Trade unions demand better healthcare working conditions at Dialogue+ conference in Madrid

The discussions focused on the mounting pressures facing healthcareprofessionals across Europe, including rising living costs, persistent staffshortages, increasing workloads and growing psychosocial risks. Participants andyoung trade union leaders explored how social dialogue, collective bargainingand EU policy instruments can help improve working conditions and ensure thelong-term sustainability of healthcare systems.

Healthcare workers under increasing pressure

A central concern raised by trade unions was the growing mismatchbetween the demands placed on healthcare professionals and the workingconditions, benefits and recognition they receive.

Against a backdrop of rising living costs, demographic change andgrowing demand for healthcare services, healthcare professionals areincreasingly expected to work longer hours, take on additional responsibilitiesand maintain high standards of care, often without corresponding improvementsin pay or working conditions.

Participants warned that relying on an already overstretched workforceto compensate for persistent staff shortages risks further undermining theattractiveness of healthcare professions and the retention of qualified staff.Sustainable solutions require adequate staffing levels, fair remuneration,work-life balance and stronger professional recognition.

Psychosocial risks, stress and burnout must be addressed

The conference placed particular emphasis on psychosocial risks,including work-related stress, emotional exhaustion and burnout. Demandingworking environments, irregular shifts, excessive workloads and the emotionalpressures associated with patient care leave healthcare professionalsparticularly exposed.

Discussions addressed relevant EU policy developments, including theEuropean Parliament's work on psychosocial risks at work and initiatives aimedat improving job quality, such as the forthcoming Quality Jobs Act.

Trade unions stressed that preventing these risks requires more thanindividual resilience. Organisational and collective measures, includingmanageable workloads, adequate rest periods, sufficient staffing and meaningfulworker participation in occupational health and safety decisions, are essentialto protecting workers' well-being and ensuring the quality of patient care.

As Paloma Repila, President of CESI's expert commission ‘HealthcareServices’ and representative of SATSE, highlighted:

“Healthcare professionals are increasingly exposed to working conditionsthat put their mental health at risk, yet when they develop stress-relatedillnesses, anxiety or burnout, they are often left to struggle on their own.Not only is there insufficient institutional support, but workers also facesignificant difficulties in proving that their health problems are directlylinked to their working conditions. The burden of proof falls on those who arealready suffering. We need stronger recognition of work-related psychosocialrisks, better protection mechanisms and a system that supports healthcareworkers rather than forcing them to fight to have their conditionsacknowledged.”

Social dialogue and collective bargaining as essential tools

Effective social dialogue and collective bargaining emerged as centraltools for addressing the structural challenges facing healthcare workers.

Trade unions underlined the importance of involving workers and theirrepresentatives in decisions affecting employment conditions, workforceplanning, professional development and the organisation of healthcare services.

While social dialogue allows workers' concerns to inform reforms andpolicy decisions, collective bargaining plays a crucial role in securing fairpay, appropriate working-time arrangements and stronger occupational health andsafety protections.

The importance of trade union involvement was also illustrated byongoing regulatory discussions in Spain, particularly the reform of thenational healthcare framework legislation (Estatuto Marco).

Laura Villaseñor, President of SATSE, underlined the organisation'sefforts to ensure that legislative changes deliver concrete improvements:

“At SATSE, we have been working tirelessly to ensure that the reform ofSpain’s healthcare framework legislation translates into real improvements fornursing professionals and the wider healthcare workforce. The current frameworkmust be updated to reflect the realities of today's healthcare system,including persistent staff shortages, excessive workloads and the need forbetter professional recognition and working conditions. Through sustained tradeunion advocacy and social dialogue, we have been pushing for a reform thatstrengthens workers’ rights, improves staffing and ensures that healthcareprofessionals receive the recognition and protection they deserve. Legislativereform must lead to tangible improvements, not simply promises on paper.”

Making better use of EU recommendations and policy frameworks

Another key focus was how trade unions can use European policyinstruments to advance workers' interests at national level.

Through DIALOGUE+, participants explored opportunities offered by the EuropeanSemester, the European Pillar of Social Rights and its Action Plan, alongsidethe EU's wider quality jobs agenda, including the Quality Jobs Roadmap and itsforthcoming Act.

Particular attention was given to EU recommendations and othernon-binding instruments, commonly referred to as soft law. Althoughthese measures do not necessarily create directly enforceable obligations, theycan provide valuable benchmarks for national reforms and strengthen tradeunions' positions in discussions with governments and employers.

Participants examined how these frameworks could support strongerprotection against psychosocial risks, improved workforce planning andinvestment in healthcare employment.

The exchanges highlighted the importance of translating European policyobjectives into concrete national measures, with trade unions actively involvedin their development and implementation.

Through DIALOGUE+, CESI continues to support independent trade unions inshaping socially sustainable reforms that respond to workers' needs.

The conference concluded with a celebration of SATSE's 40 years oftrade union action in Spain, recognising four decades of commitment todefending healthcare workers' rights. CESI warmly congratulates SATSE on thismilestone and its continued dedication to strengthening the voice of healthcareprofessionals.