I don’t think Korian has changed that much. As a company headquartered in France, we have had long-term experience there of how beneficial a collective bargaining partnership with strong trade unions can be. But in Germany, at least in the care of the elderly, the trade unions are not nearly as strong as in France. Unfortunately, I have to say. However, it is up to the employees themselves to what extent they want to organize themselves in a union.

In contrast, in the neighboring sector – hospital care – the trade unions are very strong in Germany. Accordingly, collective agreements are much more common in this sector, whether for example in-house collective agreements, agency-wide collective agreements or even nationwide collective agreements such as the TvöD. In this area we are in competition for the scarce resource of nursing staff. Both – our experiences from France and the competition for staff – mean that we are increasingly tackling collective bargaining and want to reach agreements.

I do not think so. But as the largest private operator of nursing homes in Germany, we are particularly in focus. Regarding the term “robber barons”, I would like to point out that Korian – unlike other companies in the industry – is not a private equity company and also reports very transparently on its ownership structures.

At the moment, something like this is still the absolute exception in our industry. We have just reached a collective agreement in two houses in Rhineland-Palatinate and last year we already concluded a collective agreement for a house in Lower Saxony.

The main reason is that in most houses we do not have a contact person for collective bargaining at eye level. Because as I said, the level of organization of the trade unions in geriatric care is still very low and therefore they often lack the legitimacy for negotiations.

No, we are not. After all, we too want to reach collective agreements. As I said, we are in competition with the hospitals for nursing staff. In addition, collective agreements make our work easier. For example, clear, comprehensible fee structures are very important for negotiations with long-term care insurance funds about the long-term care rates. That’s why we want strong unions in care.

It is simply a question of practicability: only strong collective bargaining partners can make a difference together and conclude and further develop agreements with the appropriate legitimacy.

What we brought into the collective bargaining agreement is the model that we have had internally in the company for a long time: a binding and transparent pay structure. Our goal is to harmonize the very heterogeneous structures in the company caused by the many acquisitions in recent years. And of course it is clear to us that we have to bring considerable wage improvements into the system, also in order to be able to compete with the clinics for nursing staff. According to the Federal Statistical Office, the average wages for nurses in hospitals are 500 to 600 euros higher than those in nursing homes.

The pressure on the care industry to agree on tariffs has increased enormously as a result of the Health Care Development Act (GVWG). From September 1st, providers of geriatric care must have a collective wage agreement for their employees, either in a regional or in-house collective agreement – or based on the average wages in a region. We do not think that a collective wage agreement makes sense. On the one hand, the differences in the cost of living in the regions are too great for that. On the other hand, we want to be able to design collective agreements ourselves for the needs of our company. That is why we are now going into pilot degrees that can serve as a reference for individual federal states.

Nursing is something very local. Nursing staff usually live in the same place where they work. They are rooted in their respective communities. In our experience, the willingness to move to a house in another federal state is rather low among employees in geriatric care.

Collective bargaining is not just about hourly wages, but also about working conditions and appreciation. When it comes to wages, I expect that the GVWG will lead to an adjustment process in the care sector. In order to remain competitive with hospitals, for example, geriatric care will probably have to come within a corridor of plus or minus ten percent of the average salaries for nursing staff in clinics.

That’s right, the care will be massively more expensive. We are expecting an increase of around 20 percent in personnel costs as a result of the wage agreements alone. So in the order of 120 million euros. There has never been such a massive increase in expenditure in our company. And that’s not the only factor. Parallel to the provisions of the GVWG, politicians are increasing the minimum wage significantly. This will also lead to additional costs, especially for suppliers and in the logistics areas of care. Finally, we have the issue of inflation.

These massive cost increases put a strain on both the long-term care insurance funds and the residents. And with that, of course, the social agencies, who step in with the care costs if a person in need of care cannot raise the funds themselves.

The relief in the personal contributions, which the GVWG also includes, will only very insufficiently protect most of those in need of care in the homes from the price increases. Because they are staggered according to the time in the home, and only after three years of living there is a noticeable relief. But the years of life of most residents in a home are less.

That is why there is now an urgent need for further steps on the part of politicians to relieve those in need of care of the expected significant price increases. This includes freeing residents from the statutory co-payments for the training costs of nursing staff. And this also means that the health insurance companies pay for components of care in the home that are a medical service – such as the care of wounds or diabetes symptoms – according to the service specifications of the statutory health insurance, as is the case in the hospital. These services are more complex than body care and are therefore more expensive. And that certainly includes additional tax-financed subsidies.

If someone now has to pay an average of 1,800 euros per month for their care in the home, then it may well be that this will be up to 1,000 euros more from autumn. That’s huge. The federal government should therefore quickly initiate the further relief announced in the coalition agreement. Then the average additional load can probably be capped at around 400 euros. In my opinion, that is still justifiable, especially since something good is being done with it, namely creating the conditions for more people to stay in the nursing profession, those who have left to return there and more to choose this profession.

Let’s put it this way: We still have vacancies in almost every one of our houses. At some locations, this means that the space capacity for which they were originally set up cannot be fully utilised. In some facilities, we had to temporarily close entire living areas because the required quota of skilled workers – around 50 percent, depending on the level of care for the residents being cared for – is not being reached.

We make sure that, to compensate, we also look after residents who have a lower level of care, for whom a lower proportion of skilled workers applies. More so-called nursing assistants who have completed a one-year training course can then be deployed there.

But in order for the nursing home industry to be able to achieve any type of staff ratio, politicians must think about making the previously rigid quotas for skilled workers more flexible and allowing the facilities to hand over more tasks to the nursing assistants. That would only be a redistribution of tasks within the workforce. But to be honest, I don’t expect the total number of nurses to increase significantly any time soon.

I think you have to differentiate between those who came to us a few years ago and basically left their old home country behind and those who only recently arrived in Germany. This means that among those who fled to Germany from Syria in 2015, for example, there are certainly some who make this career choice. We, too, have found highly motivated new employees among them.

But I think that those who are now coming to us from Ukraine mostly hope to be able to return to their homeland. So we don’t expect many of them to decide to train as nurses in Germany – but of course we’re happy about everyone who does it. However, the refugees will not be able to fundamentally change the shortage of nursing staff. The way to alleviate the shortage is through higher wages and competitive working conditions in geriatric care, a more flexible quota of skilled workers and relieving employees of non-care-related tasks.