Healthcare assistants play a vital role in Europe's health systems, yet their wages lag far behind. A recent report by the European Federation of Public Service Unions (EPSU) exposes significant pay differences that are only worsening with rising living costs. This situation creates a highly unstable environment for workers.

Uncovering the Wage Gap in Europe's Healthcare Sector

International Wage Disparities in Healthcare Assistants

In a comparison of 15 European countries, EPSU's researchers discovered concerning salary variations. In Germany, an assistant's median hourly wage is around €20, while in Romania, it is less than €5. Romania stands out as an extreme example, with the report noting that even degree-qualified nurses earn, on average, 22% less than the national median wage. This wage gap clearly shows why Romania is struggling with health worker brain drain.Healthcare professionals' salaries often fall well below national average and median incomes. In some cases, like in England, Ireland, and Spain, some healthcare assistants are paid as little as the national minimum wage. Despite this, they handle important duties such as assisting with patients' personal hygiene, helping with meals, and monitoring vital parameters.

The Impact of Task Shifting on Healthcare Assistants

Many of these responsibilities were originally part of nurses' workloads but have been shifted to assistants as part of a broader trend. Mainstream health policy analysts view task shifting as a way to redistribute workloads within a depleted workforce. However, for employers and policymakers, it seems to mean expecting workers to take on more tasks with significantly less training and pay. For instance, in England, healthcare assistant training can be completed in as little as one month, compared to the three years needed to become a nurse.According to Can Kaya from EPSU, there is another crucial aspect of task shifting regarding health workers' rights. While presented as a technical solution, in practice, it often leads to cutting corners and costs in health workforce plans. "It means shifting tasks to lower-paid workers to save expenses," Kaya explains. As a result, healthcare assistants are stuck at the intersection of workforce shortages and austerity.

The Role of Trade Unions in Addressing Wage and Workload Issues

The presence of trade unions can make a difference in this situation. Even in the private sector, when unions are present, the wage gap tends to be less pronounced. For example, in select Scandinavian countries with high unionization rates in private institutions, wage gaps are narrower compared to Italy, where trade unions are stronger in the public sector.In some cases, healthcare assistants in the public sector can earn 30% or more than their counterparts in private institutions spreading across Europe. The largest differences between public and private wages are seen in Italy, Ireland, Spain, and Cyprus. This highlights another factor contributing to wage disparities, as Kaya explains: "The private sector is a business focused on maximizing profit, which it achieves by paying workers less. Commercialization drives lower wages."

The Failures in Europe's Health Workforce Strategy

The current staffing crisis is a national and European issue. National governments have a duty to safeguard the health and care sectors. Kaya emphasizes that the European Union must also take action, including revising its fiscal rules. "Austerity will only make the staffing crisis worse," he warns. More decisive action and investment at all levels of European governance are crucial to combat staff shortages and ensure safe staffing levels.People's Health Dispatch is a fortnightly bulletin published by the People's Health Movement and Peoples Dispatch. For more articles and subscriptions, click here.

In a significant turn of events, a $120 million deal to sell three Northeast Pennsylvania hospitals to a nonprofit group has fallen through. Community Health Systems Inc. announced on Tuesday that WoodBridge Healthcare Inc. will not be purchasing Moses Taylor Hospital, Regional Hospital of Scranton, and Wilkes-Barre General Hospital, which operate under CHS’ for-profit Commonwealth Health System. This development has left the local healthcare landscape in a state of uncertainty.

The Unraveling of a Promising Hospital Deal

Reasons for the Deal's Failure

The termination of the purchase agreement was primarily due to WoodBridge’s inability to satisfy the funding requirements. As stated in a CHS release, certain developments affected the expected proceeds available to WoodBridge from the issuance of publicly offered tax-exempt and taxable bonds. This led to WoodBridge’s inability to secure the necessary financing for the acquisition. WoodBridge officials had retained investment banking firm Zeigler to issue tax-exempt bonds and secure deal funding. However, despite issuing a ‘Highly Confident Letter’ in April, Zeigler was ultimately unable to sell the bonds. This has left the hospitals without a buyer and the future of their operations in doubt.The hospitals in question have been facing financial difficulties. According to the Pennsylvania Health Care Cost Containment Council 2023 fiscal year report, all three hospitals lost substantial amounts of money in fiscal year 2023. Wilkes-Barre General, with 369 beds, was the largest of the three, followed by Regional Hospital of Scranton with 186 beds and Moses Taylor with 122 beds. Expenses outpaced revenues by 24.1% at Moses Taylor, 15.7% at Wilkes-Barre General, and 9.5% at Regional. These financial challenges have made it difficult for the hospitals to attract potential buyers and secure the necessary funding.

Impact on the Local Community

The news of the deal’s failure has been met with disappointment and concern from the local community. Scranton Mayor Paige Cognetti, who herself relied on Moses Taylor for the birth of her two daughters in the past five years, called the news “disappointing and troublesome.” She pointed out that the city’s police and fire departments make many daily trips to the hospital’s Scranton emergency room with people they serve on their beats. The idea of losing this emergency room is a cause for concern. While CHS has not publicly mentioned closing any emergency rooms or other facilities connected with the three hospitals, the company’s pattern of disinvestment raises questions. Since 2020, the company has sold off or announced the sale of dozens of hospitals nationwide, including Berwick Hospital in 2020 and Tyler Memorial in Tunkhannock and First Hospital Wyoming Valley in Kingston in 2022. This pattern has led Mayor Cognetti to assume that CHS is not going to start investing in these hospitals.State Rep. Bridget M. Kosierowski (D-Waverly) has been leading efforts to find new ownership for the facilities. As a nurse and lifelong resident of Lackawanna County, her top priority is ensuring that the healthcare services their community depends on remain accessible and high-quality. She will continue to monitor the situation closely and advocate for solutions that prioritize patient care and the community’s health.

Details of the Hospitals and the Parties Involved

Tennessee-based Community Health Systems Inc. is a publicly traded, for-profit company. Its subsidiaries own or lease 69 affiliated hospitals in 15 states. WoodBridge Healthcare, on the other hand, is a Bucks County-based nonprofit previously described as a “hospital turnaround firm.” The proposed deal with WoodBridge Healthcare was announced in July, but it has now fallen through. The hospitals involved in the deal include Moses Taylor Hospital, Regional Hospital of Scranton, and Wilkes-Barre General Hospital, which operate under CHS’ for-profit Commonwealth Health System. These hospitals provide a wide range of services, including ambulatory surgery centers, emergency departments, imaging centers, laboratories, outpatient rehabilitation, sleep care centers, walk-in clinics, and wound care centers, as well as a physician network. The loss of these hospitals would have a significant impact on the local healthcare system and the community they serve.