Health and social care workforce

Employment in health and social care represents a large and growing share of the labour force in many countries across the world (UN High-Level Commission on Health Employment and Economic Growth, 2016). In the OECD, health and social work activities constituted around 10% of total employment on average in 2015 (Figure 8.1). The employment share is particularly pronounced in the Scandinavian countries, Finland and the Netherlands, where jobs in health and social work represent 15-20% of these countries’ workforces.

8.1. Employment in health and social work as a share of total employment, 2000 and 2015 (or nearest year)
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Source: OECD National Accounts; OECD Annual Labour Force Statistics for Iceland and Turkey.

 http://dx.doi.org/10.1787/888933604533

Moreover, the percentage of workers employed in health and social work has steadily risen across much of the OECD between 2000 and 2015. For the OECD overall, there was an average percentage point increase of 1.7 from 2000 to 2015. Some of the greatest increases have taken place in Japan, Ireland, Korea, Luxembourg and the Netherlands. Four countries experienced a decrease in share of employment in health and social work: Latvia, Mexico, Poland and the Slovak Republic.

The rapid employment growth in health and social care contrasts markedly with the experience in other sectors (Figure 8.2). Across the OECD, employment in health and social work grew on average by 42% (with a median value of 34%) between 2000 and 2015. Over the same time period, there was an overall decline in the number of jobs in agriculture and industry in the OECD countries. Employment growth in health and social work was also noticeably higher than employment growth in the services sector, and was significantly above the growth in total employment.

8.2. Employment growth by sector between 2000 and 2015 (or nearest year), OECD average1
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1. Average of 30 OECD countries (excluding Chile, Iceland, New Zealand, Switzerland and Turkey).

2. Health and social work is classified as a sub-component of the services sector.

Source: OECD National Accounts.

 http://dx.doi.org/10.1787/888933604552

Past and current experiences show that employment in the health and social sector tends to be less sensitive to cyclical fluctuations than employment in other sectors in the economy. While the total employment declined slightly in the United States during the economic recessions of the early 1990s and significantly in 2008-09, employment in the health and social sector continued to grow steadily over this same period. In most OECD countries, the number of doctors and nurses continued to rise through the recession period (see indicators on doctors and nurses).

Looking forward, employment in health and social care sector is likely to increase, but the type of skills and functions are expected to change. This reflects a number of factors. Ageing populations will change the pattern of demand for health and social services. This could include greater demand for long-term care and related social services, which are particularly labour-intensive (OECD, 2011). Over time, rising incomes and availability of new technologies will raise expectations on the quality and scope of care (OECD, 2015).

Many countries have also started to introduce new care delivery models that will involve greater integration of health and social services in order to meet the needs of ageing societies. These changes are expanding the roles of non-physician providers (such as nurse practitioners and pharmacists and community health workers) into health care, aimed at maintaining access to services and increasing the productivity of the health workforce, as well as improving the continuity and quality of care for the patients. These changes will likely lead to significant transformations in staffing profile and skills requirements in the health and social care sector.

Definition and comparability

Health and Social Work is one of the economic activities defined according to the major divisions of the International Standard Industrial Classification of All Economic Activities (ISIC). Health and Social Work is a sub-component of the Services sector, and is defined as a composite of human health activities, residential care activities (including long-term care), and social work activities without accommodation. The employment data are taken from the OECD National Accounts (SNA) database for the 35 OECD member countries, except for Iceland and Turkey where the source is the OECD Annual Labour Force Statistics (ALFS) database.

References

OECD (2016), Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places, OECD Publishing, Paris, http://dx.doi.org/10.1787/9789264239517-en.

OECD (2015), Fiscal Sustainability of Health Systems: Bridging Health and Finance Perspectives, OECD Publishing, Paris, http://dx.doi.org/10.1787/9789264233386-en.

OECD (2011), Help Wanted?: Providing and Paying for Long-Term Care, OECD Publishing, Paris, http://dx.doi.org/10.1787/9789264097759-en.

UN High-Level Commission on Health Employment and Economic Growth (2016), Working for Health and Growth: Investing in the Health Workforce, Geneva, WHO. Retrieved from http://www.who.int/hrh/com-heeg/reports.