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 "I am a big defender of Spain's health system, but workers there are
not treated well enough," he said, explaining that he had felt
professionally thwarted back at home.
Like Iglesies, thousands of doctors and nurses have left Spain in
the past decade, exasperated by austerity cuts in the health system
and seeking better pay and prospects abroad.
It is a similar story in Italy and Portugal, two other southern
European nations that slashed budgets in response to the financial
crisis and are paying the price as a second wave of coronavirus hits
the continent and puts hospitals under enormous strain.
The pandemic hit Italy and Spain especially hard, with the two
countries registering 47,217 and 42,039 deaths respectively.
Portugal was largely spared in the spring, but now has record
numbers of COVID patients filling intensive care units.
"Coronavirus has made the situation worse because the workload has
increased significantly," said Carlo Palermo, head of Italy's
ANAAO-ASSOMED doctors' union.
In 2019, Spain had a shortage of more than 4,000 public doctors,
according to a study by Las Palmas University requested by the
Health Ministry.
It was expected to rise to around 7,000 in 2020 but the figure could
be higher still due to the pandemic, said co-author Patricia Barber.
The CGIL union in Rome estimates that Italy needs an extra 15,000
specialist doctors.
Governments are hurriedly trying to fill the gaps, but it is proving
difficult.
MONEY MATTERS
Italy is pushing medical students onto the frontline and trying to
entice retired doctors back to the wards. The southern region of
Campania advertised this month for 450 doctors and used state
television to broadcast nationwide appeals for help.
It only received 165 applicants.
In Spain, the government has allowed regions - which manage
healthcare - to temporarily hire some 10,000 additional health
workers, mainly graduates and professionals from outside the
European Union.
But while Barcelona's Sant Pau Hospital has the budget to open new
intensive care wards, it cannot find highly qualified people to
staff them all.
"There's not enough trained people and the existing ones are very
tired," said its medical director Xavier Borras.
Borras' lament carries little weight with Lluis Enseñat, 35, who
moved to France in 2017, where he works in the intensive care unit
of a hospital in a Paris suburb. His 5,500-euro net monthly salary
more than doubles what he earned in Barcelona.
"(The authorities) should not be moaning because these people left
after they were offered crappy contracts," he said.
Money is a major factor in many moves abroad.
Anna Dalmau, a 29-year-old family doctor in Barcelona, thinks she
will leave next year, doubtful that conditions will improve despite
a string of recent strikes aimed at putting pressure on the
government.
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"For me, it's like a moral obligation to leave," she said, adding that she had
seen job offers in southern France that would more than double her 2,000-euro
gross monthly wage.
Francesco Staltari, 29, from Calabria in southern Italy, emigrated to Germany in
2014 and works as a nurse in Hamburg.
The basic salary is at least 2,000 euros a month, before overtime and night
bonuses, he said. At home, the average salary for a nurse is 1,400 euros,
Italy's Nursing Up union says.
"I would never go back to Italy," said Staltari. "Here they offer you free
training courses and in Germany we are generally very respected both socially
and in the hospital."
TEMPTING OFFERS
Even before the virus struck, Europe's southern nations were short of nurses.
In a 2019 report, the Organisation for Economic Co-operation and Development
said Italy and Spain had just 5.8 nurses per 1,000 inhabitants and Portugal 6.7
compared with 12.9 in Germany and an average of 8.8 amongst major industrialised
nations.
The Nurses General Council in Madrid estimates that Spain needs as many as
150,000 nurses to come into line with the European Union average.
Between 2010 and 2019, close to 75,000 Spanish nurses were registered working in
nine foreign countries, it said.
Antonio De Palma, the head of Nursing Up, said Italy needed about 60,000-65,000
nurses.
"The optimal ratio between nurses and beds should be 1-to-6. In Italy it has
reached peaks of 1-to-17," he said, denouncing some local health authorities for
relying heavily on part-time workers who had no job security and were paid as
little as 16 euros an hour.
Portugal's Order of Nurses says some 18,000 Portuguese nurses work abroad,
mostly in Britain.
Their importance to the British National Health Service was highlighted in April
when Prime Minister Boris Johnson publicly thanked a Portuguese nurse for his
care after he was hospitalized for COVID.
The Portuguese Order says 30,000 nurses are needed at home to help deal with the
coronavirus crisis, but has warned about a spike in requests from other EU
nations looking to attract their members, including from the Netherlands, which
was offering bigger salaries, accommodation, transport and language courses.
"We cannot continue to buy ventilators and export nurses," said Ana Cavaco, head
of the order.
(Additional reporting by Catarina Demony in Lisbon; Editing by Ingrid Melander,
Crispian Balmer and Mike Collett-White)
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