Remuneration of nurses
The COVID-19 pandemic has brought further attention to the pay rate of nurses and the need to ensure sufficient remuneration to attract and retain nurses in the profession.
On average across EU countries, the remuneration of hospital nurses in 2020 was slightly above the average wage of all workers. However, in some countries like Lithuania, France, Latvia and Finland, nurses earned less than the average wage of all workers (Figure 7.18).
Figure 7.19 compares the remuneration of hospital nurses in Euros adjusted for differences in cost-of-living to provide an indication of the relative economic well-being of nurses across countries and the financial incentives to consider moving to another EU country to obtain better-paid jobs. In 2020, nurses in Luxembourg and Belgium had remuneration levels more than three times higher than those working in Lithuania and Latvia. This explains at least partly why Luxembourg and Belgium are able to attract a large number of nurses from other countries. In general, nurses working in Central and Eastern European countries had the lowest levels of remuneration, also partly explaining why many choose to migrate to other EU countries.
In many countries, the remuneration of nurses has increased in real terms since 2010, albeit at different rates. In many Central and Eastern European countries, nurses have obtained substantial pay raises between 2010 and 2020, allowing them to partially catch up to the EU average (Figure 7.20, right panel). In many Western European countries, nurse pay increases over the past decade have been more modest. In France, the remuneration of hospital nurses in real terms was about the same in 2019 as in 2010. In Spain, the remuneration of nurses fell after the 2008-09 economic crisis due to wage cuts in the public sector, but it has recovered since 2013, so that the average remuneration level was about 7% higher in real terms in 2020 than in 2010. In Belgium and the Netherlands, the remuneration of nurses in real terms was about 7% to 10% higher in 2020 compared to a decade earlier, with a large part of the growth occurring in 2020.
Many countries provided one-off COVID-19 bonuses to nurses and other frontline health workers following the first wave of the pandemic in 2020, in recognition of the elevated health risks and their additional workload and commitment. The value of these bonuses and the coverage of nurses varied across countries. Permanently higher pay, rather than one-time bonuses, are an even more powerful tool to raise pay and recognise the value of nurses. Up to November 2021, there had been fewer government-led initiatives to provide permanent pay increase for nurses.
In France, most hospital workers, including nurses and nursing aids, received a COVID-19 bonus after the first wave, ranging from EUR 1 000 to EUR 1 500, depending on the intensity of the pandemic in each region. To improve recruitment and retention, all health workers in hospitals and nursing homes received a permanent pay raise of EUR 183 per month in 2020, followed by another raise of between EUR 45 and EUR 450 per month, depending on professional categories and years of experience (OECD/European Observatory on Health Systems and Policies, 2021[1]).
The remuneration of nurses refers to average gross annual income, including social security contributions and income taxes. In most countries, the data relate specifically to nurses working in hospitals. Data refer only to registered (“professional”) nurses in most countries. The data for some countries (such as Italy and Slovenia) do not include additional income such as overtime payments. Informal payments, which represent a significant part of total income in some countries, are not reported.
The income of nurses is compared to the average wage of full-time employees in all sectors in the country. It is also compared across countries based on a common currency (Euros) and adjusted for cost-of-living (purchasing power parity or PPP).
References
[1] OECD/European Observatory on Health Systems and Policies (2021), France: Country Health Profile 2021, State of Health in the EU, OECD Publishing, Paris, https://doi.org/10.1787/7d668926-en.
