Poor wages, understaffing and workplace violence are driving healthcare workers out of the profession, according to a recent survey by the federation of trade unions UNI Global Union. This trend threatens the quality of care and the overall survival of healthcare systems, the unions argues.
While (health)care workers were often applauded as heroes during the Covid-19 crisis, five years on, significant issues in the sectors are yet to be addressed by multiple governments and employers, the UNI Global Union highlighted in a press release.
To obtain a snapshot of the situation, the organisation carried out a survey including data from 11,233 (health)care professionals in 63 countries, including Belgium. Despite the global nature of the survey, the UNI Global Union noted "remarkably similar" results.
'Work overtime'
As expected, issues with understaffing were reported in all surveyed countries, with Belgium being one of the leading countries in this regard. Almost 67% of all respondents said they regularly work with insufficient staff members, while 36.4% stated to "always" be short-staffed.
The issue remains one of the causes of high turnover rates in the sector, the report highlighted. "Staff cannot take a break to eat. We have to work overtime and are allowed to return to work early the next day, resulting in insufficient sleep," reads the testimony of a nurse at a Belgian hospital.
Patient waiting at a hospital. Credit: Belga/Dirk Waem
Such work environments have significant consequences for the well-being of workers. Around 66% of workers have at least one sleep-related issue, with just over half (52.2%) reporting to have experienced "exhaustion" due to their profession. Additionally, 56.3% of respondents reported that their job has caused them to develop anxiety, depression or burnout.
However, understaffing does not only take a toll on workers, it can also impact the quality of care. Around two-thirds of the survey respondents said that a lack of staff has caused a decrease in the quality of care.
In some facilities, patient treatment is impacted by time restrictions put in place to address staff shortages, the report noted. "Nine minutes to take care of a human? That means washing, dressing, styling, brushing or 30 minutes to feed 10 people," read a testimony by a caregiver in Belgium.
Violence and harassment
Workplace violence and harassment were reported by most survey respondents. Nearly three-quarters of workers reported having experienced or witnessed harassment or violence. Almost a quarter reported witnessing or experiencing this monthly.
In Belgium, the topic gained media attention last year, after a nurse was punched by a patient's daughter at a hospital in Hainaut, Wallonia. Last month, a campaign to tackle the issue was launched in Brussels and Flanders, amid multiple reports of hospital workers claiming to have been exposed to aggressive behaviour at work.
Marie Curie hospital in Belgium, in December 2024. Credit: Belga/Nicolas Maeterlinck.
The UNI Global Union report noted that harassment and aggression were more frequently experienced by immigrant healthcare workers.
For some survey respondents, short-staffing worsens the situation: "Due to a shortage of staff, too much of our structure is missing for these residents, causing them to respond differently to people. This sometimes results in aggression, because non-permanent employees do not know our residents well enough," said a caregiver in Belgium.
Underpaid and undervalued
Over half of survey respondents (62.6%) were unsatisfied with their pay. Workers who felt unsatisfied with their pay were increasingly more likely to believe that their profession was not sustainable until retirement age.
Another significant commonality in the thousands of respondents was the reported "systematic undervaluing of health and care work" which impacted the lives of professionals in the sector, during and outside of work. The UNI Global Union report indicated that workers at hospitals and care homes were disappointed and disillusioned with healthcare policies at a governmental level.
In a testimony included in the report, a nurse in a Belgian care facility for the elderly expressed being "very disappointed for the future of our profession, given all the changes that the government wants to put in place."
Wake-up call
Although training new workers and recruiting migrants to increase the workforce is beneficial, it will not solve the issue in the long run, according to the Head of Care for UNI Global Union, Alan Sable. "Unless we address the core issues driving people out of the sector...the cycle of worker shortages and declining care quality will continue."
Sable added that the shortage of workers is often a misunderstood situation."There is no shortage of care workers. There is a shortage of care workers willing to endure low pay, chronic understaffing, and unsafe conditions."
Nurse walking with a patient. Credit: Belga/Dirk Waem
The union calls for governments and employers to increase wages and benefits, implement violence prevention policies, and improve healthcare staffing through initiatives such as patient-to-worker ratios.
The organisation further calls for working conditions, in general, to be addressed, and for the expansion of union memberships, as a measure to increase the sustainability of the profession.
"This report is a wake-up call. Without immediate action to raise wages, improve staffing levels, and combat workplace violence, care systems will collapse," warned the General Secretary at UNI Global Union, Christy Hoffman.
About the survey
UNI Global Union represents workers from multiple sectors in over 150 different countries. Their research included responses from 11,233 healthcare workers across 63 countries. In Belgium, 155 people participated in the survey.
The majority of respondents (66.8%) worked at a public or private hospital. Workers from other care facilities such as elderly care (11.4%) or mental healthcare (6.2%) were also included. Data was gathered between 6 January 2025 and 3 February 2025. The study received support from the Ford Foundation and the Care Fund.
