Wages Below the Subsistence Threshold and the Emigration Risk of Ukraine's Health Workforce After Border Reopening: A Comparative Analysis of the British Experience (1919–2023) and the Polish and Wider European Migration Destinations

Abstract Ukraine's health system is approaching a point of critical workforce risk that is currently restrained by two temporary barriers: the wartime ban on the departure of men of conscription age, and the language threshold in destination countries. After martial law ends and borders reopen, both barriers weaken, while the structural driver of outflow — pay that does not cover basic needs — remains. This article argues that the key risk to workforce sustainability is not any single regulatory decision, but the accumulated gap between a health worker's real remuneration and the cost of living, multiplied by the accessibility of the nearest destination markets. Drawing on verified 2026 financial data, I analyse the minimum, average and high pay levels of a Ukrainian doctor separately and demonstrate that even the high public-sector level — despite the January 2026 pay increase for primary and emergency care — barely covers the needs of a three-person household, while the minimum covers less than half. Through a structural comparison with the British experience (the hidden erosion of NHS real incomes that drove emigration) and a quantitative comparison with three realistic destinations — Poland, the Czech Republic and Germany — I identify a stable inverse relationship ("higher pay ceiling → higher qualification-recognition barrier") and show that the economic rationality of emigration for a Ukrainian specialist and for mid-level medical staff is extremely high. I separately analyse the multi-channel outflow of mid-level and junior medical staff, three of whose four channels already operate independently of border reopening. I propose the "Index — Floor — Window" framework, in which the "Window" is reconceived as a time-limited period that is narrowing from both sides — the Ukrainian border and the liberal access regime of destination countries.