Europe’s Health Systems Grow More Dependent on Foreign Workers, WHO Warns
Oct 6, 2025
Category: EU Foreign Workers
The World Health Organization (WHO) warned that Europe’s growing dependence on foreign-trained doctors and nurses is affecting healthcare systems and could deepen workforce shortages in some areas.
A new WHO/Europe report estimated that by 2030, the region could face a shortfall of nearly one million health workers. Cross-border migration is both helping fill gaps and creating new challenges for national systems.
From 2014 to 2023, the share of foreign-trained doctors in Europe rose by 58%, while foreign-trained nurses grew by 67%, according to the report. In the same period, the annual number of new doctors almost tripled, and new nurses increased fivefold.
By 2023, 60% of new doctors and 72% of new nurses entering Europe’s workforce were trained abroad. Many came from Asia, Africa, and the Americas, with significant contributions from migration within Europe as well.
Uneven flows across the region
The rise in mobility has created sharp imbalances. Western and northern European countries, such as Germany, the United Kingdom, and Ireland, rely heavily on foreign staff.
At the same time, eastern and southern European countries are losing large parts of their workforce to higher-income neighbors. This has left some health systems short-staffed and weakened their long-term stability.
“This is not just about numbers,” said Natasha Azzopardi-Muscat, director of WHO/Europe’s Division of Country Health Policies and Systems. “Behind every migrating doctor or nurse is a story of ambition and opportunity, but also, often, of strain on families and on the national health systems they left behind.”
Aging workforce adds pressure
The report noted that an aging workforce will increase the need for new health professionals. In several European countries, more than 40% of doctors are 55 or older, making large-scale retirements likely in the next decade.
As Europe’s population ages, demand for medical care is climbing. WHO warned that these combined pressures will “inevitably ramp up the pressure for active international recruitment” unless countries improve retention and training.
Case studies reveal different strategies
The WHO analysis uses case studies from nine countries to show both the causes of health worker migration and possible solutions.
Romania, once a major source of migrating doctors, cut annual departures from 1,500 in 2012 to 461 in 2021. Officials credited higher pay, better training, and improved working conditions.
Moldova, which has long faced heavy outbound migration, has recently seen fewer doctors applying to work abroad.
Ireland, by contrast, remains highly dependent on foreign staff but has expanded medical training at home to strengthen future self-sufficiency.
Complex mobility patterns
Migration flows are not just one-way from south to north. The report shows more complex patterns shaped by language, geography, and training systems.
Germany is the main source of foreign-trained doctors in Austria, Switzerland, and Bulgaria, while doctors trained in Moldova make up the largest foreign group in Romania.
These connected flows reflect Europe’s integrated labor market and show why coordinated workforce policies are needed, WHO experts said.
Calls for policy action
To prevent deeper imbalances, WHO urged governments to strengthen workforce planning, improve working conditions, and create better retention strategies.
Dr. Tomas Zapata, regional adviser for health workforce and service delivery at WHO/Europe, said that countries should aim for both “better working conditions in sending countries on one hand, and better self-sufficiency in receiving countries on the other.”
WHO also called for long-term funding plans, education reforms, and ethical recruitment agreements to manage cross-border mobility without weakening fragile health systems.
“Health worker migration is a reality in our interconnected labor market, and it must be managed more fairly and sustainably,” Azzopardi-Muscat said.
Risks of widening inequalities
The report warned that without stronger action, existing inequalities could grow.
Countries losing workers may face reduced access to care, while those heavily dependent on international recruitment risk relying too much on outside labor markets.
“If we fail to support the movement of health workers fairly, we risk widening health inequities and leaving already fragile health systems unable to cope,” Azzopardi-Muscat added.
Travel systems meet workforce pressures
For both short- and long-term visitors to Europe, the growing reliance on foreign-trained doctors and nurses overlaps with new border management reforms.
The Entry/Exit System (EES), launching on October 12, 2025, will record all non-EU nationals entering and leaving Schengen countries for short stays of up to 90 days within a 180-day period.
By replacing passport stamps with digital records and biometric checks, EES aims to speed up border crossings and track overstays.
The European Travel Information and Authorization System (ETIAS), expected to begin in late 2026, will add another step. Citizens of 59 visa-exempt countries will need online authorization before traveling, valid for up to three years.
Together, ETIAS and EES will tighten traveler oversight while making border flows more predictable.
These changes also affect healthcare access. Tourists and short-term residents may find health systems staffed largely by migrant professionals, while stricter entry checks could impact the mobility of health workers who cross borders for contracts or daily commutes.
For migrants planning long-term stays, closer links between immigration records and labor market data could shape recruitment and residence policies in health-related fields.
Immigration policies under new strain
The WHO report comes as EU countries adjust immigration policies in response to demographic shifts and new border technologies.
Western and northern states that rely heavily on foreign-trained staff may need to formalize recruitment through bilateral agreements, while eastern and southern states may strengthen retention policies to reduce outflows.
With ETIAS and EES, immigration authorities will have more precise tools to track entries, length of stay, and compliance with visa-free rules. This gives governments a chance to connect workforce planning more closely with migration oversight.
Health worker recruitment, in particular, may face greater scrutiny to balance domestic shortages with WHO’s call for ethical international hiring.
As EU populations age and the region faces a projected shortfall of nearly one million health workers by 2030, migration policies are likely to favor selective openness.
Governments may focus on attracting skilled professionals, especially doctors and nurses, while tightening general entry requirements for short-stay travelers.
The rollout of ETIAS and EES creates the infrastructure for this shift, providing real-time data to guide both labor and migration decisions.
Building a sustainable health workforce
Europe’s increasing reliance on foreign-trained doctors and nurses shows both the benefits and the pressures of its interconnected health systems.
The WHO report noted that while migration helps fill urgent gaps, it also widens inequalities between sending and receiving countries.
The challenge for patients, policymakers, and professionals is keeping care accessible without overloading fragile systems.
The way forward lies in stronger retention efforts, fair recruitment, and greater investment in local training.
With Europe facing an aging population and a projected shortfall of nearly one million health workers by 2030, the question is clear: will governments act now to build a resilient workforce—or wait until the shortages become harder to fix?