Health workforce crisis plan: EU should recruit 1 million workers by 2034

Despite being non-legally-binding in nature, the report sets clear strong recommendations towards the European Commission and Member State governments to:

• recruit up to one million additional healthcare workers by 2034, to close workforce gaps in the sector by 2034.
• address healthcare shortages through better retention, achieved through better working conditions. The reports supports fairer pay, job security, adequate minimum wages, predictable shifts, limits on long and consecutive night shifts, proper rest, paid leave, mental-health support and stronger protection against precarious employment. It also demands effective enforcement of the Working Time Directive.
• establish minimum safe staffing standards. Member States should establish evidence-based staffing thresholds, workload controls, doctor-to-patient and nurse-to-patient ratios, and adequate minimum consultation times, according to the report. Parliament also proposes a standardised EU tool to measure nurses' workloads.
• ensure stronger protection for junior doctors and trainees. Residents and postgraduate trainees should be legally recognised as both workers and learners, receive fair pay and social protection, and have protected rest, proper supervision and mental-health support. Students must not be used as substitutes for employed staff.
• step up public funding and protection from austerity. The report calls for increased public healthcare spending and suggests examining whether healthcare investment could be shielded from austerity measures, subject to fiscal oversight. It calls for health funding ring-fenced in the EU's next Multiannual Financial Framework (MFF) 2028–2034 and criticises the likely absence of a dedicated post-2027 health budget line in the EU's next budget.
• avoid deregulation and privatisation. It explicitly notes that healthcare should be protected from the EU's so-called 'Omnibus' deregulation agenda. The text also warns that privatisation may restrict access and weaken public control.
• pursue action against 'medical deserts'. EU cohesion and social funds should finance housing, scholarships, tax incentives, career opportunities and infrastructure to attract workers to rural, remote, island, outermost and depopulated areas.
• foster ethical mobility rather than dependence on foreign recruitment. The report supports easier recognition of qualifications and fair movement within the EU, but notes that international recruitment must not drain countries already facing shortages. Recruitment from abroad should supplement—not replace—domestic education and retention policies.
• expand nursing, pharmacy and multidisciplinary roles. The report supports carefully regulated task-sharing, advanced-practice nursing and potentially wider pharmacist responsibilities. These changes must include training, supervision, clear accountability and pay reflecting the additional responsibilities.
• guarantee human-controlled AI and digital healthcare. AI, telemedicine and digital tools should reduce paperwork and complement professionals—not replace staff, professional judgment or face-to-face care. The report calls for human control over clinical decisions, identifiable liability, worker involvement and potentially EU legislation on algorithmic management at work.
• ensure strong health data safeguards. The report supports the European Health Data Space and interoperable systems, but insists on informed patient consent, data protection, transparency and professional ethics.
• promote gender equality and protection from violence. Because women constitute most of the workforce, the report stresses the role of equal pay and implementation of the Pay Transparency Directive, access to public child care and career advancement and stronger action against harassment, discrimination and workplace violence.
• foster primary and community care in health care planning. Everyone should have access to a family or primary care doctor and continuity of care, ideally throughout life. Telehealth should not displace community workers or the patient–doctor relationship.
• advance EU-level workforce monitoring. The report calls for a European observatory producing regular forecasts of workforce supply, demand, workload, mobility, regional shortages and skills needs.

CESI has been strongly advocating for safe staffing levels and decent employment and working conditions in the healthcare sectors during the negotiations on the text, and long before, too. Since September 2025 position CESI had 21 asks covering staffing, pay and working conditions, skills, mobility, equality and governance. In particular it pleaded for European patient/staff-ratio guidelines and a common staffing benchmark, fiscal room for health staffing, attractive pay and manageable hours, psychosocial-risk and violence measures, enhanced training and digital investment, ethical mobility, improved gender equality, better workforce data, better prevention, and more inclusive social dialogue in the sector.

The adopted text featured a substantial part of that agenda. As such, CESI welcomes the report as an important step towards addressing Europe’s healthcare workforce crisis, with many of its recommendations reflecting CESI’s longstanding priorities. At the same time, a substantial qualification is that the European Parliament stopped short asking for a binding EU directive to address certain challenges in the sector. Voluntary standards alone cannot guarantee safe working conditions and quality patient care. CESI will therefore continue to advocate for binding EU rules to accomany recommendations.

Paloma Repila, affailite of the Spanish nurses trade union union SATSE and President of the CESI's Expert Commission ‘Healthcare Services’ said: "The CESI Expert Commission ‘Healthcare Services’ welcomes the final initiative submitted, while highlighting a key weakness: It remains merely a recommendation and lacks clear oversight mechanisms to ensure that Member States implement its provisions effectively and comprehensively. Given the strategic importance of the issue and the well-documented staffing crisis, the expected results are unlikely to be achieved unless mechanisms are put in place to audit the implementation of these recommendations. Therefore, CESI will work to secure such tools and will continue to advocate and exert influence at the EU level, urging its members to strive to turn these recommendations into reality in their respective countries."

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