The OECD has just released its biennial review, Health at a Glance. OECD Indicators, which looks at the 80 key indicators for population health and health system performance in a number of stated related to OECD countries (members, candidates and partners). One of the sections is dedicated to Health Workforce statistics, covering data for both practising professionals and new medical graduates. These numbers have been steadily growing in recent years, however, the staff shortages are still a major problem, notably in the UK.
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Medical Graduates
According to OECD (2019a), since 2000 the number of new medical
graduates per capita has risen, although increases have not been steady with
the global economic crisis playing its part.
By the end of 2017, the total number increased to nearly 120,000, with
13.1 medical graduates per 100,000 inhabitants in OECD countries on average. In
this particular document the leader is Ireland, with 24.9 in 2017 (latest
available data). However, elsewhere (OECDb) more recent data show that in
Belgium the number in 2018 stood at 28.8, an impressive growth from 2017 (14.8).
Among the leaders were also Latvia (22.1 graduates in 2018), Denmark (21.5 in 2016)
and Lithuania (19.3 in 2017). In the UK the number was 12.9 in 2017, in
Australia – 15.4 and in the US – 17.8 in 2017. The outsiders were Japan and
Israel, with about seven medical graduates per 100,000 population.
In the meantime, the UK admissions service Ucas
announced in early November (Triggle 2019) that a record number of 23,710
students have applied to study medicine at UK universities next September, a 6%
increase compared to last year. Of those, 18,500 are from the UK (+5% y-o-y), 1,680
are from the EU (+1%) and 3,530 are students outside the EU (+10%).
Across the Atlantic, the US medical schools received 53,371 applications for 2019–2020 academic year compared to 42,741 in 2010–2011 (AAMC 2019). Considering that medical school application process in the US may cost prospective students as much as $5,000 to $10,000 (Mitra 2019),the growth is impressive.
In Australia,
for example, a 0.01% y-o-y decrease is observed in the number of students who commenced
studying medicine in 2018 (3,822). However, it has grown from 3,469 in 2010 to
3,799 in 2018, and is expected to remain stable in the future (Medical Deans Australia and New
Zealand 2018).
Healthcare Employment Figures
The OECD report (2019a) shows
that employment levels in health and social systems has been growing steadily
and now reached its historic peak, accounting for about 10% of all jobs in 2017
(+2% since 2000). The leaders are Nordic countries (especially, Norway) and the
Netherlands with more than 15% of all jobs there being in health and social
work. The sector was fastest-growing in countries such as Japan, Ireland and
Luxembourg.
Doctors. The number of doctor per population shows a steady increase in
OECD countries: in 2017 the average was 3.5 practising doctors per 1,000
population. Greece was a leader with 6.1 in 2017 (it should be noted, however, that
the number
of doctors there increased until 2008 before stagnating from 2012 due to economic
crisis). It is followed by Austria
(5.2) and Portugal (5.0). Notably, in many countries the number is still below
the average: 2.8 in the UK, 2.7 in Canada 2.7 and the US 2.6, for example. In
Indonesia, India and South Africa it is less than 1.
Nurses. The OECD countries had on average 8.8 nurses per 1,000 population in 2017 (7.4 in 2000), ranging from about less than 2 in Indonesia, Colombia, South Africa, Brazil and India, to more than 17 in Norway and Switzerland. Between 2000 and 2017 the number of nurses per capita grew in almost all OECD countries, except for the Slovak Republic, Israel, the UK and Ireland.
Nurses outnumber physicians in most OECD countries: with average
being 2.7:1, the ratio is about 1:1 in Chile, Turkey and Greece and more than 4:1
in Japan, Ireland, Finland and the US. In the UK it is 2.8:1, in Australia –
3.2:1.
The NHS Staffing Crisis
The NHS has
notoriously been one of the major elements in Brexit
tug-of-war (BBC Reality Check 2019), and its importance is only increasing in
light of the upcoming elections (Rowland 2019).
Although the OECD review (2019a) acknowledged
that the number of doctors was on the rise in the UK, the problem of healthcare
staff shortages remain (Triggle 2018). According to one study (Adzuna 2019), despite
the general drop in the number of vacancies, healthcare and nursing jobs have
increased 17% y-o-y. The NHS has 81,430 unfilled positions and is currently
short of around 40,000 nurses in specialities such as occupational therapy,
diagnostic radiography and midwifery (Triggle 2019).
The UK government is in the process of expanding training places and has promised to fast-track NHS visa for foreign doctors and nurses if the conservatives win the elections in December (Al Jazeera 2019). Furthermore, the number of medical school places at the UK universities has been growing for the third year in a row, according to Ucas (Triggle 2019). One recent example is a new Institute of Health set up in the University of Cumbria (2019) to deal with a shortage of trained staff.
References
Adzuna (2019) UK Job
Market Report October 2019.
Available from https://www.adzuna.co.uk/wp-content/uploads/2019/10/UK-PR-October-2019-Adzuna-Job-Market-Report-Final-2.pdf
Al Jazeera (2019) Brexit: Johnson promises doctors and nurses 'fast-track NHS visa.' Available from https://www.aljazeera.com/news/2019/11/brexit-johnson-promises-doctors-nurses-fast-track-nhs-visa-191108122315873.html
Association of American Medical Colleges (AAMC) (2019). Applicants,
Matriculants, Enrollment, and Graduates of U.S. Medical Schools, 2010-2011
through 2019-2020. Available from https://www.aamc.org/system/files/2019-11/2019_FACTS_Table_1_0.pdf
BBC Reality
Check (2019) General election 2019: Labour's £500m NHS claim fact-checked.
Available from https://www.bbc.com/news/health-50295231
Medical
Deans Australia and New Zealand (2018) Student Statistics Report: 2017 –2018.
Available from https://medicaldeans.org.au/md/2018/12/2018_Student_Statistics_Report.pdf
Mitra M (2019) Here’s
how much medical students are paying just to get into school. Available from https://www.cnbc.com/2019/10/04/it-can-cost-10000-to-apply-for-medical-school.html
OECD (2019a) Health at a
Glance 2019: OECD Indicators. Available from https://www.oecd-ilibrary.org/sites/4dd50c09-en/index.html?itemId=/content/publication/4dd50c09-en&mimeType=text/html
OECD (2019b), Medical graduates
(indicator). Available from https://data.oecd.org/healthres/medical-graduates.htm
Rowland D
(2019) What should be in the election manifestos on health and social care? Available
from https://blogs.lse.ac.uk/politicsandpolicy/2019-manifestos-health-social-care/
Triggle N
(2018) NHS vacancies a 'national emergency' https://www.bbc.com/news/health-45485814
Triggle N
(2019) Does UK lag behind other rich nations on health and care? Available from
https://www.bbc.com/news/health-50330807
University
of Cumbria (2019) New institute’s ambition to tackle NHS staffing crisis.
Available from https://www.cumbria.ac.uk/about/news/articles/articles/new-institutes-ambition-to-tackle-nhs-staffing-crisis-.php