Care in need – Up to 690,000 skilled workers will be missing by 2049
Patients, those in need of care and relatives have long been feeling the stress and shortage of personnel in care in Germany. The search for a place in a home or outpatient care is often grueling. Patients and residents report a lack of attention. And time and again, poor care in hospitals with staff shortages comes to light. For Nurses’ Day this Sunday, actions by unions and nurses are planned in many places in Germany, as well as celebrations by employers to recognize the work of nursing staff. The situation of care, the perspectives and the political plans at a glance:
background Deadline is approaching: Use money for care from 2023 by the end of June
How does the responsible minister assess the situation?
Dramatic. “We have allowed major problems in care,” said Health Minister Karl Lauterbach (SPD) on Tuesday at the Doctors’ Day in Mainz. Every sixth shift is now understaffed. This year too, the frustration of those affected is likely to play a role on International Nurses’ Day, which is celebrated annually on May 12th. Lauterbach also admits this: “The high level of disillusionment in nursing is also due to the massive work overload of the nursing staff.”
Is the situation in old people’s homes looking better?
No. “The personnel reserves in geriatric care have long been exhausted,” says Eugen Brysch, board member of the German Patient Protection Foundation. The facilities are often no longer able to staff their shifts with skilled workers. According to a survey by the Evangelical Association for Work with the Elderly and Care in February, four out of five care facilities have to limit their offerings because there is a lack of staff. Nine out of ten outpatient services rejected new customers in 2023. In total, there are currently only 44 unemployed people for every 100 registered jobs for qualified nursing staff.
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Background: Social professions in crisis? 17 percent less earnings
Are there professions with major shortages?
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No. “Trained nursing staff are in first place among all professional groups with a shortage,” according to the Federal Employment Agency. Almost 1.7 million nursing staff in nursing, geriatric and pediatric care were employed in regular jobs in 2023 – 10,000 more employees than in the previous year. 82 percent of all nursing staff are women. Of these 1.39 million women, just over one in two work part-time.
What’s next?
The situation is likely to get worse. With the increasing number of older people in Germany, there are also more and more people in need of care. According to scientific forecasts, the number of people in need of care will increase from around five to six million today within 15 years. The increase in people in need of care is likely to vary greatly regionally, particularly strongly due to demographics in Bavaria and Baden-Württemberg, for example. According to the Federal Statistical Office, there will be a nationwide shortage of between 280,000 and 690,000 nursing staff by 2049 based on a February forecast.
Background: Nursing staff: Staff shortages in clinics are getting worse
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What is the government doing?
Several things. This is how she advertises for foreign nursing staff. In fact, employment growth in nursing since 2022 has been exclusively due to foreigners. They now make up 16 percent of nursing staff. But the options are limited. Lauterbach explained: “If we have to convey the message that here you are allowed to do less than what you can do, you will definitely not be paid better, you have to prove that you speak difficult language beforehand and you won’t get a daycare place – that’s how we become the nursing staff from abroad can’t advertise.”
What other attempts to remedy the situation are there?
After years of preparation, the Federal Council approved Lauterbach’s regulation in April, which even the German Nursing Council praised as a “milestone”. The aim is to compare clinic by clinic, how the staffing of nursing staff is and how it should be. Hospitals and employee representatives had already fundamentally agreed on an instrument for measuring the need for nursing staff in 2019. A similar staffing calculation has been in place in geriatric care since 2023. However, the staff must first be found. That’s why the job should become more attractive. With a competency law, nursing staff should be given more competencies according to their qualifications. The Federal Employment Agency also promotes further training for nursing assistants to become skilled workers – because there are many more unemployed people than registered positions.
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Background: Why nursing home care is becoming more expensive
What else is putting a strain on care in Germany?
The rising costs – and the question of who pays for them. Last July, the coalition decided to increase contributions for elderly care to 4 percent for those without children and to 3.4 percent for those with one child. The company health insurance companies sounded the alarm on Monday with projections according to which there is a risk of a nursing care insurance deficit of one billion euros this year and of 4.4 billion euros in 2025. The social director of Diakonie Deutschland, Maria Loheide, warns: “If the money from long-term care insurance is no longer sufficient, the care of people in need of care is at risk.” Today, health insurance companies and municipalities often ignore increased personnel costs due to tariff increases, Loheide told the German Press Agency. Lauterbach already sees the pure contribution financing of long-term care insurance coming to a possible end. In the long term, there is no way around tax funding for this, he said two weeks ago at the geriatric care trade fair in Essen. In contrast, the federal government currently wants to save money rather than spend more. dpa/da
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