The number of formal jobs in the healthcare sector fell by 37,000 in 2013, the national statistics office CBS said on Thursday.

In total, 1.4 million people worked in the care industry, either on permanent or temporary contracts, the CBS said.

The reduction in traditional jobs has largely been offset by a 29% rise in freelance healthcare workers. For example, the number of freelancers involved in caring for the elderly has almost doubled to 11,000 in five years, the CBS said.

Healthcare unions are concerned about the rise in freelance jobs in the healthcare sector. They point out many freelancers are ex-permanent workers who were sacked and then hired back as self-employed staffers without sick pay or holiday pay rights.