Maintaining an overview of employment and mobility in the health and care sector is crucial, especially in light of a constantly increasing need for such services in the popu-lation. This increase is the result of an ageing population, but there is a growing need for such services even among young people. It has been estimated that by 2040, the need for new positions in the health and care sector will increase by 14 000 to 123 000 (NOU 2023: 4).
In this report we describe features of the employment situation in the health and care sector in the period from 2015 to 2023. We review the employment trend in the sector (Chapter 2), total mobility into, within and out of the sector (Chapter 3), and mobility in various occupational groups (Chapter 4).
Through presentation of fairly substantial statistical data we wish to elucidate the fol-lowing questions:
1. What occupations and service areas are growing quickly and slowly, respectively?
2. What is the extent of mobility in the health and care sector?
a) Are there any specific occupations, age groups and job categories that stand out in terms of having high or low mobility?
b) What does the flow of mobility look like?
3. Have the scope and flow of mobility changed in recent years?
Health and care service employees
The Norwegian labour market has grown by eleven per cent over the last eight years. In the primary health services and the municipal home-based nursing and care services, growth has exceeded this level. Total employment in the institution-based services has fallen.
The number of employees in the municipal health and care services increased from a little more than 208 000 in 2015 to more than 230 000 in 2023. In that year, the majority worked in the nursing and care services, and among these, the home-based services with their 117 000 employees constituted the largest group. Institution-based municipal health and care services employ a total of 79 000 workers. The municipal nursing and care services are one of Norwayʼs most female-dominated industries. In 2015, alto-gether 87% of the employees in this sector were women, falling to 82% in 2023. The average age is 41 years, somewhat higher among women and somewhat lower among men. The proportion of young workers is highest in the nursing and care services and lowest in the hospitals.
Total mobility
In Norway, approximately one in every four employees leave their current job every year. In 2022, mobility in the municipal health and care services was somewhat higher, at nearly 27 per cent in the primary healthcare service and over 28 per cent in the nurs-ing and care services.
The mobility rate was somewhat higher in 2022 than in 2015, meaning that leaders and employees switch jobs more often than before. Part-time employees are approximately twice as mobile as full-time employees (Table 3.2). The same applies to young
employees compared to those who are older, and to employees with no formal training in health care and social work compared to those who have such training.
Even though many older employees retire, their mobility rate is less than half that of younger employees.
Mobility by age, sex, education and FTE percentage
Employees who are male, young, have little education and work part-time have the highest rates of mobility.
Age is the variable that has the strongest impact on mobility. Employees younger than 30 years are more than twice as mobile as those older than 50. This applies in the health and care sector as well as in the labour market in general.
In the labour market as a whole, part-time employees have twice the mobility rate of full-time employees. In the health and care sector, with its strong culture of part-time work, the difference in mobility between these groups is somewhat less.
A comparison of mobility in the different service areas has shown that the hospitals have the most stable workforce.
Mobility and change of workplace
When examining different occupational groups, a pattern emerges: mobility increases with falling levels of education.
Approximately half of the mobile employees in the municipal health and care services change to a new employer in the same sector, while one in four leave the sector and one in four leave the labour market. Among those who stay in the sector, a large propor-tion choose to stay in the same service area. For example, 27 per cent of those who left the home-based services in in 2022 changed to another job in the home-based ser-vices in 2023. Between 40 and 50 per cent of those who left the municipal services went to other health and social services or embarked on further training. In addition, many moved into public administration, and some to retail trade.
Approximately half of the mobile employees in the municipal services changed to a job in their home municipality. Almost as many found a new job in another municipality. Most of them remained living in the same place after switching jobs; only one in ten moved to another municipality.
Mobility within occupational groups
Leaders
The number of employees in leadership positions in the municipal services has in-creased more than in the labour market as a whole. Leaders have below-average mobil-ity. On the other hand, the approximately 20 per cent mobility among leaders in munici-pal health and care services is somewhat higher than that among leaders in other in-dustries. Leaders in the municipal services, especially in the nursing and care sector, take up new leadership positions more frequently when compared to leaders in other industries.
Doctors
In the period 2015–2023, the number of doctors in the primary healthcare service in-creased, whereas it declined in the nursing and care services. The mobility of doctors in municipal services is 40 to 60 per cent higher than that of their colleagues in the hospi-tals (26 per cent), although much of this mobility is between the hospitals and the mu-nicipal services.
Nurses
In 2023, more than 40 000 nurses were employed in municipal services. Relatively speaking, the increase was greatest in the primary healthcare service, but there were still more nurses in the health and care services. Nurses in the municipal services had a mobility rate slightly above 20 per cent in 2022. With the exception of nurses in the home-based services, mobility was somewhat lower in 2015. Nurses who changed jobs most frequently – almost three in every ten cases – went to a new job in the same ser-vice area. Approximately one in every five nurses were gainfully employed, but not working as a nurse.
Social educators
More than 12 000 social educators were employed in municipal services in 2023, the vast majority of whom were in the home-based services. However, all service areas employ more social educators today than in 2015. The mobility among social educators has varied to some degree, but in 2022 nearly three in every ten social educators in the municipal services were mobile, somewhat less in the home-based services.
Nursing associates
The number of nursing associates in the municipal services changed little from 2015 to 2023. In 2023, the majority worked in the nursing and care services, mostly in the home-based services. Nursing associates in general had a mobility rate of nearly 22 per cent, both in 2015 and 2022, although at a somewhat higher level in the course of this period. The highest mobility was found among nursing associates who were not em-ployed by municipal services or hospitals, while those employed by hospitals or munici-pal institutions had the lowest mobility rate.
Workers with no formal training in health care or social work
In 2023, a total of 72 530 persons were employed in occupations that require no train-ing in health care or social work, often referred to as ‘unskilledʼ. Of these, 81.6 per cent worked in municipal nursing and care services, the vast majority as healthcare assis-tants. Mobility has remained high among the unskilled throughout the period, with somewhat less than 40 per cent in 2015 and a little higher in 2022.
General practitioners changed jobs most frequently in 2022, followed by in-home care-givers, care assistants and psychologists. The high levels of mobility seen among doc-tors in the municipal sector are only matched by young, unskilled part-time workers.
Leaders and nurses have the highest employment stability. Overall, the gender differ-ences are minimal.
