Switzerland and Austria have increased regulation of their national in-home nursing sectors. In Germany, however, caregivers are rarely afforded regular breaks and are often expected to work unpaid overtime.
"Polish nurses are desperate to leave Germany for Switzerland," the caregiver Izabela Marcinek told DW. She herself spent years working as a caregiver after arriving in Germany and has since found work in Switzerland. "The differences are immense," said Marcinek, who is 58, "especially when it comes to regulated working hours."
For the past 10 years, caregivers in Switzerland have fought hard for better working conditions. It has paid off. In 2015, Swiss-based Polish nurse Agata J. went to court over outstanding pay for overtime and on-call shifts. She won, with the court forcing her employer to pay her 13,000 Swiss francs (€11,900/$14,000). "It was a groundbreaking verdict," Elvira Wiegers, of the Swiss Union of Public Service Personnel (VPoD), told DW after assisting Agata J. in her court case.
A similarly groundbreaking court ruling was delivered on June 24, when Germany's Federal Labour Court ruled that caregivers — most of whom are female and hail from Central and Eastern Europe — must receive the minimum wage when on call. As most nurses are in-home caregivers, who are available around the clock, this could mean getting paid for up to 24 hours a day. Up to 300,000 German families who employ caregivers now face the prospect of significantly higher labor costs. Developments in Switzerland could shed some light on what employers in Germany might now expect, but German caregivers have a long way to go to secure the conditions their counterparts have in neighboring countries.
Improving caregiver conditions
After the 2015 court ruling, Switzerland's government devised a standardized caregiver labor contract, which stipulates that nurses must work no more than 44 hours a week, are entitled to one and a half days off per week and should earn 25%-50% of their hourly wage when on nighttime stand-by — depending on how often they are summoned each night.
Switzerland's individual cantons are tasked with implementing labor standards. But not all are going along with the changes. "More progressive cantons have adopted the rules," Wiegers said. "Others have not." She added that further court cases have drawn greater public attention to the fraught situation. Nurses have also joined together to form alliances, she said. Even so, the problem of unpaid overtime persists. Gradually, however, there is a growing awareness that on-call services must be remunerated, she said.
The regulations mean that families who wish to hire caregivers need deep pockets. Recruitment agencies connecting nurses and Swiss families now charge 4,200-7,400 francs, depending on region and the nature of the care. Families can save such fees by hiring caregivers themselves. In Switzerland, nurses make 2,300-2,700 francs per month after tax, somewhat more than they would earn in Germany, where the cost of living is lower.
Marcinek was hired directly by her client's family. "The first two months, I snapped pictures of my timesheets, sending them to authorities for monitoring purposes," she said. If her client is in need, she will tend to her. If the unexpected visits become a regular occurrence, Marcinek has the recourse to ask her Swiss employers to adapt her contract accordingly.
'Off the books'
Most of Austria's 60,000 caregivers are self-employed. Technically, they could push for better working conditions. But only "recruiting agencies can really leverage that kind of power," Csilla, from neighboring Slovakia, told DW. She asked not to use her surname. Csilla has worked in Austria for 20 years — initially, without a contract. She has been technically self-employed since Austria introduced a law to better regulate the in-home nursing sector in 2007. "Things are better now, though half of my hours remain off the books," she said.
Self-employed caregivers are now fully registered and entitled to insurance, yet can claim neither overtime nor on-call availability pay. Nursing jobs are allocated through special agencies, who decide how much caregivers are paid per day. Daily rates range from €50 to €80 before taxes. Low-income pensioners are entitled to state subsidies.
Germans are looking to Austria as an example of how to better regulate the nursing sector. "Traditional labor contracts do not do justice to in-home carework," Daniel Schlor, the chair of the VHBP, Germany's association for in-home care, told DW. "Our legal system does not currently capture live-in work models," said Schlor, who represents recruiting agencies. He said Germany needed rules similar to those in place in Austria.
But Wolfgang Mazal, a professor of labor and social law at Vienna University, told DW that Germany should not emulate Austria. In-home caregivers who are "bound by instructions" should be regarded as conventional employees, rather than self-employed agents, Mazal said. He cited a 2011 ruling by Austria's Supreme Court of Justice that had arrived at this very conclusion. "It is scandalous that such a verdict is being ignored," he said. Legal complaints by Austrian caregivers are not being taken seriously, he added.
Legal action has significantly improved conditions for Swiss caregivers. "When we learned about exploitative labor practices, we used to wait until a contract was up before going to court," Wiegers said. Now, labor activists are educating caregivers, informing them which rights they hold and how they can enforce them.
Alas, with a significant pay gap persisting across Europe, may employers will continue recruiting nurses from poorer countries — and asking them to tend to clients around the clock. Csilla said this was certainly the case in Austria. "First, agencies recruited women from the Czech Republic and Slovakia, then they recruited Romanians and Bulgarians, and now they are seeking women from Moldova and Ukraine," she said.