Nursing staff are on strike in Berlin and President Christine Vogler is drafting a gloomy end-of-life scenario at the German Care Day. There are a few years left to avert it
The word “nursing emergency” first hit the headlines in 1984. Since then, a total of ten federal governments have been looking for ways to counter him. Now the eleventh is forming, probably a traffic light coalition. She inherits the problem and will have to solve it. Because the postponement period is running out. In 2030, it is estimated that up to 500,000 caregivers will be lacking, while the number of those in need of care will rise from 4.1 million to around five million by then.
The new government has to come up with more ideas than its predecessors, who did what governments do: pass laws with cryptic names. Small selection: Nursing Strengthening Act, Nursing Wages Improvement Act, Employee Posting Act, Relatives Relief Act, Work of Tomorrow Act, Skilled Worker Immigration Act, Occupational Health and Safety Control Act, Health Care and Long-Term Care Improvement Act. Federal Minister of Health Jens Spahn alone managed 40 such laws, and otherwise he acted actionist, he drummed up the important players in the health system for the “concerted action care” and recruited foreign nurses in Kosovo and Mexico. But even his success remained manageable.
While the party leaders are negotiating in Berlin, the situation outside in the capital is worsening dramatically. Several thousand people demonstrated on Saturday afternoon in Neukölln for more staff and better working conditions in Berlin clinics. The nursing staff at the Vivantes clinics set off the highest escalation level 35 days ago, they are on strike, many wards in their hospitals are running in emergency mode. “In a sense, we give up to be there for others,” said the 35-year-old carer and fellow striker Carolin Puschke star. “And this stress is in the bones, every day.”
End time scenario 2033: The unemployed are committed as “care supporters”
The German Care Day, which is meeting today, is also sending clear signals to the upcoming government. In her brilliant inaugural address, the new President Christine Vogler conjured up an end-of-life scenario in 2033: After the pandemic, hundreds of thousands of nurses fled their jobs, the number of those who remained has shrunk to 200,000, they coordinate “care supporters: inside” – the unemployed, who were obliged to do auxiliary jobs. Outpatient care has been abolished due to a lack of staff, people aged 80 and over can easily contact the “termination authority” and “ask for their end of life”. Vogler’s voice becomes urgent: “We actually still have it in our hands today. Even if the numbers sound and are catastrophic, we can create conditions that secure health care.”
Christine Vogler, President of the German Care Council, drafted a gloomy end-of-life scenario for the year 2033 at the German Care Day
© Jan Pauls / German Care Day
Your demands are not new: Salaries from 4,000 euros, so that more carers stay in the job and those who have left their jobs return. Better working conditions through the introduction and further development of mandatory personnel codes. But above all: extended competencies for carers. In addition, 20 percent should complete a degree in order to cope with increasingly demanding tasks, as the Council of Experts has been calling for for many years to assess developments in the healthcare sector.
Careers from nursing assistant to professorship must become possible
It is worth thinking about these points in particular: expanded skills, more university-educated nurses. Because what is it about? As long as the nursing profession remains as it is, young people will no longer be enthusiastic about it. Then working conditions will not improve either, it is a vicious circle. How about getting people interested who have so far not even considered care – because they don’t want a job in which they remain authorized to give instructions all their lives and from the age of 35 have hardly any opportunities for further development? So people who prefer to study medicine or pharmacy today. Abroad, for example in Canada, the Netherlands or the Scandinavian countries, care has long offered lifelong development prospects. Careers from nursing assistant to professorship are possible there. Nurses do research as “Advanced Practice Nurses” at university hospitals, work as “School Nurses” in the school service to prevent undesirable developments in children and adolescents, as “Community Health Nurses” they manage health care in rural areas or in problematic social areas Cities. They are on an equal footing with the doctors and ensure that older chronically ill patients can live independently for as long as possible. In short: you take care of everything that the overworked family doctor often does not come to. What a dream to be able to work so independently.
In Germany, such careers have so far remained the great exception. Because in this country there are still many who are convinced that care must remain an assistant profession. But if it were possible to inspire completely new target groups who see the hospital or nursing home as a “flow heater” on the way to higher consecration and work with the perspective that they only have to hold out for a few years – then the working conditions would be in a couple of years Years ago, they were no longer so unattractive that they would later have to flee their jobs. Because there are many more caregivers.
This time it must not fail because of the money
The chances that nursing jobs will become real dream jobs are actually better than ever when the traffic light coalition becomes a reality. Because both the SPD and the Greens and the FDP have long been open to the care council’s demand for “expanded competencies”. It is one of their greatest similarities on health policy. If it weren’t for a tiny little thing: Where should the money come from to massively upgrade care? The FDP will insist on compliance with the debt brake. Citizens’ insurance, which would immediately wash fresh money into the long-term care coffers, cannot be made with the Liberals either. Maybe higher tax subsidies? Also difficult to do, after the pandemic the state went into high debt, and asking high-income earners to pay higher taxes is a red line for the FDP.
And unlike the Greens and the SPD, many liberals think it’s okay if profits from our solidarity-financed health system continue to flow into the pockets of large corporations and investment funds in the Cayman Islands – instead of refinancing our system.
So where the many billions will come from that are needed to make our health system and care future-proof is currently still uncertain. But the new government will also have to solve this problem. This time it must not fail because of the money.