Many young nurses from southern Europe come to Germany looking for work. But those who work for private nursing companies can often feel exploited - and that they have no way to leave.
23-year-old Maria Sanchez (name changed) had high hopes when she first arrived in Germany. At home in Madrid, she had no real prospects of finding work as a trained nurse. But she finally managed to find a position - in Berlin.
Now the young Spaniard would like to change her employer. But she signed a contract with the private nursing service, part of which included a clause that Sanchez now finds extremely worrying.
If she wants to quit before the two year contract is up, she has to pay 6,600 euros ($9,000). As for what costs the 6,600 euros is supposed to cover, she has no clue.
"The contract isn't clear, things aren't very well explained," she told DW. So Sanchez has decided to stay put - her fear of incurring a debt is far too big. "At the moment I can't look for a better job."
Sanchez' case isn't unique. Secretary of German trade union Ver.di, Kalle Kunkel, has dealt with many workers who find themselves in a similar situation. He says he currently knows of more than 100 employees from Spain, Greece and Portugal who feel trapped by these kinds of contracts. In some companies, nurses are even threatened with contractual penalties of up to 10,000 euros.
"That ensures that workers are effectively tied to the company," he said. The exact amount that's charged in the invoice varies and is often unclear, he added. "The bill isn't very transparent."
Most of these workers need to pay rent or and legal documentation costs on their own. But the time they need to do a mandatory language course takes the biggest toll. The course is, for the most part, covered by EU funding from the European Social Fund. But caregivers have to pay for the time they spend studying - hours during which they can't work.
No choice to change
These demands often have serious consequences for the nurses. The pay is poor, and many would like to look for a new job.
"When they come to Germany, these workers find that, although they have a job here, they're paid a whole lot less than what they could be earning [elsewhere in Germany]," said Kunkel.
He says that although many of them would have seen their contracts before leaving Spain, they only learn how much the hourly wage represents- and that German workers earn significantly more - once they arrive in Germany.
Germany's Society for Medical Intensive Care (GIP) is not bound by collective bargaining agreements and doesn't have a workers' council. By default, foreign nurses earn about 9.50 euros per hour working privately in Germany.
By comparison, public sector or social service nurses earn 30 to 40 percent more per hour.
Wages for private nurses shrink further still if they take sick leave or a vacation. Spanish nurse Maria Sanchez reports that she is only paid for around 6 to 7 hours out of the 12 hours of regular service she provides per day.
'It's a political scandal'
According to Kunkel, "That's exploitation of human resources, and it's making the nursing profession, and certainly the option of moving to Germany, much less attractive."
And this at a time when Germany sorely needs foreign nurses. While there are fewer and fewer nursing positions in the Spanish health system, there are about 30,000 vacancies in Germany. Industry representatives warn there will be a shortage of 220,000 skilled workers in the sector by the end of the decade.
That's why Germany has spent the past several years promoting its health care system abroad. The southern European countries of Spain, Greece, Italy and Portugal are the main targets of this campaign, according to a parliamentary query put to the federal government in 2013.
"It cannot be that we, as German companies, tap into the know-how of other countries and then force costs on those workers," said Kunkel. "It's a political scandal."
Bad name for Germany
But tough contracts aren't the only concern. According to Kunkel, poor working conditions are also a major complaint, with nurses sharing their experiences on Internet forums. Some, for example, reported that they had told to use fewer diapers in order to save money or that wounds on heavier patients were being ignored.
One of Sanchez' colleagues has already cut her losses. She decided to leave her job at the private care provider despite the dreaded penalty of 6,600 euros.
"The working conditions just weren't fair," she said. "But I'm still happy."
In fact, she plans to stay in Germany for another four years.