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Spain has above-average number of doctors, but not enough nurses, says OECD report
SPAIN is in the top 10 in the developed world for the most doctors per inhabitant, but has half the average number of nurses, recent statistics reveal.
According to the Organisation for Economic Cooperation and Development (OECD), which covers all the first-world nations on earth and several emerging countries – a total of 356 – the average number of GPs and hospital doctors per 1,000 inhabitants is 3.4.
In Spain, however, this is 3.9, meaning patients are amply covered.
But this is not the case with nurses – the OECD average is nine nurses per 1,000 inhabitants, whilst in Spain, it is just 5.3.
Part of the reason, and the result, of the much lower number of nurses per capita in Spain is the fact that much of the non-medical care of hospital patients is expected to be given by family members, including bed-pans, spoon-feeding and giving pills provided by nurses at the correct intervals.
Ward visiting hours are normally unrestricted and a less able patient would typically have at least one family member staying with him or her overnight.
To a large extent, however, due to Spain's close family responsibility network, it is the relatives themselves who want to look after patients in hospital, and they believe nurses should be 'left to get on with nursing'.
But the limited number of nurses is also partly due to a funding shortage, and a large number of student nurses say they intend to move abroad once they qualify to find work.
Spain's doctor-patient ratio is, however, 10th out of 35 – higher even than wealthy countries such as the UK, France, USA, Canada and Australia.
It sits just behind Russia's four doctors per 1,000 inhabitants and Germany's 4.1.
Sweden and Switzerland both have 4.2 doctors per 1,000 inhabitants, whilst Lithuania is slighly ahead with 4.3, Norway with 4.4, Portugal with 4.6 and Austria with 5.1.
Greece is number one for the most doctors per patient, with 6.3 per 1,000 residents.
Switzerland is top for nurse numbers, with 18 per 1,000, followed by Norway's 17.3, Denmark's 16.7, Iceland's 15.5 and Finland's 14.7.
Germany has 13.3 nurses per 1,000 residents, whilst figures for Ireland and Luxembourg at 11.9 and Australia and the USA at 11.5 and 11.3 respectively are very similar.
Spain's 5.3 per 1,000 is way below numbers for its nearest neighbours – France has 9.9 per 1,000, whilst the UK has eight and Portugal, 6.3.
Only three OECD countries in Europe have fewer nurses than Spain – Poland is close with 5.2 per 1,000, whilst Latvia has 4.7 and Greece, 3.2.
With the comfortably-high number of doctors and much lower-than-average number of nurses, this also means the doctor-nurse ratio in Spain suffers – at 1.4 nurses per doctor, it sits at half the developed world average of 2.8, and a long way behind the 4.6 nurses per doctor in Japan, Finland and Denmark.
Spain also has fewer nursing graduates than most other OECD nations, which may be explained by the fact that students interested in a career in medicine appear more attracted to being a doctor – a profession with similarly long hours, arduous tasks, high responsibility levels and onerous decision-making, relatively little difference in length of time required for training and study, but generally much better paid.
In Spain, students who graduate in nursing make up just 2.32 in 10,000 – meaning the country's coverage of 5.3 nurses per 1,000 inhabitants is in fact quite an achievement.
The average for the OECD is 4.6 nursing graduates per 10,000 inhabitants, and Spain is only ahead of six out of 35 countries – Chile (2.15 per 10,000), Italy (2.06 per 10,000), Israel (1.9), Czechia (1.58), Luxembourg (1.28) and México (1.2).
An even greater sign that Spain's healthcare management strategy is working well is the fact that, despite being above the OECD average for numbers of doctors, it has a very low number of students who graduate in medicine every year.
Nursing graduates nearly double the number of newly-qualified doctors who finish their training each year – the latter amounted to just 1.3 per 10,000 inhabitants in 2015.
But medicine graduates are low throughout the developed world – the OECD average is 1.21 per 10,000 inhabitants, which Spain amply clears.
Ireland beats both hands down, however, with 2.37 doctors graduating every year per 10,000 inhabitants.
One situation of particular concern, both in Spain and the developed world as a whole, is the number of doctors aged over 55 – for Spain, just one in 10 fitted this description in the year 2000, but as at 2015, nearly a third did so.
This means as time passes, more doctors could be retiring than starting the profession.
Italy fares worse, however, with 53% of doctors aged over 55, along with Israel (49.9%) and France (46.6%).
Just before the OECD report was released, however, Spain's ministry of health had already started developing short-, medium- and long-term strategies to tackle the doctor and nurse shortage in the country, which is particularly severe in rural or remote areas and in given specialist areas.
But it may mean that in the near future, students undecided about their future career will know exactly which way to turn and which profession is sure to be the most in demand.
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