In a third of countries in the region, at least 40% of doctors were aged 55 or over, the report said. Even when younger practitioners stayed despite stress, long hours and often low pay, their reluctance to work in remote rural areas or deprived inner cities had created “medical deserts” that were proving almost impossible to fill.
“All of these threats represent a ticking time bomb … likely to lead to poor health outcomes, long waiting times, many preventable deaths and potentially even health system collapse,” warned Hans Kluge, the WHO regional director for Europe.
In some countries the worst shortages are among GPs, with France in particular paying the price for previous planning errors. Back in 1971, it capped the number of second-year medical students through a so-called numerus clausus aimed at cutting health spending and raising earnings.
The result was a collapse in annual student numbers – from 8,600 in the early 1970s, to 3,500 in 1993 – and while intakes have since climbed somewhat and the cap was lifted altogether two years ago, it will take years for the size of the workforce to recover.
Even though 10% of France’s GPs now work past retirement age, older doctors leaving the profession outnumbered newcomers entering it last year, when numbers were still 6% down on what they were even a decade ago. It could be 2035 before the country reaches a satisfactory ratio of doctors to inhabitants nationally.