Nursing crisis deepens as Germany caps care budget

German nurses and hospitals revolt against budget cap on care wages

In an open letter to the federal government, employee representatives from more than 20 hospital groups and university medical centers have warned of severe consequences for nursing care if Health Minister Nina Warken's (CDU) reform plans are implemented in their current form, according to reports by the Funke Mediengruppe newspapers (Friday editions).

The current proposals would have massive repercussions on the work of colleagues "who give their all every day—on the wards, in functional units, diagnostics, therapy, services, technical departments, and administration—to ensure high-quality patient care," the employee representatives write. The letter was addressed not only to Health Minister Warken but also to Chancellor Friedrich Merz (CDU), Vice Chancellor Lars Klingbeil (SPD), Labor Minister Bärbel Bas (also SPD), and the leaders of the governing coalition factions. "All the progress made in recent years to make the healthcare sector a more attractive workplace risks being undone."

Warken intends to cap the nursing care budget introduced in 2020 and ensure that wage increases for nursing staff are no longer fully reimbursed. Under her plan, hospitals would have to bear the additional costs themselves—yet many are already facing severe financial strain.

Frank Werneke, chair of the Verdi service workers' union, has warned that the situation in nursing could deteriorate further—and some hospitals may even face closure. Staffing shortages in nursing are already widespread, Werneke told the newspapers. "If the nursing budget is capped, understaffing will become permanent and worsen in the coming years."

Without full reimbursement for wage increases, hospitals would have no choice but to cut jobs, he added. "This pushes adequate nursing staffing levels even further out of reach." For patients, that would mean poorer care. For nursing staff, it would mean even greater pressure and stress, raising the risk that more colleagues will leave the profession because they can no longer endure the strain, Werneke cautioned. "We would be back in a vicious cycle that we had just begun to break."

Many facilities are already hanging by a financial "thread," the union leader said. "If these plans go through as they stand, we will see a wave of closures."

The letter was signed by employee representatives from Helios Clinics, Charité, and the university hospitals in Essen, Göttingen, and Magdeburg, among others. Together, the signatories represent around 323,000 employees.