As 80-year-old Marcelle Mivelaz marked her birthday surrounded by loved ones at a Cheseaux-sur-Lausanne nursing home in western Switzerland, the smooth running of her celebration and daily care at the facility depended entirely on a team made up mostly of immigrant nurses and caregivers. This small, personal scene reflects a widespread reality across Switzerland’s entire healthcare system: decades of chronic domestic staffing shortages have left the sector deeply dependent on foreign workers, a dependence that has placed it at the heart of a fierce national debate ahead of the June 14 popular vote on a strict immigration cap proposal.
The initiative, dubbed “No to a Switzerland with 10 million!”, was put forward by the hard-right Swiss People’s Party (SVP). It aims to cap the Alpine nation’s total population — which currently stands at 9.1 million — below 10 million through 2050 by drastically cutting annual immigration levels. While the proposal has drawn broad opposition from the federal government, national parliament, and most major business groups, recent public opinion polls indicate the outcome of the vote remains too close to call, leaving the healthcare sector bracing for a potential devastating outcome.
For many on the ground at care facilities across the country, the risk of the cap passing is an immediate threat to patient safety. Carine Savioz, a native Swiss nurse working at the Cheseaux-sur-Lausanne nursing home, told AFP that a steep drop in new immigrant caregivers would push the entire national healthcare system toward collapse. “If there aren’t enough caregivers, our healthcare system is headed for disaster,” she said. Her warning was echoed by 81-year-old resident Marie-Therese Barraz, who added: “We must have respect for the people who care for nursing home residents.”
The scale of the sector’s reliance on foreign labor is stark. Christian Weiler, director of the Primeroche Foundation that operates the Cheseaux-sur-Lausanne facility and cares for 360 patients across multiple sites, revealed that nearly 80 percent of his 240 total employees are foreign nationals. Weiler noted that the foundation already cannot meet existing demand for care: 240 elderly people are currently on waiting lists for nursing home spots in the Lausanne region alone. If the immigration cap passes and cuts off the supply of new workers, the foundation will not be able to expand capacity to meet that need, he warned, triggering a ripple effect across the entire health system.
“If there aren’t enough places, they’ll go to the hospital,” Weiler explained. “And when hospitals are full of elderly people, they won’t be able to fulfil their role, and the system will become very problematic” as Switzerland’s population continues to age. This assessment is shared by the Swiss federal government, which has publicly warned that the proposal “threatens the proper functioning of society” by leaving hospitals and nursing homes unable to deliver the same level of care to sick and elderly patients that the public expects.
The SVP has pushed back against these warnings, arguing that the cap will not cripple healthcare. Party leaders say the initiative still allows up to 40,000 new immigrants to enter the country each year, and they are calling for expanded training programs to increase the number of native Swiss healthcare workers. SVP parliamentarian Thomas Blasi, an independent pharmacist based in Geneva, also argued that overreliance on foreign workers has actually harmed young Swiss health graduates. “Despite the urgent need for healthcare staff, our young graduates cannot find employment because we prefer to rely on foreign workers,” he claimed.
But healthcare leaders and sector representatives reject that argument, pointing to persistent data showing a chronic shortage of domestic candidates for open roles. The demanding nature of care work and relatively uncompetitive salaries have long discouraged many Swiss nationals from entering the field, they say, leaving foreign workers to fill the gap. A broad alliance of major healthcare groups — including the Swiss National Association of Hospitals and Clinics and the Swiss Nurses’ Association — has formed a dedicated committee to campaign against the proposal, which they have labeled the SVP’s “chaos initiative” that directly endangers patient lives.
The committee warns that understaffing from an immigration cap would force facilities to rely on underqualified personnel, leading to a measurable increase in mortality risk, particularly for patients in emergency care settings. Official data from the Swiss Medical Association (FMH) backs up the sector’s claims of structural dependence on foreign-trained workers: 43 percent of all practicing doctors in Switzerland are trained abroad, and that share continues to grow each year. FMH vice-president Philippe Eggimann told Swiss newspaper Le Temps that Swiss universities only graduate between 1,200 and 1,300 new medical professionals each year, while the system needs 3,500 to 4,000 new doctors annually to meet demand.
“The country remains far from being able to ensure the replenishment of its medical workforce on its own,” the FMH concluded. That gap is just as stark for nursing roles. At Geneva University Hospitals (HUG), one of the country’s largest public health systems, nursing director Sandra Merkli explained that the facility needs to hire 200 to 300 new nurses every year, but the local canton’s medical school only graduates 150 to 160 new nursing candidates annually. As of 2025, nearly half of HUG’s 13,000 total employees are foreign nationals: the share hits 60 percent for nursing staff, and 45 percent for physicians, reflecting a nationwide trend that leaves the sector scrambling ahead of the upcoming vote.