making in health and care.

From applause to action

The applause of 2020 is nothing but a distant memory for health and social care workers. Workers across Europe are calling for urgent change to address unsafe staffing levels and low pay. Europe cannot wait for its health and social care systems to collapse. It’s time for policymakers to listen to workers. It’s time to transform applause into action.

On World Health Day, we remind policymakers of the demands adopted by EPSU’s Pan-European Conference on Health and Social Care. We call on policymakers to:

Recognise the urgency of the crisis in health and social care.
Strengthen collective bargaining and sectoral collective agreements that uphold adequate, needs-based staffing levels, fair wages, good working conditions and trade union rights. Establish a sectoral social dialogue committee in social services, as requested by EPSU and the Social Employers.
Ensure sufficient public funding and investment to allow health and social care workers to deliver high quality care. Exclude health and social care from austerity measures.
Protect health and care as a public good and prevent its commercialisation. Ensure that if profit is made it is fully reinvested to improve working conditions and care delivery. Reverse commercialisation to safeguard the sector’s resilience and focus on the rights of care recipients.
Prevent companies that do not have collective agreements from accessing public funds.
Implement the European Care Strategy by strengthening cooperation between EPSU and the European institutions and tightening regulations and quality mechanisms on access to public funds for care services.
Increase the protection of and funding for occupational health and safety, including against psychosocial risks and post-COVID conditions. Develop a dedicated Directive on Psychosocial Risks to protect workers from stress and burnout caused by work.
Rebuild the public nature of care services. Recognise the crucial role social services play in our societies. Reduce inequalities by ensuring universal access to health services and delivering the Right to Long-Term Care.
Improve cooperation between the relevant European organisations - including WHO Europe, ILO Europe, the Council of Europe and the EU institutions - to tackle issues in the health sector.
Protect medical data under current and future regulations.
Implement the European Pillar of Social Rights, particularly the right to health and care.