The UK’s National Health Service (NHS) will see its biggest strike on Monday when ambulance workers join nurses in pickets in England.
It comes after tens of thousands of nurses across the UK went on strike on 15 and 20 December. These were the first strikes in the 106-year history of their union, the Royal College of Nursing (RCN), and were then the largest in the history of the NHS to date.
Data on wages and inflation suggest this shouldn’t come as a surprise. Annual gross salaries of hospital nurses in the UK increased by 10% in nominal terms but fell by 6% in real terms between 2010 and 2019, according to a dataset published by the Organization for Co-operation and Development economic (OECD).
The UK isn’t the only country where health workers went on strike in 2022.
In Spain, thousands of health workers, including doctors working in emergency services, went on strike in November. In addition to a dramatic increase in their salaries, they required more staff and more resources.
In France, health workers joined protests in several cities in June with similar demands. Doctors in Germany went on strike in March.
In Turkey, health workers went on strike in March for better wages and working conditions. They also took to the streets in several Turkish cities in July to demand more action to prevent violence after a cardiologist was killed by a patient’s relative.
According to the Turkish Medical Association, thousands of Turkish doctors have left their jobs to work abroad over the past decade. Mostly they prefer to move to western countries, especially Germany.
Healthcare personnel, especially hospital nurses, have been working around the clock during the COVID-19 pandemic. In many European countries they are demanding better wages, better working conditions and more resources.
How much are nurses paid in Europe? Which countries pay nurses the most and least, and how much have nurse salaries changed over the past decade?
There are significant differences in nurse salaries across Europe.
In 2020 or the closest year with available data, official annual gross salaries in hospitals ranged from around €11,880 in Lithuania to €101,151 in Luxembourg, according to the OECD. The data set includes 25 European countries.
Annual gross salaries of nurses (2020)
Apart from Luxembourg, the annual gross starting salary was above €50,000 in seven countries. Germany (€46,829) and the United Kingdom (€42,588) are not among them, according to OECD data.
Nurses in France and Italy earn half of what they earn in Belgium and Switzerland
The annual salary of a nurse in France (€35,531) or Italy (€29,222) was less than half the annual salary in Belgium (€72,508) and almost exactly half that in Switzerland (€70,965).
With the lowest salaries for nurses, Lithuania (€11,880) is followed by Turkey (€12,172) and Latvia (€13,551).
Wages and purchasing power parity
The ranking changes if we look at wages in terms of purchasing power parity (PPP). PPP is an indicator of price level differences. In other words, it reveals how many units of currency a given amount of goods or services costs in different countries.
The use of PPP can “eliminate the effect of price level differences between countries”, according to Eurostat as it can be used as a kind of currency conversion rate to convert expenditure expressed in national currencies into a common currency artificial.
In 2020, PPP-based salaries of nurses ranged from €18,700 in Lithuania to €66,800 in Luxembourg. The average across the 20 EU countries was €35,300. Although the PPP gaps between countries are smaller than the differences in nominal wages, they still vary significantly.
Belgium (€62,300) and the Netherlands (€50,600) follow Luxembourg in terms of higher PPP-based wages. At the bottom, Lithuania is followed by Latvia (€18,800) and Portugal (€21,400).
Annual gross salaries of nurses in terms of purchasing power parity (2020*)
In Finland (€31,200), the PPP-based salary of nurses was lower than the EU average.
Surprisingly, Turkey (€31,700) had a higher PPP-based salary for nurses than several EU countries such as Finland, Italy and Greece.
Nurses are paid less than the average wage in France
The ratio of nurse salaries to median salaries in each county is also a useful indicator. The average wage in a country is based on the total wages paid and the average number of employees in the total economy.
In 2020, the ratio of a nurse’s salary to the average salary ranged from 0.88 in Lithuania to 1.58 in Belgium. This means that nurses in Belgium earn 1.58 times more than the country’s average wage. This ratio averaged 1.2 for 20 EU countries.
In Finland, Latvia, France, Switzerland and Lithuania, nurses are paid less than the country’s average wage. The ratio of a nurse’s salary to the average salary was 0.91 in France and 0.88 in Switzerland. The ratios were highest in Spain (1.5), the Czech Republic (1.42) and Poland (1.36).
Ratio of nurse salaries to average wages
How have nurse salaries changed over the past decade?
The nominal change in annual gross salaries of nurses between 2010 and 2020 was the highest in Iceland, where salaries have increased by 123% over the past decade. Nominal variation refers to the values obtained when inflation is not taken into account.
Some EU Member States, such as Hungary (104%), Estonia (94%), the Czech Republic (92%) and Slovakia (91%) also recorded notable increases over this period.
Nominal changes in nurse salaries in euros between 2010 and 2020
Nurse salaries decreased in three European countries between 2010 and 2020: Norway (1%), Italy (4%) and Greece (16%). In Norway, the decrease was caused by changes in the exchange rate.
Change in real terms: decline in the United Kingdom and stagnation in France
The change in real terms is more significant as it takes into account inflation. Among the nine countries selected, wages increased in real terms in seven countries between 2010 and 2020 (Hungary, Slovakia, Poland, the Czech Republic, the Netherlands, Spain and Belgium). However, they fell by 6% in the UK over this period (2010-2019) and did not change in France.
Changes in nurse salaries in real terms* between 2010 and 2020
A closer look at the UK
If we take a closer look at the UK, the figures show that nurses’ salaries decreased in real terms while nominal salaries increased between 2010 and 2019. Nominal salary and real salary were equal in 2010 at 100 points. The nominal salary then steadily increased, reaching 110 points in 2019. However, taking into account inflation, the real salary progressively decreased until 2017, reaching 93 points, and increased by only one point in 2019.
Annual Gross Salaries of Nurses in the UK: Nominal Salary and Real Salary
This figure reveals that annual gross salaries of hospital nurses in the UK increased by 10% in nominal terms, but fell by 6% in real terms between 2010 and 2019.