Do you remember Erna Solberg’s New Year’s speech a few years ago, when she asked Norwegians to have more children?
The reason for the call was that birth rates in Norway have been steadily falling, and she was worried about the sustainability of the whole society.
1,090,000 Norwegians are gone
Recently arrived Statistics Norway with a new report where they looked at the need for health personnel in light of the wave of elderly people.
In this connection, they analyze new calculations on how many people they think will live in Norway in the coming years.
The figures are sometimes very dramatic:
Compared to what Statistics Norway thought as recently as 2018, they now believe that Norway will have 1,090,000 fewer inhabitants in 2100 than they thought less than five years ago. This is even though they now believe that Norwegians will live longer than they thought at the time.
Already in 2040, Statistics Norway has “removed” 170,000 Norwegians, which corresponds to 10,000 people a year.
The fall comes as a result of two things: Norwegian women are believed to give birth on average to 1.7 children, instead of the 1.8 they previously thought. In addition, average net immigration has been adjusted downwards by 6,000 people a year.
– The effect on the overall population of the downward adjustments in fertility and net immigration is stronger than the effect of the elderly living even longer. In 2060, the population will pass 6.1 million, well 0.4 million less than [antatt i 2018]. In 2100, this difference has increased to well over 1 million, writes SSB.
In recent years, birth rates have actually been even lower than this, down to 1.48 in 2020.
We are getting much older
Lower birth rates and the fact that we want to live longer means that Norway’s population is aging relatively quickly.
The graph below shows how population growth in Norway is assumed to level off, while the number of people over 80 will skyrocket.
In 2100, 1 in 6 people in Norway may be 80 or older.
In short, there are more and more people at the top of the population pyramid, while the “pyramid” is now actually moving towards the bottom.
This development has already been going on for some time. Below you can see the change in Norway from 1992 and 2022:
This development will get much worse in the coming years: The proportion of normally working age between 22 and 66 falls significantly. At the same time, the group of pensioners – and especially those over 90 – is increasing massively.
The main challenge with this is that there are fewer and fewer young people to look after more and more elderly people. And the elderly in particular have a much higher need for care than the younger ones.
The graph below shows how the distribution of today health personnel are distributed according to the patients’ age groups. Women around 90 clearly make up most of the total employees, although the group is very small.
In a few years, the group in the most needy group will increase massively.
Things are getting worse, not better
Statistics Norway writes in its report that their findings can easily be misunderstood. They write that it may be “close to believe” that lower population growth than previously thought means that the healthcare system will not need as many employees as previously thought, and that the problem with the wave of elderly people has thus become smaller.
It is, however, a conclusion they warn against:
– The interest (or concern) in the growing need for HO resources (health and care) is to a small extent due to the absolute growth in itself, but to the fact that it will seize a strongly increasing share of both overall employment and total tax revenues , write SSB’s researchers.
– Seen in isolation, the revisions to the population projections after 2018 therefore give a certain reinforcement of the problems that will be encountered over time with a) increasing HO staffing to meet the HO demand, and b) tax financing the HO services that are under the current public provision -for-responsibility.
Statistics Norway has looked at a number of different scenarios for the need for employees in the health and care sector in the coming years.
Need for three times as many health workers
In 2019, there were 314,657 people who worked in health and care in Norway.
Depending on what kind of assumptions are made, Statistics Norway assumes that it will have to increase to somewhere between 500,000 and over one million by 2060.
The exception is if you are actively involved in reducing the resource use of each individual for each and every year in the future.
Need for as much as one million employees in the health sector, and that we have one million people over the age of 80.
And that with a total population of just over six million.
The real bomb
The increase in the number of employees is one thing, but Statistics Norway are clear that things are far more challenging than that number might appear in itself:
Today, around 13 percent of all man-years performed in Norway are within the HO sector. Depending on the assumptions they make, Statistics Norway reports that it could be as high as 39 per cent in 2060.
It is when today’s kindergarten children are around 40 years old.
– Keeping the public man-hours share at around 13 percent in the coming decades will require radical breaks with the historical trends for man-hours per user and public responsibility. It is not in itself a problem that a greater proportion of society’s resources goes to health and care, as a result of the aging of the population and rising living standards. But that may require deprioritizing other benefits, says researcher Erling Holmøy in an SSB article about the report.
– In several scenarios, the population’s desired HO use will require a doubling of the HO sector’s share of total man-years by 2060, from today’s 13 per cent. A tripling cannot be ruled out, SSB states in its conclusion.
This means that 4 out of 10 people who have a job in Norway will have to work in health and care. In practice, all of these will be public servants.
People have to change professions to health and care
Statistics Norway has put this increase in a different context:
In almost all scenarios, the need for employees within health and care is increasing more than growth in the number of people who are assumed to be in work throughout Norway. This means that other workplaces must be closed, to free up more people to look after the elderly.
Statistics Norway refers to this as “reallocation of labour”.
– The increasing proportion of elderly people up to 2060, and the low number of working people, will present challenges related to both staffing and funding if the current offer within the health and care services is to be maintained, says researcher Erling Holmøy.
In particular, the challenge is great in the period between 2040 and 2060, where Statistics Norway mentions that there will be a very high increase in the elderly.
With the option (max) if is close to the historical development, in this period there will be a need for more than 20 times more new employees than will be available in increased labor in the whole of Norway.
The rest must be sourced from other industries.
Even with the reference development, where one assumes that people remain healthier longer and one does not improve the provision for the elderly, there will be a need for almost 6 times more employees than the growth in employment.
In another SSB report which came at the same time, you can see that Statistics Norway believes that the supply of nurses and care workers, even in the most optimistic estimates, is not enough to keep up with the need. And those calculations end when demand is really expected to increase in 2040.
Both reports are part of the Health Personnel Commission’s work, which will be presented in February.
