What is the German government doing for those in need of care, and for the carers?
The status quo – and the government’s goals
Statistically, the average age in Germany is one of the highest anywhere in the world. As life expectancy rises, so too does the number of people in need of nursing care – and thus the demand for nursing staff.
Well trained and well paid nurses are needed – in the field of geriatric nursing and in general nursing. The German government thus intends to improve working conditions and pay. Reformed training is to make the profession more attractive again. The German government is also supporting people caring for family members at home.
During the last legislative period, the German government focused on improving the situation of individuals in need of nursing care. As of 1 January 2017, for instance, a new definition of when an individual is in need of care was adopted. This was designed to ensure that services provided under long-term nursing care insurance focus on the actual support required. Thanks to the reform, the number of service recipients increased significantly.
During the last parliament a total of three acts of parliament to strengthen nursing care were added to the statute books, bringing more services for those in need of care, more respite and certainty for individuals caring for family members at home, and better advice on nursing services.
What we have achieved to date
... for more staff:
- An emergency programme has ensured that 13,000 new jobs can be financed in geriatric nursing with little red tape. In hospitals, every new nursing post is funded.
- The Concerted Action on Nursing scheme has agreed on specific measures to tangibly improve working and training conditions for nurses. Within the scope of this scheme, the German government works with all actors in the nursing sector, including federal states and local authorities, professional associations and training bodies, those affected and employers. Agreements include the following objectives and measures:
- More trainee nurses
- Higher pay for nursing staff
- Needs-driven staffing levels in care facilities and hospitals
- More qualified nursing staff to be recruited from outside Germany
- More health promotion, workloads to be cut by stepping up digitalisation, and more responsibility for fully trained nursing staff.
- The new, more general training in nursing makes the profession more modern and more attractive. To encourage people to pursue a career in nursing, training fees for geriatric nurses have been abolished and training remuneration introduced. The new training will begin in 2020. In the run-up to the start of the reformed training regime, the German government has launched a nationwide drive to attract candidates to the training courses.
- The German government is improving pay for nursing staff: the Act to Improve Remuneration in Nursing (Gesetz für bessere Löhne in der Pflege) lays the foundations for across-the-board wages in line with collective bargaining agreements. Pay varies depending on the level of nursing qualifications held (fully qualified nurse or auxiliary).
- A new nursing care budget will make it possible as of 2020 to pay nursing staff costs on an individual hospital by hospital basis, thus ending the saving drives at the expense of nursing staff. Hospitals will be able to step up their levels of fully trained nurses.
- Red tape is to be cut, making it easier to recruit qualified staff from outside Germany. Conditions have been improved in order to attract non-German candidates to train in Germany. An agreement has been concluded with Kosovo to recruit nursing specialists, and cooperation agreements have been concluded with Mexico and the Philippines.
- Since October, DeFa (Deutsche Fachkräfteagentur für Gesundheits- und Pflegeberufe) has been helping hospitals and care homes with requests for non-German nursing staff. The agency works locally in partner countries to ensure that the application documents of recruited nursing staff are complete and correct. In Germany, it handles procedures to have qualifications recognised in Germany, work permits and visa applications, significantly accelerating the administrative side of things. Nursing staff from outside Germany, initially from the Philippines, should be able to begin work in Germany within six months.
... for people caring for family members at home:
- In future, grown-up children will only be required to make maintenance payments for their parents’ nursing care if their own gross annual income exceeds 100,000 euros. This is laid out in the government’s Act to Reduce the Burden on Families (Angehörigen-Entlastungsgesetz).
- In future, if individuals caring at home for family members are admitted to a rehabilitation centre as in-patients, they can have the family member they care for admitted to the same establishment.
And this is next on our agenda
As part of the Concerted Action on Nursing scheme, five working groups have agreed on a large number of binding objectives and concrete measures. Within the Federal Ministry of Health, a Concerted Action on Nursing business unit has been set up. It is responsible for reviewing implementation of Concerted Action on Nursing agreements regarding HR management, occupational health and safety, innovative care delivery approaches and digitalisation. A relevant report will be published for the first time in 2020.
The outcomes of the Training Drive for Nurses are also monitored and evaluated on an ongoing basis, and presented to the general public. The partners involved in the Concerted Action on Nursing have undertaken to increase the number of trainees in nursing. By 2023, the number of trainees is to rise by 10 per cent, while the number of training facilities too is to increase.