Who cares?

The provision of care has become one of the most in-demand services in the German economy, according to a study by WifOR, an institute for financial and economic research at the Technical University in Darmstadt.

The study found that the care sector employs more people than Germany's automotive, electrical engineering or mechanical engineering industries. Statistics from 2008 show that some 1.2 million people work as caregivers for the sick, elderly and disabled in Germany.

Serious shortage looming

But the sector is already warning of a serious lack of personnel in coming years, especially as the number of Germans relying on either in-home or institutional care is expected to increase dramatically. A national association of privately employed caregivers, BPA, is warning that by 2020, the country will have a deficit of some 300,000 carers.

"Germany needs a thorough qualification offensive for carers, and a green card scheme for foreign carers," said BPA President Bernd Meurer. He called for the country to gather social services representatives for a conference on the topic of care provision this year.

"Continuing to defer this unresolved problem will have terrible consequences for millions of elderly people - something that, in the end, affects us all," he said.

Demographic experts in Germany are predicting that the number of people requiring care is set to double by 2050 to over 4 million, as fewer family members are able to care for their sick and elderly relatives and rely on professional caregivers instead.

This is related to several developments: the fact that more women in Germany are employed outside the home; that family members increasingly live further apart; and that Germany's low birth rate has led to a situation where there are fewer children to care for their elderly parents.

Government mulls scheme for immigrants

Germany's Minister for Family Affairs Kristina Schroeder says she's aware of the pending social crisis due to a shortage of carers and has called for "a clear and practical framework" to bring more qualified caregivers from Eastern Europe into German households.

Germany is not the only EU country facing the dilemma. Frank Goodwin, secretary of Eurocarers, a Dublin-based association for organizations representing caregivers, says it's a European problem.

"There's a growing demand for family carers and for formal, paid carers, not only for older people but also people who have heavy dependency needs residing in their homes rather than in institutional care, and that process is happening across many countries in Europe," said Goodwin.

He added that as hospitals and nursing homes focus their services on patients with acute treatment needs, more and more unpaid caregivers in private homes are providing quite advanced care - essentially performing a job they wouldn't be allowed to do in the public sector without proper training.

To this end, governments are also considering schemes to provide training to unpaid caregivers. Goodwin said that Ireland, for example, is midway through a program that earmarked 600,000 euros ($790,630) to provide training for 8,000-10,000 family caregivers up to mid-2011.

"Those people who complete the training would then be qualified to work as paid carers as well, should they choose," he said.

Between 1996 and 2008, Germany saw the number of people employed as carers grow by about 50 percent, which translates into a yearly average rise in employment of 3.9 percent, according to information from the Wifor Institute.

During this same period, the entire German economy registered an average yearly growth of 0.6 percent. "The sector is hiring six times the number of workers than the economy as a whole," said the study's author, Dennis Ostwald.

The health and social service sector was responsible for almost one in every five jobs created across the EU between 1995 and 2001.

Battling the low-pay image

Despite those increases, there are still too few trained caregivers. A 2009 study completed for the European Employment Observatory noted that public action aimed at encouraging workers' up-skilling and professionalization of the sector was on the rise everywhere.

"Training is indeed necessary to ensure good-quality care and to provide the horizontal and vertical career mobility required to keep workers in the profession," the paper noted. However, it went on to say that training policies were not without problems - the most common being that the profession remains a low-pay, low-job quality sector all over Europe.

While the flow of cheap, legal caregivers in the wake of EU enlargement is undoubtedly having an effect on care labor markets across Europe, the paper's authors predicted two possible outcomes for Germany, a country which already has a sizeable informal market in private carers working without permits. One is a greater integration of immigrant caregivers on a legal basis; the other, however, could see the country slide "towards the Mediterranean model with its reliance on irregular migrant carers."

Author: Deanne Corbett
Editor: Sam Edmonds