Susanne Simmler, First District Councillor and Head of Health in the Main-Kinzig district, accuses Chancellor Olaf Scholz and Health Minister Karl Lauterbach (all SPD) of a "failure at all levels" in care and calls for a fundamental improvement in the situation in a letter. The occasion was the "International Nurses' Day" on Friday.

Luise Glaser-Lotz

Correspondent of the Rhein-Main-Zeitung for the Main-Kinzig district.

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Simmler speaks of a huge problem for the aging society. But it is not apparent that there is a convincing approach to solve the difficulties in the interest of the caregivers, the relatives, the employees in the care and the future caregivers. "We can't go on as before! Today's system of care is not sustainable! We are in the middle of a nursing crisis, we are heading for a collapse," Simmler describes the situation.

Numerous closures of some large and renowned institutions proved the imbalance. For years, these facts have been repeated in incendiary letters and the "concerted action care". But nothing happens.

Financial overload

Simmler calls for the creation of a special fund for the care of the elderly, so that further insolvencies of elderly care companies could be prevented. The energy crisis, costs for temporary employment agencies and the current unabated high inflation rate drove expenditure on care to absurd heights. The absorption of these increased financial burdens by new care rate negotiations is a mockery. Those in need of care and their relatives would be financially overwhelmed by the increasing personal contribution, so that the social welfare agencies would have to step in. "Should this spiral really continue to turn in the wrong direction?" asks the head of social affairs. A genuine, tax-financed long-term care partial comprehensive insurance is overdue.

In the letter, Simmler alludes to the right to self-determination and the free development of the personality enshrined in Article 2 of the Basic Law. But a very elderly person cannot live a self-determined life if he is dependent on help and this only refers to "full, clean and quiet" because there is a lack of staff for more performance. The right of self-determination is also restricted for caregivers, for example if a caregiver cannot be with her family because she has to work for the third weekend in a row.

Simmler also complains about a lack of appreciation of work in view of unfair pay. For example, there are no remuneration tables for the employees of the elderly care. Care and support services would be determined for up to two years on the basis of prospective personnel cost budgets. The pandemic and the Ukraine war with rising energy costs have clearly demonstrated what could happen within two years.

Temporary employment agencies took advantage of the situation

In Simmler's view, nursing training should be generalised by not only giving the qualifications of nurses and geriatric nurses equal status, but also paying them equally. Simmler considers the current practice of the mass use of temporary workers in the care sector to be an aberration, which further weakens an already strongly shaky system. Temporary workers are important in order to relieve care facilities and clinics during peak loads. However, temporary employment agencies have taken advantage of the current shortage of skilled workers and high sickness rates by actively strangling permanent employees. The consequence is a change in skilled workers from permanent employment to temporary employment agencies with massive consequences. To counteract this, employers must be encouraged to provide more attractive working conditions.

This, however, presupposes comparable starting positions, which do not exist, since better framework conditions have not been created by the legislature and the long-term care insurance funds. No operator can compete with the advantages of temporary employment agencies and act economically. It is time to turn words into deeds and finally give the nurses relief and a perspective for improvement. What is needed are revolutionary reforms and no more doctoring of symptoms, it needs the big hit, Simmler writes to Berlin.