Doctor shortage: a Europe-wide problem

Endless waiting lists, hospitals under pressure, and medical staff struggling to meet a growing demand. Healthcare in Europe is now one of the most urgent challenges. With systems constrained by limited resources and a growing doctor shortage, the future of public health appears increasingly uncertain.

According to a report by the World Health Organization, this emergency is particularly serious in many European countries. The UK, Germany, France, Spain, and Italy especially need urgent structural reforms to address issues tied to ineffective management and staff shortages.

Common problems

Some challenges are widespread, as are their causes. The COVID-19 pandemic disrupted or delayed non-urgent procedures, diagnoses, and treatments, worsening waiting lists. Three years of constant emergency pushed doctors and nurses to their limits, forcing them into exhausting shifts and leading to increased burnout, voluntary resignations, and early retirements. Meanwhile, many people postponed essential check-ups, risking late diagnoses and delayed treatments.

In addition to these new factors, there are long-standing structural issues shared across countries, such as ageing populations, a rise in chronic illnesses, and increasing obesity rates. At the same time, public spending on healthcare has declined in most European countries. Although the number of doctors and nurses has grown over the last ten years, the increase hasn’t kept pace with rising demand, which is leading to a worsening doctor shortage.

Mental health is also becoming increasingly important, with more and more healthcare professionals suffering from burnout and psychological stress.

Even though Western European countries share many core issues, each has its own specific causes and strategies for coping with the crisis.

United Kingdom

In the UK, Brexit has made it even harder to recruit doctors and nurses, adding further pressure on hospitals. The National Health Service (NHS) is facing an unprecedented crisis due to staff shortages, underfunding, and rising demand for care. With over 7 million people on waiting lists, the British healthcare system is struggling to meet demand. In 2022, the UK public sector reported around 132,000 job vacancies, highlighting the difficulties in recruiting and retaining necessary staff.

As highlighted by The Guardian, the situation is made worse by healthcare workers’ growing burnout. Despite government announcements of new hires and legislative reforms, the situation remains critical and calls for urgent action.

Germany

Germany spends more on healthcare than any other country in Europe, yet its hospital sector is still facing a crisis. The shortage is especially severe in fields such as neurology, gynaecology, and anaesthesiology, where hospitals struggle to provide adequate care due to a lack of qualified staff. It is estimated that hospitals are missing around 23,000 doctors and nurses.

There are several root causes. On one hand, the ageing population has increased the demand for medical care, especially for chronic illnesses. On the other, the shortage of specialists stems from a lengthy and highly selective training process that fails to produce enough new doctors.

As a result, current staff face grueling shifts, high stress levels, and increasing burnout. As Deutsche Welle reports, Health Minister Karl Lauterbach has announced a so-called “revolutionary” hospital reform plan. Its main goal is to optimise resources and improve efficiency through a three-tier reorganisation: highly specialised hospitals, intermediate care facilities, and small centres for basic healthcare. One of the most controversial measures involves closing underperforming hospitals, a decision that may worsen access to care in less populated areas.

France

In France, despite healthcare spending reaching 12% of GDP, 30% of the population lacks adequate access to medical services. According to Deputy Health Minister Agnès Firmin Le Bodo, 87% of the country is considered a “medical desert”.

The situation is further exacerbated by the uneven distribution of doctors, with severe shortages in rural areas and densely populated, disadvantaged districts. The main cause is the retirement of many professionals without sufficient generational turnover—an outcome of France’s university numerus clausus system, which was in place for nearly 50 years until 2020. One proposed solution is to introduce “medical assistants” who would handle administrative tasks, freeing up doctors to focus more on patients.

Spain

Spain’s healthcare system also faces serious shortages, which have lengthened waiting lists and increased pressure on emergency services. The crisis is severely affecting healthcare workers themselves: more than 50% report symptoms of burnout. The key issue is low salaries and inconsistent conditions across different regions, leading to a counterproductive internal labour market competition. For many doctors and nurses, working abroad—in Switzerland, Germany, or France—offers better pay and conditions.

In addition to the doctor shortage, Il Post reports that in Madrid and other autonomous regions, there are no available beds, forcing patients to wait 3–4 days on stretchers in emergency department corridors.

Italy

Italy is no better off. Despite high demand, many hospitals struggle to meet patients’ needs because the system fails to attract and retain qualified staff. The numbers are stark: in 2022, 4,349 doctors resigned from the national health system—a dramatic rise from 1,564 in 2016.

Major contributing factors include cuts to public healthcare spending, low wages, short-term contracts, and hiring freezes. To bridge the gap between medical supply and patient demand, the public health system heavily relies on freelance professionals and temporary “on-call” doctors. These short-term fixes are expensive and have ultimately weakened the healthcare system.

Contrary to popular belief, the main problem in Italian healthcare is not the number of doctors but the inability of the NHS to attract and retain healthcare workers, due to several factors:

• Italian nurses earn 19% less than their European counterparts, and doctors earn 4% less;
• Managing complex patients with limited resources makes hospital work extremely stressful, significantly increasing burnout risk;
• Nearly one in two Italians has experienced overcrowding in hospitals or clinics. These situations not only drive people to forgo care, but also increase violence toward healthcare workers. Doctors often become scapegoats for systemic failures and unmet expectations.

Over time, working in the public health system has become increasingly demanding, stressful, and unrewarding. This has driven professionals to seek less exhausting, more fulfilling alternatives—whether in private practice or abroad.

Conclusion

The doctor shortage in Europe is a structural, social, and economic issue, reflecting years of neglect, poor political choices, and lack of investment. Each country has its own unique challenges, but what unites the entire continent is the urgency to act. Tackling this crisis requires multi-level interventions: reforming training pathways and hiring policies, and ensuring a more equitable distribution of healthcare resources across territories.

Only through coordinated and forward-thinking efforts can we ensure the sustainability of healthcare systems and meet citizens’ needs effectively.