Whether healthcare workers – and nurses, in particular – are paid adequately has been a long debate for many years.

“The COVID-19 pandemic and, more recently, the cost-of-living crisis, have brought further attention to the income of nurses, with concerns about whether remuneration is sufficient to attract and retain nurses in the profession,” the OECD’s ‘Health at a Glance 2023’ report warned.

In 2021, while nurses’ salaries were mostly higher than the average wage across Europe, there are some countries, including the UK, where nurses made less than the average worker.

The remuneration of nurses increased in real terms in the decade leading up to the pandemic in most countries. However, this fell in five countries, including the UK.

Recent years have seen a series of nurse strikes taking place across Europe, with organised walkouts significantly increasing in 2022 and 2023.

In the UK, the Royal College of Nursing has already issued further strike notices for January 2024 for members employed by Care Plus Group (CPG).

In Italy, doctors and nurses, calling themselves “the forgotten heroes,” are expected to continue taking to the streets in 2024. They demand better working conditions and pay.

How much do nurses earn per month? How do nurses’ salaries compare across Europe? Which countries pay nurses the most and the least? Have nurses’ salaries improved in the last decade?

The OECD’s recently published report is based on 2021 figures, which are perhaps not completely up-to-date but do provide useful insight to compare European countries.

In 2021, annual gross salaries of nurses ranged from €10,461 in Turkey (€872 per month) to €107,862 in Luxembourg (€8,989 per month). This range demonstrates the huge differences in nurse salaries across Europe in nominal terms.

Besides Luxembourg, the annual gross salaries of nurses were above €50,000 in seven European countries. The EU’s “Big Four” and the UK were not among them.

Nurses in Germany (€46,829, 2018 data) had the highest gross salary, followed by Spain (€38,627), France (€37,508), and Italy (€29,224). This figure was €41,023 (£35,276) in the UK (€3,419 per month).

Purchasing power parity (PPP) is an indicator of price level differences. It shows how many currency units a particular quantity of goods or services costs in different countries.

The use of PPP can “eliminate the effect of price level differences across countries,” according to Eurostat, as it can be used as a currency conversion rate of sorts to convert expenditures expressed in national currencies into an artificial common currency.

This indicates the relative economic well-being of nurses across countries.

Looking at salaries in PPP, the differences compared to nominal salaries decreased, but there are still wide disparities across Europe.

In 2021, nurses’ PPP-based salaries varied from €18,720 in Lithuania (2018 data) to €70,455 in Luxembourg.

The gross income of nurses in Luxembourg was almost four times higher than those working in Lithuania and Latvia.

This figure was also above €50,000 in Belgium and the Netherlands. Germany (€44,100, 2018 data) had the highest PPS-based salary among the “Big Four,” followed by Spain (€39,150), France (€32,400), and Italy (€28,764).

Nurses’ PPS-based salaries were below €30,000 in eight of 21 EU countries. Nurses in Turkey (€29,177), a candidate country to join the EU, were in a better position than seven member states.

At the bottom, Lithuania and Latvia were followed by Portugal, Slovakia, and Greece.

In general, nurses working in Central and Eastern European countries had the lowest levels of remuneration, explaining at least in part why many choose to migrate to other EU countries, according to the OECD report.

Nurses in the UK earn less than average wage

The salary-to-average wage ratio is a useful indicator showing how each profession is paid in each country. In 15 of 25 countries in Europe, nurses’ salaries were above the average wages.

However, in the UK, Switzerland, Finland, and Latvia, nurses made less than the average worker. The ratio of nurse salary to average wage was 0.9 in these countries.

This ratio was 1.5 in Czechia, Luxembourg, Greece and Slovenia, indicating that nurses received 50 per cent more than the average wage.

How did nurses’ salaries change in the last decade?

The nurses’ salaries increased in real terms (when inflation is considered) in the decade leading up to the COVID-19 pandemic in most countries across Europe.

This was particularly the case in many Central and Eastern European countries, including Hungary, Poland, Slovakia, and Czechia, where nurses obtained pay rises averaging 4–5 per cent per year in real terms between 2010 and 2019.

These rises helped to narrow the gap with other EU countries.

Nurses in Turkey and Iceland received considerable pay rises in this period, at 4.9 per cent and 4.7 per cent respectively.

On the other hand, nurses’ salaries fell in real terms between 2010 and 2019 in Greece, Italy, Portugal, Finland, and the UK.

A closer look at nurses’ salaries in the UK

While nurses’ income increased in nominal terms in the UK in this period, it fell by over 3 per cent in real terms “mainly due to public sector pay policies implemented between 2011/12 and 2017/18,” according to the OECD.

Between 2019 and 2021 in the UK, the real average income of nurses increased very slightly following the Agenda for Change pay deal for 2018–21.

The chart below shows the trends in nurses’ salaries in real terms between 2010 and 2020.

It demonstrates how the salaries gradually and substantially increased in Hungary, Poland, Slovakia, and Czechia, whereas they slightly rose in Spain, Belgium, and the Netherlands. It also indicates stagnation in France and a fall in the UK.

The Health Foundation’s ‘Nurses’ pay over the long-term: what next?’ report found that NHS nurses’ basic earnings grew by 13 per cent in nominal terms between March 2011 and March 2021.

However, after accounting for consumer price inflation, this amounts to a 5 per cent reduction in real terms.

Role of COVID bonuses in the pay increases

The OECD report underlined that a large proportion of nurses and other health workers received one-off COVID-19 “bonuses” in 2020 and 2021 in recognition of the frontline role they played during the pandemic.

These lump-sum bonuses have, in most cases, not been included in the regular wages.

Source: https://www.euronews.com/next/2023/12/14/nurses-salaries-across-europe-which-countries-have-the-highest-and-lowest-wages