In 2022, the legislature introduced regulations on fair collective bargaining pay in long-term care. These stipulate that long-term care facilities may only be approved to provide services under the statutory nursing care insurance if they either bind themselves to collective contractual arrangements — such as collective wage agreements or church employment law regulations — orient themselves towards such arrangements, or apply the regionally customary level of remuneration.
The scientific evaluation shows that the regulations have achieved their objective. The wage increases observed between 2022 and 2025, particularly in the lower income groups, are largely attributable to these regulations. Wage levels rose across all federal states during this period, albeit to varying degrees: for example, the regionally customary remuneration level for auxiliary staff rose by around 39% in Bremen, but by only approximately 15% in Schleswig-Holstein.
The wage increases also had an impact on prices in long-term care: in the two years following the introduction of the regulations on collectively agreed pay, prices for outpatient and inpatient care services rose considerably more sharply than in the three preceding years. Overall, however, the regulations led to an enhancement of the nursing profession through better pay, thereby contributing to the achievement of the goals of the "Concerted Action on Nursing" (Konzertierte Aktion Pflege).
The current draft bill a reform of the statutory nursing care insurance (Pflegeneuordnungsgesetz, PNOG) proposes suspending the regulations on collectively agreed pay for an initial period of four years. Prof. Dr. Heinz Rothgang (SOCIUM, University of Bremen) stated: "In our view, these proposals are heading in the wrong direction. We considered the suspension of the regulations as a scenario in our evaluation, but rejected this option. The regulations are fulfilling their purpose and should in principle be retained, even if adjustments are made to the details."
Prof. Rothgang also offers his assessment of the current debate on collective bargaining regulations in long-term care in this video (German only): https://www.youtube.com/watch?v=dN_MqDNbvXY
Contact:
Prof. Dr. Heinz Rothgang
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58557
E-Mail: rothgang@uni-bremen.de
