Croatia faces critical shortage of nurses as ageing pressures mount

There is an EU-Wide shortage of medical workers

ZAGREB, 29 May 2025 – Doctors, nurses, carers and pharmacists are in short supply across Europe, putting further pressure on healthcare systems that have been under strain for years.

The issue is particularly acute in Croatia, where the effects of an ageing population, workforce emigration, and long-standing underinvestment are coming to a head.

According to the European Newsroom (ENR), of which Croatia’s HINA is a part, health services across the continent are grappling with a shortage of qualified professionals. While this trend affects many sectors, the healthcare and long-term care fields have been hit especially hard.

A 2023 report by Eurofound, the EU agency for the improvement of living and working conditions, summed up the crisis:

“Labour shortages are particularly widespread in sectors with demanding working conditions, such as health and long-term care. These shortages have been exacerbated by low levels of investment, the impact of the pandemic, and a gender-segregated labour market. Europe’s ageing population and workforce will only intensify the problem in the years to come.”

Croatia’s Ageing Population Deepens Pressure

Demographic trends are stark. Across the EU, the share of people aged 65 and over rose from 16% in 2000 to over 21% in 2023, according to a 2024 OECD report. Projections show this figure could reach nearly 30% by 2050.

In Italy, the outlook is particularly concerning. A study by the Teha think tank found that while older adults represent just 25% of the population, they account for around 60% of all health expenditure—putting immense strain on the system.

France’s health research agency (DREES) has warned that demand for care is expected to rise by 55% by 2040, largely due to chronic illnesses, outpacing the growth in the number of nurses.

Germany’s new Health Minister, Nina Warken, has called for better working conditions for health professionals to meet the needs of an ageing population.

Health Workers Are Also Getting Older

Europe is not only seeing an ageing patient base—but also an ageing medical workforce. France’s nursing regulator noted that, despite an increase in the number of registered nurses (over 565,000 in March 2025), the average age is around 40, with some 12,000 already over 60.

In Bulgaria, the average age of nurses in 2024 was 49. Around 20% were of retirement age, according to the Bulgarian Association of Health Care Professionals—five times the EU average. Since 2015, the number of nurses in Bulgaria has dropped by 30%.

Spain is facing a looming retirement cliff, with nearly 50,000 nurses aged between 55 and 64 expected to retire within the next decade. With just 6.3 nurses per 1,000 residents, Spain faces a shortfall of approximately 123,000 professionals.

Italy is in a similar situation. Around 77% of general practitioners are over the age of 55, according to national statistics head Francesco Maria Chelli, who warned that both the number and age profile of healthcare workers are critical challenges.

Overworked and Understaffed

Workforce shortages are not evenly distributed. On average, the EU has four doctors and nine nurses per 1,000 residents. But Croatia has only 4.6 nurses per 1,000—far below the EU average.

This shortage means existing staff are overworked. Nurses often work long shifts with minimal breaks, contributing to burnout and high stress levels.

In Spain, primary healthcare workers are similarly overstretched. Each doctor conducts an average of 6,906 consultations a year—28 a day—while nurses handle 4,104 annually.

Urban-Rural Divide

Access to healthcare is also uneven geographically. In many countries, medical professionals are concentrated in urban areas, leaving rural and remote regions underserved.

In France, suburban and border regions lack adequate medical coverage. A proposed law aiming to regulate where doctors may practise sparked protests in April from medical students and practitioners.

In Bulgaria, 20% of the country’s nurses work in the capital, Sofia. In Croatia, the overall number of doctors is close to the EU average, but they are unevenly distributed, with rural areas and islands particularly affected.

Portugal, despite having 5.6 doctors per 1,000 residents, struggles to provide care in inland regions where attracting and retaining staff remains difficult.

Medical Brain Drain Hits Croatia and the Region

Low pay, difficult working conditions, and limited career prospects are prompting healthcare workers to seek employment abroad. Between 2019 and 2024, over 6,000 clinicians left Portugal’s public health sector, worsening shortages in key areas such as maternity and paediatrics.

Bosnia and Herzegovina has lost more than 4,000 nurses and 2,000 doctors over the past decade, according to both national and international sources.

In May 2025, Bulgarian health workers demanded a 150% pay rise, pointing out that supermarket staff often earn more than nurses.

Croatia has experienced a significant outflow of doctors and nurses, especially since joining the EU. According to the Croatian Medical Chamber, 1,214 doctors emigrated between 2013 and 2023.

In 2024, Croatia was estimated to be short around 4,000 nurses. Most emigrants have moved to Germany, Austria, Ireland, or Sweden. However, recent pay increases have slowed the trend.

Slovenia, too, has seen its workforce shrink. A 2022 report showed a 20–25% shortfall of nurses in hospitals and primary care. The country has long attracted health workers from the Western Balkans—but even that pipeline is drying up.

Germany remains a major destination. Around 20% of workers in its hospitals and care homes are now foreign-born.

Is More Money the Answer?

The EU’s post-pandemic health programme, EU4Health, has earmarked €4.4 billion (2021–2027) to bolster health systems. While much of the funding focuses on cancer prevention and pharmaceutical strategy, some countries have used it to support healthcare workers.

Bosnia and Herzegovina, which joined the programme in 2024 as an EU candidate, is now eligible for funds aimed at training, digitalisation, and boosting resilience in the sector.

Slovenia has tapped into the EU’s Recovery and Resilience Facility to support its healthcare workforce and invest in digital tools to improve care quality.

Still, money alone is not enough. As Eurofound noted, tackling healthcare workforce issues requires more than just salary increases. Quality of life, education, work-life balance, and career development all play a crucial role.

Women Carry the Burden

Women make up more than 75% of nurses across the EU. As the population ages, informal care—often provided by family members—is expected to become even more critical.

If no reforms are introduced, women will disproportionately bear the burden, says the Bruegel think tank. Many are likely to reduce their working hours or leave the workforce altogether to provide unpaid care at home.

Italy’s health minister Orazio Schillaci recently acknowledged this challenge, stressing the need to rebuild trust in public healthcare and make the profession more appealing.

As Europe faces a future of older populations and rising care needs, the message is clear: unless healthcare systems are reformed and workers better supported, the cracks will only deepen.