Italy trains nurses, but it is Europe that recruits them – and it does so ever earlier and ever faster. According to an investigation by Nursing Up, foreign countries no longer wait for graduation but target nursing students directly at university, turning Italian training into a pool for early recruitment.
A mechanism that in practice shifts abroad the value created in Italy: universities do the training, the national health service makes the investment, but it is foreign hospitals that reap the benefit of fully trained professionals.
“We are Europe’s training cash machine: we pick up the bill, others cash in by taking our professionals,” says Antonio De Palma, president of Nursing Up, summing up a trend that is increasingly evident across international healthcare.
The cost to Italy: over 200 million a year in human capital
The financial impact is just as striking. Training a nurse costs the state around €30,000. If around 6,000 to 7,000 professionals leave the country every year, the “gift” to other countries exceeds €200 million annually.
All this is happening in an already fragile context: Italy is estimated to be short of around 175,000 nurses, with one of the lowest ratios of nurses to population in Europe.
And it is not only a question of numbers. The problem is also economic and linked to attractiveness: Italian salaries are among the lowest in the OECD area, more than 9,000 dollars below the average.
Abroad, triple salaries and full welfare
The investigation highlights increasingly aggressive recruitment programmes aimed directly at university students.
In Germany, for example, schemes such as Germitalia offer students board, lodging and language courses while they are still studying, with starting salaries of between €2,400 and €2,600 gross which, once their qualification is recognised, can rise to €3,300 to €3,800 and exceed €4,000 with allowances.
In Norway offers can reach around €3,500 net per month, combined with a comprehensive welfare package that covers housing, bills and even flights. Pay is even higher in Switzerland, where in the Zurich and Basel areas monthly salaries reach 5,000 to 6,500 francs, equivalent to up to around €6,700.
The comparison with Italy is stark: here a nurse earns on average between €1,500 and €1,700 a month and has to cover housing costs alone, making the gap in pay and conditions increasingly hard to bridge.
The deeper causes: low pay and a system under strain
The exodus is not driven by pay alone. According to various analyses, including those by the Gimbe Foundation, other factors include:
- heavy workloads
- chronic staff shortages
- poor career prospects
These factors are making the profession increasingly unattractive to young people, while the number of resignations and moves abroad continues to grow. The trend is also part of a wider crisis: all of Europe is suffering a shortage of nurses, but the stronger countries are managing to plug the gaps by recruiting precisely from countries like Italy.
Italy’s paradox: exporting nurses and importing replacements
The national health service thus finds itself facing a paradox: while it trains professionals who then emigrate, it is forced to look abroad for staff to fill the gaps. Several regions have launched recruitment programmes in non-EU countries, from Latin America to Central Asia, in an attempt to contain the emergency.
In Lombardy projects have been launched to bring in around 3,000 Uzbek nurses and, in the past, initiatives such as the Magellano project brought in South American staff after just four weeks of Italian language courses.
At the same time, regions such as Lazio, Veneto, Calabria and Puglia have organised recruitment missions in countries such as Chile, Peru and Cuba, with the aim of addressing structural shortages through professionals trained outside the European Union.
A strategy which, however, according to Nursing Up, does not solve the structural problem and risks making it worse. The consequences could be far-reaching. The shortage of nurses has a direct impact on the quality of care and on the resilience of the public system.
Italy already has fewer nurses per inhabitant than the European average, and the gap risks widening even further in the coming years. The danger, De Palma warns, is a gradual “bleeding dry” of the national health service, which is unable to retain its own expertise.
The union’s demand is clear: invest in Italian nurses, starting with pay and working conditions.
“Foreign stopgaps are not what we need,” concludes De Palma, “but serious policies to value those we already have.”
