Eastern Europeans Pick Up Health Care Slack in Germany | Germany | News and in-depth reporting from Berlin and beyond | DW | 16.03.2008

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Eastern Europeans Pick Up Health Care Slack in Germany

A new initiative in Brandenburg is aiming to remedy Germany's acute doctor shortage with professionals from eastern Europe. They'll be joining the growing ranks of health care workers from former communist countries.

A doctor pulls on his surgical gloves

Many Eastern European doctors in Germany have spent years unemployed

Country doctors are few and far between in Germany. General practitioners in the countryside earn around 20 percent less than their colleagues in the cities. In the eastern states in particular, many working doctors either go abroad or to large urban hospitals and specialized practices, where there are more private patients and therefore more money to be earned.

The result is an ever-worsening doctor shortage outside the cities, which health ministry officials in the state of Brandenburg now hope to reverse with a unique project -- allowing doctors from eastern Europe to pick up the slack.

The initiative, unveiled this week, is a win-win idea. It foresees countering the doctor shortfall in Brandenburg by allocating out-of-work doctors from former communist countries to country practices -- not only helping integrate Germany's minorities into the working world but also helping solve what has become an acute problem within the health services.

The Eastern European element

A care worker sitting with an elderly woman

Many old people are reluctant to get into homes

In fact, eastern Europeans have long been a presence within Germany's health services. As Germany struggles to cope with an ageing population, carers from eastern Europe are stepping in to help the country meet a growing need for trained workers. Many of them work illegally, but growing numbers of Internet agencies now provide the services of hired help from countries such as Poland, Romania, Hungary and Bulgaria.

Nonetheless, many of them operate in a legal gray area given Germany's restrictions of free movement of labor within the EU. One way the carers can circumvent these regulations is by registering in their home countries as freelancers, which allows them to spend up to six months working in Germany. Agencies tend to send them to various EU countries for limited periods and then rotate them across the Continent.

Other agencies are entirely above board, offering East European professionals a chance to sign contracts with companies in their home countries which work with partner agencies in Germany. They get sent not only to private homes but also to understaffed hospitals and clinics.

Dumping prices?

But critics say that the eastern Europeans are providing cheap labor and undercutting their German counterparts. Coming from poorer countries, they are usually willing to work for considerably less than their German counterparts and often prove more flexible to families looking after aged relations at home.

Given that the agencies are also taking a cut, how profitable is it for the nurses themselves?

"Few of them last longer than six months," said Michaela Niclaus from the agency "Help4seniors."

29-year-old Marta from Krakow didn't even stay that long. She was sent to the small town of Treis-Karden in Rhineland-Palatinate to look after Johannes Wessler's 87-year-old mother.

"My mother can't be on her own in the house," Wessler said. "She can't get around by herself and she doesn't want to go into a home."

A pensioner on a parkbench

Germany is struggling to look after its ageing population

His problems were answered when he found Marta on an agency Web site. He isn't the only one in his neighborhood to take advantage of affordable 24-hour care by trained eastern European care workers. These days, the area -- which is popular with pensioners -- is home to growing numbers of Poles, Romanians and Bulgarians all looking after the elderly local population.

But Marta was allowed just two hours off a day, six days a week -- and packed her bags after less than six months.

By 2011 at the latest, the government in Berlin will be able to lift restrictions of free movement of workers within the EU. Until then, Marta can be easily replaced.

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