Germany’s health and aged-care systems rely on migrant workers, with 690,000 foreign-born people working in the sector, experts say.
Migrant workers form an integral part of Germany’s care sector, due to an aging population with steadily increasing demand for care and an already abundant labor shortage.
“Without migrant experts at all levels of the health system, the German health system will face collapse, as the COVID-19 pandemic has shown at the latest.” report Read by the German Expert Council on Integration and Migration.
Of the 4.2 million people working in the entire German healthcare sector, 690,000 were born abroad, according to an expert conference.
Foreign-born workers span all types of health professions, from doctors and nurses to support and more managerial positions, but the highest proportion are elderly care workers, making up the largest share of all workers. 25% are immigrants from abroad.
Many elderly people who need nursing care live at home rather than in fixed facilities such as nursing homes. However, as the number of traditional multi-generational households is decreasing, there is a high demand for support from external personnel.
Thus, the largest immigrant group in Germany’s long-term care sector operates in a legal gray area, the so-called live-in care. That is, they go directly to the elderly’s homes to support families in caring for their elderly relatives at home.
Exact numbers are unknown, but estimates range from 300,000 to 700,000 migrants working in this system.
Families are often promised 24-hour support from employment agencies to elderly relatives, but “this is not legally possible,” said a helpdesk funded by the German government and trade unions. Faire Mobilität,” explains Justyna Oblacewicz. legally advising affected workers;
On paper, workers often have legal forms of employment through the rules of the EU’s Posted Workers Directive or by running their own business in their home country. ‘ Oblacewicz told his EURACTIV.
Contracts often only cover 30 to 40 hours of work per week, but workers are expected to be available 24 hours a day for potential emergencies.
But as a 2021 Federal Labor Court ruling confirmed, this also counts as hours worked, so they should be paid at least at the minimum wage, which in practice is usually not the case.
Major regions of Eastern Europe where workers come from
According to Oblacewicz, most of the direct domestic workers are women over the age of 50 from Central and Eastern European countries.
According to the expert meeting, the main countries of origin are Poland, Romania and Slovakia.
But while EU nationals make up the bulk of the affected workers, there are also an increasing number of non-EU nationals working under such arrangements, Oblacewicz said, citing Ukraine and Serbia as examples. .
This reflects the overall pattern of immigration of health- and care-related professionals, with Germany’s largest group of migrant workers coming from countries that have joined the EU since 2004, as well as other countries in Eastern Europe. I come from a non-EU country.
Unlike medical or long-term care professionals in fixed care homes who are required to obtain foreign qualifications, family household workers often do not have specific medical or long-term care qualifications, experts say. Stated.
“The problem is that in many cases, no special qualifications are required, which means that recruitment works within days and you don’t need to be trained in nursing,” she said.
Oblacewicz said workers often don’t know what to expect from their jobs, so it can quickly become overburdened.
German care system encourages care at home
This practice will also be facilitated by the structure of the German long-term care insurance system.
If an elderly person is affected by certain medical conditions, such as dementia, the family may receive fixed care and a direct payment (care allowance) ranging from €300 to 900 per month, depending on the medical condition of the affected person. You can choose either.
A panel of experts noted that 80% would choose to take care of relatives at home.
This allows payments from long-term care insurance to be used to pay part of a live-in care agency’s monthly fee, which typically stays with the agency in large part, instead of reaching the worker.
“The problem is that nursing allowances are used to support such a business model. If in doubt, be in doubt,” Oblacewicz said.
[Edited by János Allenbach-Ammann/Nathalie Weatherald]
