On the evening of Monday, April 3, as part of the 28th Annual Advanced Training Seminar for Physicians Evangelismos Hospital an honorary event was organized for retired directors of the hospital. “In total, 24 names of managers who left at the end of 2022 were read out. The number is impressive. This staff is not compensated in any way.” notes on “K” pulmonologist George Bulbasakos, one of the departed hospital executives. In his recent statement Ministry of Health for permanent residents National Health Service doctors11 posts were announced for hospital. He himself, as he notes, with great difficulty and having exhausted all the possibilities that existed from the old crises of the medical personnel, took care and “left” from the clinic with a good age distribution and doctors of all ranks. This is not always possible.

“In 90% of the clinics, the medical staff consists mainly of managers and assistants, due to the fact that for many years there were no appointments of permanent staff. This means that the knowledge and experience that resident doctors have is not transferred to the clinic, but goes outside, as the adjuncts leave after the end of their contract. And this qualitative advantage of NSS is gradually being lost,” says Mr. Bulbasakos.

One of the largest hospitals in the country with 627 hospital beds, 31,900 patients last year and 103,781 emergency department visits (highest emergency department attendance of all NSH hospitals), Nice hospital has no permanent nursing staff 40 Coordinating Directors , managers 89, curators A’ 59 and curators B’ 51. “The group of managers is more numerous than the group of curators. In practice, this means that 129 resident doctors are on average 55 years of age or older, 59 doctors are 50 years of age or older, and 51 are under 50 years of age. Proof that the NHS medical staff is aging every year,” said the neurosurgeon, director of the NHS at the hospital and general secretary of the Federation of NHS Physicians (OENGE), Panos Papanicolaou. As he notes, “there are 53 auxiliary specialists in our hospital. That is, there are even more contractors than supervisors B. At Cismanoglio, 83 permanent medical staff are managers, 24 are A’ supervisors and 28 are B’ supervisors.

In this particular hospital, about 40% of the full-time doctor positions are vacant (105 positions). “At least half of the directors are over 60 years old. But even a relatively young 50-year-old doctor experienced emotional burnout during the two years of the pandemic,” notes the second vice-president of the Federation, a urologist. Konstantinos Livadas.

What’s the matter

According to Mr. Papanicolaou, governments – “and older ones,” he says – are responsible for this situation and do not comply with what is prescribed by law. That is, when the doctor’s retirement at the age of 67 is imminent, six months before the announcement of the position at the entry level of curator B’.

It is estimated that each year about 700-750 doctors leave the NHS. This staff is rarely replaced. Last year, 350 out of 700 staff doctor positions announced were announced in the district. This year, three weeks ago, 854 positions were announced for NHS units, of which 743 were for hospitals. As OENGE points out, “Of the 743 vacancies, 350 are the remaining listings for 2022, so there are 393 positions left for 2023, and among them there are also positions from 2021 that may have remained unfilled.”

Resignations

Of the annual layoffs, almost half are retired, and the rest are layoffs. It is significant that from the beginning of the year until March 31, 47 acts of acceptance and resignation of full-time doctors of the National Health Service were issued, in most of them the heads of A’ (20) and B’ (17), that is, relatively new doctors placed in “Diaugeia” .

“The main reason for layoffs is overwork, as well as low wages,” said the president of the Piraeus Association of Physicians of Athens Hospitals. Matina Pagonis. “Doctors see that if they privatize or work abroad, their earnings will be much better.” According to a recent OECD analysis, about 6,800 Greek medical graduates are currently working abroad (excluding Greek doctors who studied medicine abroad, may have trained in Greece and emigrated). 50% of them moved during the financial crisis.

As Ms. Pagoni points out, “hospitals need staff. Physician crisis procedures and nurse recruitment procedures must be followed so that NHS units can deal with difficult situations such as a pandemic.”

In Greece, the medical staff is also old. As the President of the Panhellenic Trade Union Federation of Nurses ESY (PASYNO-ESY) noted, George Avramidis, “The average age of nurses is about 50 years old, and this figure is constantly growing. Tired, discredited medical staff without motivation.” According to him, about 14.5 thousand permanent nurses and about 2.5 thousand support staff are currently working in hospitals. “We estimate that in the next two years, approximately 15-20% of full-time nurses will retire,” he notes. At the same time, layoffs and migration are observed among nursing staff. As Mr. Avramidis emphasizes, “the approximately 3,500 nurses who have gone abroad have clearly better working conditions and much higher wages. Their contribution is quickly recognized and most of them are in positions of responsibility with additional bonuses and development. In our country, they prefer to give up permanent positions in hospitals after 15 and 20 years of service and work as school nurses, even if they are not permanent. Many decide to leave, moving into management positions or even choosing a completely different career. They can’t take it.”

Numbers

84 230 NHS hospital workers in December 2022.

medical staff
19 921 doctors in NHS hospitals, 49% of them permanent.
700-750 physicians leaving the NHS each year due to retirement or retirement.
47 acceptance and resignation certificates of resident doctors of the National Health Service were placed in “Diavegia” in the first quarter of this year.

medical staff
0.4 nurses to a bed in Greece.
2.03 nurses per bed on average across OECD countries.
50 years average age of nurses in Greece.
35-37 average age of nurses in the EU.

The European health system is sick

Years of austerity, a months-long health pandemic, and a broader demographic challenge have left the Old Continent’s health care system in a quagmire. At the end of 2022, an outbreak of respiratory viruses “overwhelmed” emergency departments in all countries of Europe.

At least 43 patients died while awaiting examination in the emergency department in France, according to official figures. The situation in Britannia this is even more worrisome as it is estimated that up to 500 people were dying from the same causes every week by the end of 2022. Elderly people predominate among the “victims” of understaffing. IN Sweden, France, Switzerland and the Netherlands, more than one in five older people with chronic conditions reported no or delayed treatment at the height of the pandemic. For those who live outside urban centers, it is almost impossible to find a primary care physician or an intensive care unit.
The cuts have led to this stalemate – as EU spending on health as a percentage of GDP has remained stagnant for more than a decade – a wave of resignations, but also an aging of doctors themselves.

IN Francealmost half of doctors are over 55, while in Italyapproximately 100,000 public sector doctors will quit or retire over the next four years.

In order to staff the hospitals of rich member countries, intra-EU immigration was activated. Romanian doctors are a typical example. OUR Romania it “produces” the most medical graduates in the EU, which has been proven to “export” as the ratio of doctors and citizens to patients is below average.

A popular destination is Germany, where Romanian doctors make up the largest ethnic group of doctors. In Germany, qualified Romanian doctors can earn at least three times more money than in Romania. Conversely, German doctors move to Switzerland for 20% higher salaries.

In Sicily, emergency departments have half the doctors needed. The Sicilians are looking for solutions across the Atlantic. Thus, 13 doctors from Argentina are expected to work on 9-month contracts.