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Germany desperately lacking care home workers

February 1, 2018

Is creating 8,000 new jobs going to ease pressure on Germany's overstretched care home sector? Negotiators trying to form a "grand coalition" government think so, but experts warn it is just plastering over the cracks.

Care workers in Germany
Image: picture-alliance/dpa/S. Kahnert

The Social Democratic Party (SPD) were quick to celebrate it as another victory for their negotiators, as they continue to try and beat a new grand coalition deal into shape with Angela Merkel's conservative Christian Democratic Union (CDU).

SPD Deputy Leader Malu Dreyer announced on Wednesday evening that 8,000 positions for new care workers would be created immediately — and at no extra cost to patients. Furthermore, care work training programs would be improved, and the minimum wage for care workers — a profession which is currently one of the least attractive and poorly-paid in Germany  would be adjusted to balance differences between individual German states.

SPD negotiator Malu Dreyer celebrated the agreement with the CDUImage: picture-alliance/dpa/M. Kappeler

The Paritätische Wohlfahrtsverband — Germany's leading association of charities — estimates that the country needs an extra 100,000 care workers to cover its current needs adequately.

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'Nowhere near enough'

The immediate reaction from care-workers' representatives and charities to Wednesday's deal was scathing. Herbert Möller, advisor for the German Foundation for Patient Rights (DSP), called the agreement no more than a "drop in the ocean."

"These 8,000 positions means in practice, given that we have 13,600 care homes, less than one position per home," he told DW. "That won't solve the shortages in Germany at all. It might bring a tiny bit of relief, but if you talk to care workers they're rather disappointed with what is on the table."

"There are various problems. Working conditions in the homes need to be improved," he added. "A lot of care workers leave the job after about 10 years because they're burned out, or because they have an ambition to do good care work, but can't do it under these conditions, simply because there aren't enough people doing it. We need to do something right now to make sure we don't lose even more care workers."

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Old people's homes in Germany are desperately understaffed, with workers from abroad being brought in to fill positionsImage: picture-alliance/dpa

The other problem, as Möller explained, is that the job simply isn't well-paid enough to be attractive on the labor market. "In the last few years, even though more and more people have decided to do the training, the job hasn't really been attractive."

Malu Dreyer, who is also state premier of Rhineland-Palatinate, said that the new provisions would make it easier to increase wages. On average, hospital care-workers start on around €2,300 ($2,850) a month before tax, though old-age people's carers earn significantly less — around €1,700 — while those in the increasingly large private sector earn even less.

That's if they can find people to do the job in the first place. "You have to imagine: in care work up till now, trainees in some states had to actually pay to do the training," Möller said.

That problem, at least, has now been dealt with, or is in the process of being dealt with. A new law passed by the last German government means that from 2020, care work training must be free to all, and indeed must be paid; "but that step should have been taken a long time ago," said Möller.

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The Economics of healthcare

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An undervalued job

Johanna Knüppel, spokeswoman for the German Nurses Association (DBfK), was also dissatisfied with the new plans. "It's nothing," she told DW.

Knüppel explained that the state's influence on the situation was limited. "The reason why the salaries are so low is because a lot of care work is in the hands of private operators," she said. "They're not tied to certain tariffs. Private investors pay what they want to pay, and pay so that there's a certain profit left over for them. That's their business model, and there are no negotiations with the unions."

As a result, it makes little difference what the coalition negotiators promise: The government cannot control wage negotiations in the private sector.

And the salary, says Knüppel, is not the basic problem. "Politicians like to point out how many young people join training programs," she said. "But so few of those actually go into the job. They start with classes of 25 people, but by the second year half of them have already thrown in the towel. And the number that actually does the exams at the end of three years is just a fraction of those."

The reason why people are being driven out of the job "is not the money," she added, "but the working conditions in the chronically understaffed old people's homes - and they already see that in the training, so we shouldn't wonder if young people re-orientate themselves early in their careers to avoid getting caught up in that mess."

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