Better pay, lighter workloads and more trainees: that's how the government hopes to plug a huge vacancy gap in Germany's crisis-hit care sector.
There are almost 40,000 unfilled nursing care positions throughout the country. The issue is particularly urgent because the number of people who need care in Germany is expected to rise significantly in the coming decades: from the 3.3 million counted in 2017, to four million by 2030, and 5.3 million by 2050, according to estimates by authorities.
Why? Because German society is getting older and that means there's going to be a bigger burden on care services, which are already struggling to cope. At the other end of the scale, people are having less babies, although family friendly policies, like paid parental leave, do seem to be having a positive impact on the birth rate.
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On Tuesday Labour Minister Hubertus Heil, Family Minister Franziska Giffey, both of the centre-left Social Democrats, and Health Minister Jens Spahn, of the centre right Christian Democrats, presented a package of measures that were agreed on with the help of key industry stakeholders.
However, the cost of the new measures is expected to be in the billions and funding decisions have still not been finalized.
Spahn said the care industry, which is known for having low pay and stressful conditions, must become more attractive to potential employees to help with the workload of care-givers. The government says this can only be addressed by getting more staff onboard - and looking abroad to recruit foreign workers.
"This not only relieves the burden on the individual carer, but also leaves more time for the care of those in need of it,” Spahn said.
Heil added that although hot topics in politics at the moment were major issues such as digitalization and climate change, the question of how to manage care should be given equal attention.
Jens Spahn, Franziska Giffey and Hubertus Heil on Tuesday. Photo: DPA
It comes after the government launched its "Konzertierte Aktion Pflege" ("Concerted Action Care," or KAP) last summer, in an attempt to recruit more people to the industry.
This involved discussions with employers, trade unions, welfare associations, churches, health insurance firms and representatives of those affected.
The three ministers now say the new proposals will be implemented - but there is some resistance to the plans and questions remain unanswered. Here’s an overview:
One of the main aims is to secure higher wages for staff working in the elderly nursing care sector. However, the government alone cannot guarantee this.
Heil is launching a law that is to come into force on January 1st 2020, and should result in two possible paths to achieve this goal.
The first provides for employers' associations and the Verdi trade union to negotiate a collective agreement.
The government would then work to make their agreement binding for the entire industry. However, private nursing home operators in particular are opposed to this idea.
In the case that a collective agreement does not work, a second way of ensuring higher pay is for a commission to suggest higher care minimum wages by May 2020. This would apply to auxiliaries as well as specialists, and the aim would be for similar levels of pay across Germany. Typically, people in eastern states in Germany earn less than in western regions.
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Heil stressed that the government hopes the first idea will work out but that a back-up plan was needed.
But what does ‘better pay’ mean?
Spahn made it clear that nursing staff caring for the elderly should be paid around €2,600 to €2,700 a month. And for many that would be a large wage increase.
Extra trainees and recruitment from abroad
Training to become a care worker needs to be more attractive, according to the government.
As of 2020, trainees nationwide will no longer have to pay education fees, but will receive remuneration of around €1,000 a month, Giffey said. It is hoped that by 2023, the average number of trainees and training institutions in Germany will have increased by 10 percent compared to this year.
Germany also hopes to attract more foreign workers and will look at ways of offering language training in their country of origin in a bid to attract them.
Better working conditions
To achieve better conditions, unions say there needs to be more reliable duty schedules and limits on the amount of people assigned to one member of care staff.
"Employees must know that their situation will improve step by step," said Verdi board member Sylvia Bühler. "There must be an end to the constant overworking."
There should also be more cooperation with other medical specialists, such as doctors, the plan says.
In addition, digital technology is to be used to relieve care employees of paperwork.
The ministers did not make any concrete announcements on the financing of the plan.
But it is clear there will be considerable additional costs. Depending on the pay scales to be determined, it could cost an extra two to five billion euros per year, Spahn explained with reference to an expert opinion.
Possible options would be higher nursing care contributions or a state subsidy such as is the case with pensions.
Spahn has already said that more contributions are needed to the country's social security system and has controversially said that people without children should pay more towards care and pension insurance.
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Currently, relatives of people in care - usually children - have to contribute to long term nursing insurance if the person receiving care can't afford it. However, in future the government wants to ensure that this burden will no longer be the case for people who earn less than €100,000 per year.
That means the gaps would have to be filled with taxpayers' money, and individual federal states would have to agree to this.
Eurgen Brysh, of the Patient Protection Foundation, said the government now had to lay out how this can all be achieved.
"They must finally present a concrete plan on how the care of the future will look and how it will be financed," he said.