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There is a shortage of an additional 120,000 full-time positions in nursing homes, says health expert Rothgang in an interview with tagesschau.de. Billions in investment are needed. But it’s not just about money.
tagesschau.de: Has the crisis in the crown made the problems of the healthcare sector more visible?
Heinz Rothgang: You could say it. Initiates also knew in advance the problems of the care industry. But the bottlenecks have become more apparent to the public. Now we are seeing the number of intensive care patients in hospitals increasing and it is becoming clear that we can have enough beds and ventilators, but we cannot “take care” of the beds.
tagesschau.de: And what about nursing homes and outpatient care?
Rothgang: Here too the effects are serious. A survey we did during the first wave found staff shortages averaging five to ten percent in nursing homes due to quarantine, isolation, and childcare. At the same time, family members and volunteers no longer entered, so there was extra work, also due to the implementation of hygiene concepts. It creaked quite a bit.
“The market has been completely empty”
tagesschau.de: This means that the Corona crisis has exacerbated the existing staff shortage in the care industry.
Rothgang: When we talk about a lack of attention, two things are often confused. In a more strict sense, it means that, on the one hand, existing positions cannot be filled. In the nursing home sector, we have five skilled worker openings for each applicant. The market has been completely empty. The other half of the emergency is that there are very few jobs in the care sector.
tagesschau.de: On behalf of the legislature, you developed a nursing staffing instrument: what did you get out of it?
Rothgang: That we need a third more nursing home staff to meet the prerequisites for professional care. We have meticulously observed the nursing staff at work and have worked closely with payers and providers; therefore, our results have great legitimacy.
tagesschau.de: According to your analysis, a third of jobs are missing, what does that mean in concrete terms?
Rothgang: We would need an additional 120,000 new full-time positions. With the part-time quotas we have in the care sector, that would be more than 200,000. That is the dimension we are talking about. Then there is the fact that many positions have yet to be filled. We are talking about 20,000 to 30,000 vacant positions.
“It will be a process that will take several years”
tagesschau.de: 20,000 more jobs means almost a billion additional costs, which means that we are talking about between four and five billion euros for the 120,000 additional jobs that you have calculated.
Rothgang: That’s right. Of course, this cannot be fully implemented overnight, because households have to change organizationally, additional training capacities have to be developed, and staff do not yet exist. We anticipate implementation over a period of several years. In this regard, no one-time costs are incurred.
tagesschau.de: How far is policy from implementation?
Rothgang: The Act on Care and Improvement of Health Care is in the form of a bill, and next week there will be a hearing in the health committee. The first results of our process are being implemented here: 20,000 additional positions are planned in the care sector. They have to take more steps.
tagesschau.de: Who should fund all this?
Rothgang: This must be combined with financial reform in long-term care. Currently, financing is regulated in such a way that long-term care insurance gives a fixed amount – and the rest is paid by the resident himself, who is already overloaded – with an average of more than 2,000 euros. The additional five billion cannot be passed on to residents of the home.
tagesschau.de: The Minister of Health is currently working on key points, are they enough?
Rothgang: They are going in the right direction. Unfortunately, the next steps to implement the staff evaluation procedure are missing. But Jens Spahn goes a long way in flipping financing by saying the copay is determined and what goes beyond it is paid by insurance companies. It also costs more staff.
More salary alone won’t be enough
tagesschau.de: It is about improving the quality of care, but also about making the care professions more attractive. To what extent is politics waking up when it comes to improving pay for nurses, which has long been demanded?
Rothgang: Regarding payment, there is a difference of 500 to 600 euros between the hospital and the residence. Particularly in caring for the elderly, more needs to be done in terms of payment. It is far below what is paid in other industries. But working conditions must also improve.
tagesschau.de: What do you mean specifically?
Rothgang: People leave their jobs, we listen over and over again, because there are so few colleagues on the shift due to lack of staff. You feel lonely and often have to step in on weekends off if there are bottlenecks. If you create more staff, the work becomes much more attractive.
The interview was conducted by Corinna Emundts, tagesschau.de
