Report: There is a growing need to involve labour from abroad in healthcare

Kaupo Koppel, an expert at the Foresight Centre, said that the shortage of healthcare workers is an urgent problem, especially among family physicians. “The proportion of medical workers over the age of 55 has increased in all major groups of the profession, but this trend is especially noticeable among family physicians,” said Koppel. “Currently, half of the family doctors are more than 60 years old and they may exit the labour market within the next decade.” In the future, the deficit of family physicians will be greater especially in rural areas, where few family doctors are currently under the age of 50.

Although the lack of nurses has received the most attention, there will also be an increasing shortage of non-clinical specialists such as caregivers and nursing assistants in the coming years. The succession of psychologists, mental health professionals and pharmacists is concerning as well. For example, currently, only half of the required number of pharmacists are being trained.

In the short report ‘Trends related to healthcare workers in Estonia’, the Foresight Centre points out that more and more medical workers are working in multiple positions and an increasing number of positions are filled by people working overtime. “This indicates that the overload is growing, although it should be noted that the contractual workload has decreased,” said Koppel. “Having a lower contractual burden in combination with more overtime may make more economic sense to healthcare workers.”

According to Statistics Estonia, medical workers were most likely to be working multiple jobs in Estonia in 2024. 59% of specialist doctors work in multiple jobs, while the national average is only 10%. Having multiple jobs is also common among psychologists and speech therapists. Estonian nurses, however, are increasingly overburdened and overtime work has increased by 40% in the last decade.

Additionally, the data show that Estonian healthcare has one of the smallest shares of migrant workforce in the European Union. For example, in 2023, only 4.5% of doctors and 0.2% of nurses were of foreign origin in Estonia, which are among the lowest indicators in the European Union. Also, the growth trend of these indicators has been modest in Estonia compared to many other countries. “Clearly, in the Estonian healthcare system, there is a growing need for labour from abroad, but the language barrier prevents foreign workers from coming,” said Koppel.

The short report also points out that the share of healthcare workers working in the private sector has increased from 32% to 37% in the past ten years. More and more support specialists and mental health professionals are working in the private sector.

The short report ‘Trends related to healthcare workers in Estonia’ (in Estonian) is part of the Foresight Centre’s research stream ‘Healthcare Sustainability’. The research stream aims to find future opportunities to analyse alternative options for diversifying healthcare financing and their impact on the availability of healthcare services in Estonia until 2050.