Making the care system future-proof: The German care industry caught between rising care requirements and increasing labour shortages

From now on, the first boomer cohorts will be retiring, followed by only weaker cohorts entering working life. As a result, there will be an increasing shortage of staff in the labour-intensive care sector. At the same time, the number of care cases has risen significantly since the introduction of the new concept of care in 2017. In around ten to fifteen years, the baby boomers will provide an additional boost to the number of cases. A new direction in care policy is needed to ensure that care can be provided even under these changed conditions.

Instead of looking for new sources of funding, the new federal government should realise short-term savings potential on the expenditure side. This applies directly to non-insurance-related tasks; more fundamental questions arise regarding care allowance. The use of the care allowance is not earmarked. In addition, it remains unclear whether and to what extent the need for care leads to a need for financial support. In view of the ever-increasing deficits in the long-term care insurance funds, the costs of an inadequate social policy must be weighed against the consequences of constantly rising contribution rates.

In the long term, however, concentrating the value proposition on core nursing services will not be enough to guarantee care with a shrinking labour supply when demand increases. To relieve the burden on nursing staff, a bureaucratisation offensive is needed. This presupposes that the regulations that trigger this are kept to a minimum.

Digitally supported solutions, the use of artificial intelligence (AI) and care robotics also promise to reduce the burden on staff. However, the application of innovative ideas has so far been hampered by regulations: digitally supported innovations require investment, but this is hardly considered in the investment costs and care rates for full inpatient care. Long amortisation periods are assumed for investment costs, which often extend beyond the economic depreciation period. This also inhibits the spread of innovative care concepts. After all, the aim of digital solutions is to reduce the workload of care staff. These savings must be considered in the instruments used to measure staffing levels, as well as the necessary personnel requirements in IT and organisational development.

While ‘outpatient’ has previously been prioritised over ‘inpatient’ in the care sector, this principle is proving to be too rigid. This is because it is not only the need for care that is developing differently in regions, but also the labour supply and capacities in full inpatient care. This is why differentiated solutions are needed instead of uniform rules, scope for innovative care concepts instead of bureaucratic standardisation.