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Why does Denmark take so long to authorise foreign medical professionals?

Denmark on Monday announced funding to speed up processing times for authorising the qualifications of foreign health professionals. But how long do authorisations actually take, and why is the process so slow?

Aalborg University Hospital. Denmark has announced spending to speed up the glacial speed of authorisation for foreign health professionals who apply to work in Denmark.
Aalborg University Hospital. Denmark has announced spending to speed up the glacial speed of authorisation for foreign health professionals who apply to work in Denmark. Photo: Henning Bagger/Ritzau Scanpix

With Covid-19 case counts and hospitalisations on the climb, Danish healthcare workers have issued a call for reinforcements from foreign doctors and nurses.

But there are hundreds to thousands of qualified healthcare professionals already in Denmark, unable to practise due to long waiting times for the Danish Patient Safety Authority (Styrelsen for Patientsikkerhed, STPS) to certify their qualifications.

On Sunday, political parties agreed on a “winter package” for next year’s budget that includes 11.3 million kroner in 2022 and 11.8 million in 2023 to bring the processing times down.

This is a dramatic step up from the figure of 1.5 million kroner proposed by health minister Magnus Heunicke on November 23rd.

“We think it is reasonable that there are language requirements, and it must be determined whether they are skilled enough to be doctors in Denmark, but it makes no sense that people should wait for one to two years to get their case decided,” Andreas Steenberg, finance spokesperson for the Social Liberals (Radikale Venstre), one of the parties behind the budget, told news agency Ritzau in early December.


Applicants from outside the EU and EEA

Currently, it takes an average of 33 months for STPS to review the qualifications of doctors or dentists from outside the EU, the agency told The Local in written responses and over the phone. Even after those 33 months, they can’t practise—the rubber stamp from STPS is the first step in a long process that involves specialised Danish language courses, medical tests, and courses in Danish health law.  

STPS is currently processing applications submitted in February 2019—since then, the agency has received an estimated 1,184 applications from doctors outside the EU and EEA.

For nurses, currently in high demand in Denmark, the waiting time is 19 months, meaning STPS is now processing applications from April 2020. 

STPS confirmed to The Local that the agency has received approximately 1,780 applications from nurses from outside the EU or EEA since April 2020, but said it can’t determine how many have been processed.

Applicants from inside the EU or EEA

The Patient Safety Authority told The Local via written responses and on telephone calls that it “cannot” share average processing times or the number of applications from EU citizens in the backlog because it did not have a record of how many there are.

A communications officer from the agency did, however, say they expect to find 60-70 EU/EEA nurses whose applications have not yet been reviewed, but did not speak to the total number of open cases. The agency did not provide an estimate of the number of EU/EEA doctor applications that have yet to be processed.

STPS also told The Local that it prioritises applications from EU and EEA applicants who can provide proof of a job offer in Denmark. According to applicants, job offers to practice medicine in Denmark are difficult to obtain without a permit to practice medicine in Denmark.

STPS told The Local that, in the month of October, it issued final decisions on the following number of applicants from EU/EEA countries: 19 medical doctors, two dentists, seven nurses and 17 other healthcare professionals. STPS certifies qualifications for a wide variety of professions, including radiographers, physical therapists, and dental hygienists.

From January to October, final decisions were issued to 150 medical doctors, 29 dentists, and 82 nurses.

Why is processing so slow?

What’s the reason for the glacial pace?

In its responses to The Local’s information requests, STPS pointed towards deficient funding and other responsibilities for the five examiners that typically make up the medical qualifications review team—“registration of Danish paramedics, and issuing Certificates of Current Professional Status (CCPS) and Certificates of Good Standing (CGS)”.

The latter two are documents that people with professional qualifications issued in Denmark can submit to gain work authorisation in other EU/EEA countries.

As of December 2nd, three additional examiners have been added to the team in an effort to reduce the backlog, the agency also said.

In a November 11th phone call, a communications officer from the agency also attributed the longer processing times to a relatively high proportion of applications from Asian countries.


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Danish study concludes women earn less than men for same jobs

A Danish study has concluded that women are often paid less than men for doing the same job.

Danish study concludes women earn less than men for same jobs

The study, from Copenhagen Business School, analysed the salaries of 1.2 million people in Denmark aged 30-55 years.

On average, women earn 7 percent less despite having the same profession and same job as their male colleagues, researchers concluded.

CBS professor Lasse Folke Henriksen, one of the report’s co-authors, said the results suggests that the overall disparity between the wages of men and women in Denmark is not solely a result of the pay grades in the professions in which they work.

“The equality debate has for some time focused on wage hierarchy in female-dominated and male-dominated professions,” he said.

“But this suggests there is also a wage gap between men and women with the same job function,” he said.

The study does not specify reasons for the wage gap. Henriksen said further research will address this, but existing research offers potential explanations.

“Family relations mean a lot. Women who have children put more work into home care and so on. That could help to explain it,” he said.

Denmark is not the only country looked at by the study.

The study uses data registered from 2015 and finds an overall wage gap for all countries of 18 percent, with women therefore earning considerably less than men on average.

Along with France, Denmark has the smallest wage gap (7 percent) of all countries analysed. Nordic neighbours Norway and Sweden are close behind with 9 and 8 percent respectively.

The largest wage gap found by the study was 26 percent in Japan.

“So Denmark is well placed,” Henriksen said.

“We also have analyses from further in the past so we can see that the wage gap has shrunk over the years. That’s very positive, and that has also happened in other countries,” he said.