Impact of the economic crisis on human resources for health policies in Southern EU countries

Abstract

Background The economic and financial crisis which started in the European Union in 2008 affected some countries more than others. Cyprus, Greece, and Portugal had to receive emergency financial aid from the so-called Troika (International Monetary Fund, Central European Bank, European Commission) and consequently were imposed severe austerity measures. All sectors were affected, including health. This paper focuses on the effects of the crisis on the health workforce, which represents the largest share of expenditures in the sector, and on policy responses from these three governments to measures ‘imposed' by the Troika. Methods A systematic search of peer-reviewed and grey literature, and key sources such as government websites was performed. Interviews with key informants were also conducted. Country data and information served to assess policy responses and their effects on the availability, accessibility, acceptability and quality of human resources for health.

Results

Countries responded to the crisis and to the conditions set by lenders by reducing or freezing salaries and benefits, by cutting on recruitment and even dismissing personnel, by increasing workloads, and by introducing other cost containment measures. The three countries do not seem to have used the crisis as an opportunity to make efficiency gains and thereby improve the performance of their health workforce.

Conclusions

This paper is included in the Workshop because it discusses policy responses to a major economic shock by governments facing external constraints, which at the same time limited their capacity for action and provided opportunities for reform