Spain: Healthcare Workers - National Policies

Density of medical doctors (per 10,000 population), 2015-2023: 42.94
Density of nursing and midwifery personnel (per 10,000 population), 2016-2023: 64.06
Density of dentists (per 10,000 population), 2016-2023: 6.03
Density of pharmacists (per 10,000 population), 2015-2023: 12.29

Source: World health statistics 2025: monitoring health for the SDGs, Sustainable Development Goals. Tables of health statistics by country and area, WHO region and globally. Geneva: World Health Organization; 2025. Licence: CC BY-NC-SA 3.0 IGO.

Hospital workforce per 1,000 population, 2021
– Physicians: 2.57
– Nurses and midwives: 4.01
– Healthcare assistants: 3.07
– Other health service providers: 1.2
– Other staff: 3.33
Practicing doctors per 1,000 population, 2021: 4.5
Medical graduates per 100,000 population, 2021: 14.2
Practicing nurses per 1,000 population, 2021: 6.3
Nursing graduates per 100,000 population, 2021: 23.0
Ratio of nurses to doctors, 2021: 1.4
Practicing pharmacists per 100,000 population, 2021: 126
Community pharmacies per 100,000 population, 2021: 47
Remuneration of doctors, ratio to average wage, 2021
– General Practitioners
– Salaried: 2.4
– Specialists
– Salaried: 2.7
Remuneration of hospital nurses, ratio to average wage, 2021: 1.4
Remuneration of hospital nurses, USD PPP, 2021: $54,000
Long-term care workers per 100 people aged 65 and over, 2021: 4.9
Share of informal carers among the population aged 50 and over, 2019
– Daily carers: 8%
– Weekly carers: 4%
– Total: 12%
Share of long-term care workers who work part time or on fixed contracts, 2021
– Part-time: 22.8%
– Fixed-term contract: 30.5%
Average hourly wages of personal care workers, as a share of economy-wide average wage, 2018
– Residential (facility-based) care: 63%
– Home-based care: 60%

Source: OECD (2023), Health at a Glance 2023: OECD Indicators, OECD Publishing, Paris, doi.org/10.1787/7a7afb35-en.

“The estimated number of physicians in Spain was 4.5 per 1 000 population in 2021, which is higher than the EU average of 4.1 per 1 000 (Figure 10). While the share of physicians who practise as general practitioners (GPs) increased slightly between 2020 and 2021 (from 20 % to 21 %), this remains lower than in 2018, when the share peaked at 22.2 %. The number of nurses in Spain has also been rising but, at 6.3 nurses per 1 000 population, remains below the EU average of 8.5 per 1 000 (see Section 5.2). However, the number of nurses for Spain counted within statistics does not include nurse assistants, who perform similar tasks to nurses in other European countries.”

Source: OECD/European Observatory on Health Systems and Policies (2023), Spain: Country Health Profile 2023, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.

“The number of physicians in Spain exceeds the EU average (see Section 4), but there are worrying trends in the health workforce. Both the rate of medical graduates (14.2 per 100,000 population) and the rate of nursing graduates (23 per 100,000) in Spain were below EU averages in 2021 (17.5 per 100,000 medical graduates and 44.3 per 100,000 nursing graduates) (Figure 19). However, nursing assistants are not included in these figures, so this under-estimates the number of new graduates from nursing-related programmes. Following a continuous decline between 2014 and 2018, the rate of nursing graduates in Spain has slightly risen from 2019 onwards. As the population ages and the burden of chronic conditions continues to grow (see Section 2), there are threats of shortages, particularly of nurses and specialist practitioners nationwide, and of GPs and paediatricians in remote areas of the country.

The share of temporary employment contracts has contributed to healthcare staffing challenges.

“In the SNS, the issuing of temporary contracts increased from 28.5 % in 2012 to 41.9 % in 2020. In efforts to reverse this trend, in July 2022, the government took measures to reduce temporary employment in the SNS through a process – the largest in the history of the system – leading to the employment of 80,000 health professionals. This process also provides a new legal framework that places limits on temporary work through modification of the Framework Statute for Health Personnel.Specific measures to address shortages in certain medical specialities include increased vacancies in the MIR specialisation programme and in nurse training places (see Section 5.2).”

“The number of doctors per 1,000 population in Spain is slightly above the EU average (see Section 4), but the distribution of physicians and nurses has persistently varied across ACs. Across the ACs in 2020, the number of primary care physicians ranged from 0.6 to 1.1 per 1,000 population while the number of primary care nurses ranged from 0.5 to 0.9 per 1,000. The number of specialist doctors varied from 1.5 to 2.6 per 1,000 population, and the number of specialist nurses ranged from 3.0 to 6.9 per 1,000.”

“New legislation adopted in 2018 expanded the role of nurses with the required qualifications to allow them to prescribe medicines and vaccinations included in the official vaccination calendar, with a view to improving access to care for the population and enhancing the career prospects of nurses. The new law also clarified the accreditation requirements for nurses to be able to perform these more advanced roles.”

Source: OECD/European Observatory on Health Systems and Policies (2019), Spain: Country Health Profile 2019, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.

“According to the latest figures, the primary health care workforce has remained stable since 2010. Regarding primary health care physicians and nurses, figures in 2014 slightly exceeded those in 2010 – from 75 to 76 physicians per 100,000 assigned insurees and from 62 to 65 staff nurses per 100,000 assigned insurees. The same observation is applicable to other specialist physicians working in hospitals and outpatient specialized settings; specialist physicians have increased from 176 per 100,000 inhabitants in 2010 to 189 per 100,000 inhabitants in 2014. In turn, staff nurses working in hospitals and specialized outpatient premises have remained stable at 320 staff nurses per 100,000 inhabitants (MSSSI, 2017b).”

Source: Bernal-Delgado E, García-Armesto S, Oliva J, Sánchez Martínez FI, Repullo JR, PeñaLongobardo LM, Ridao-López M, Hernández-Quevedo C. Spain: Health system review. Health Systems in Transition, 2018;20(2):1–179.

“The most recent data on the mobility of health workers reflects the situation in 2011. At that time, 9.4% (of the 207,042 doctors) had been trained in foreign countries, most of them in Latin America, Germany and Italy. With regard to nurses, 2.1% (of 250,277) had been trained abroad, basically, Latin America, Portugal and Romania (OECD, 2017c).

“In the aftermath of the economic crisis, the budgetary and personnel reduction policies translated into an increasing outflow of doctors and nurses seeking employment abroad. The SNS [National Health Service] as a single employer was not able to absorb the number of health workers trained in the country, and the rate of unemployment rose in the health sector. As indirect evidence from the Medical Council, the number of physicians requesting a “competence certificate”, which is required to work in other EU countries, has increased up to 2016: 1,380 physicians in 2011; 2,405 in 2012, 3,279 in 2013; 3,300 in 2014; 2,917 in 2015 and 3,500 in 2016 (Medical Council Organization, 2017). However, many doctors ask for their competence certificate but do not then move so the exact number of migrant physicians is unknown. As countries of destination, physicians looked for employment in the United Kingdom, France, Germany, Ireland and Belgium (Medical Council Organization, 2017). Similar behaviour was observed in the case of nurses; between 2010 and 2013, 4,580 nurses requested their “competence certificate” from the Ministry of Education; in 2014, 8,000 nurses were working abroad. In this case, main destinations were the United Kingdom, France, Italy, Portugal and Belgium (Galbany-Estragués & Nelson, 2016).”

Spain: Healthcare Workers - National Policies - World Health Systems Facts

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Page last updated June 23, 2025 by Doug McVay, Editor.