Trade unions, the Chamber of Employees and associations in Bremen are disappointed that there is no shake-up of the departments when it comes to the issue of "care".
The social affairs department is responsible for care of the elderly, while the health department is responsible for nursing care Photo: Jens Kalaene/dpa
The bundling of the areas of health and care in one department is demanded by the Chamber of Employees, the trade union Ver.di and the DGB from the future Bremen government, as well as the relatives’ initiative "Heim-Mitwirkung" and the care protection association "Biva". The state working group of independent welfare associations (LAG) is even calling for a joint department of health and social affairs.
The reasons: The increasingly pressing issue of nursing care and the future joint training of nurses for the elderly and nurses. Up to now, two ministries have been responsible for the areas of care for the elderly and the sick – the social affairs ministry for one and the health ministry for the other – and that’s probably how it will stay, despite the demands. At least the future coalition is not sending out any signals to the contrary.
Nevertheless, DGB regional chairwoman Annette During has not given up hope: "After all, the senators have not yet been appointed," she says. Actually, she says, there should be a commissioner in Bremen exclusively for the topic of care: "There’s enough to do for that." The red-green-red coalition seems to have recognized this, because During finds the plans in the coalition agreement "okay in terms of direction.
DGB calls for a care commissioner
Among other things, it states that working conditions in inpatient care for the elderly are to be improved through better pay and higher staffing levels, the declaration of collective wage agreements as generally binding is to be supported to ensure that they are binding throughout the country, more staff are to be recruited to supervise residential and nursing care, and home advisory councils are to be strengthened. The expansion of day and night care places is also intended to relieve the burden on relatives, and the doubling of training capacities is intended to counter the shortage of skilled nursing staff.
Arnold Knigge, spokesman for the LAG board, is also full of praise for the resolutions of the future state government: "We can well understand the content of the statements on care; there are important and correct things there," he says. However: "The good intentions must now be followed by swift action."
In saying this, he is alluding in particular to the resolution on joint nursing training. The coalition agreement states: "We want to increase the attractiveness of Bremen as a healthcare location through good education in the healthcare and therapy professions. That’s why we are implementing generalist nursing training from 2020 to train for nursing, pediatric nursing and geriatric nursing."
Start of new training is at risk
Knigge doubts that this will work, because the financing of generalist training is not secured in Bremen, he said. The new training is complex because the nursing schools and training companies of the previously separate nursing fields will have to be brought together and coordinated in the future. In the future, nursing students will have to complete an extensive part of their practical training in each area, and nursing schools will have to teach subjects from all nursing areas. All this costs money and is financed by the health and nursing care insurance funds and the state.
But: "The flat rates that the insurance companies want to pay for practical nursing training in Bremen are far below those of the other federal states," says Knigge. The ministries would put far too little pressure: "The necessary wind is missing here."
He fears that the funding negotiations will end in arbitration: "If it comes to that, the start of the new training in 2020 is in jeopardy" – and Bremen will probably be the only federal state that does not yet provide generalist training then. "That would be a disaster," says Kerstin Bringmann of the Ver.di trade union.
Reinhard Leopold, founder of the relatives’ initiative "Heim-Mitwirkung" and regional spokesman for the Biva association, is pleased that the coalition agreement envisages an increase in the number of staff at the home supervisory authority responsible for monitoring care facilities, but: "Unfortunately, this is only mentioned there as a nebulous declaration of intent – I’m missing something concrete here. The topic transparency, so Leopold, falls completely under the table: "It is very regrettable that the coalition expresses itself with no single word to the topic publication of the test results of mechanisms by the home supervision." Likewise it lacked a passage, which points concrete solutions out with proven care deficiencies. And in general: "The stationary care is dedicated straight once three sentences, in which several times ‘we want’ and not once ‘we will’ stands."
Synergy effects for family caregivers
For Leopold, merging the areas of health, care and consumer protection into one department would make the most sense. This, he says, would achieve synergy effects and the avoidance of responsibility problems, and strengthen consumer rights: "Family caregivers in particular are under high physical and psychological stress. They need simple, clear and logical structures when it comes to responsibilities and support." He is disappointed that nothing is likely to change in the departmental divisions: "Our demand has apparently gone unheard."
CDU wanted care portfolio
That would be surprising, however, because: In a "100-day program" presented shortly before the parliamentary elections for the case of government takeover, it says: "We will combine the responsibility for nursing and elderly care in a department for ‘health and care’ and appoint a care commissioner." However, this program does not come from any of the future governing parties – but from the CDU.