How do we secure the future of care? – A recap of an engaging discussion

On May 21, 2025, around 100 guests gathered at the House of Science in Bremen by invitation of the Alumni Association of the University of Bremen e.V., the high-profile area “Health Sciences”, the SOCIUM Research Center for Inequality and Social Policy, and the “Integrierter Gesundheitscampus Bremen (Integrated Health Campus Bremen). Among the participants were numerous alumni members, professionals, and interested parties from academia, practice, and politics – as well as students from the University of Bremen and the Bremen University of Applied Sciences.

The focus of the evening was a lively panel discussion with four distinguished experts from academia and practice. Present were Judith Burgmeier, co-founder of the Bremen-based nursing service vielf?ltig. GmbH, Jutta Dernedde, chairwoman of the Medical Service Bremen, and Reinhard Leopold, involved in various nursing policy initiatives such as "Heim-Mitwirkung" and the organization “wir pflegen e.V.”. The academic perspective was provided by Prof. Dr. Heinz Rothgang, health and care economist at the SOCIUM Research Center for Inequality and Social Policy at the University of Bremen. The discussion was moderated by Prof. Dr. Matthias Zündel, head of the Integrated Health Campus Bremen.

Nursing in the Coalition Agreement: A Gap or an Opportunity?

The event had been planned before the publication of the new federal government's coalition agreement – with the expectation that the topic of nursing would play an important role. Therefore, the opening statement by Prof. Dr. Heinz Rothgang was all the more disillusioning: the topic "care" barely appeared in the coalition agreement. This was seen as a significant setback compared to the previous legislative period – although, Rothgang noted critically, many of the measures announced back then had not been implemented. In this context, the current silence in the agreement could also be interpreted as an opportunity: "It will be interesting to see what actually happens now."

Working Conditions over Pay: The Skilled Worker Shortage Remains Critical

A central issue in the discussion was the ongoing shortage of skilled workers. It became clear that while pay in the care sector has significantly improved over the past ten years and is no longer the main problem in many areas, the much more pressing issue is the increasingly burdensome working conditions. These include insufficient staff-to-patient ratios, unpredictable shifts, and resulting overload. This leads to a vicious cycle: because there is too little staff, workloads increase, which in turn causes more people to leave the profession.

The important role of foreign care workers was also discussed, as they make a significant contribution to care provision. However, there are differences in education and professional understanding: in many countries, nursing is an academic profession with bachelor's and master's degrees. This can make integration into the German system more challenging, as expectations, qualifications, and standards often differ significantly.

Public Perception: Nursing Remains Underappreciated

The question was raised as to why the topic of nursing – despite its societal relevance – often goes unnoticed in public perception. Given the demographic developments, this seems hard to understand: statistically, two out of three men and five out of six women will need care at some point in their lives. These numbers clearly show that nursing is far more than a marginal issue – it concerns society at large.

Trust as a Basis for Change

A key problem identified was the lack of trust between the relevant stakeholders – such as between health insurers, the Medical Service, inpatient facilities, and home care services. This lack of trust was seen as a major obstacle to collaboration and leads to additional burdens for nursing staff, organizations, and ultimately, the care recipients themselves.

Not a Lack of Ideas, but of Implementation

In addition to structural issues, it was emphasized that the concepts for improvement already exist. What is lacking is not ideas, but their consistent implementation. Even though financial resources are limited, it became clear that many challenges are more related to coordination and management deficiencies than to a lack of funding. Nevertheless, the consensus was that additional funds are needed in the system, and these must come from the federal government.

At the same time, efficiency potentials were highlighted: Many processes could be made more effective through better coordination. Digitalization also offers opportunities here, but many technologies still lack scientific trials in practice. However, Prof. Rothgang emphasized that efforts are currently underway in Bremen, referring to the TCALL project. Additionally, the importance of prevention was highlighted. Investments in preventive measures – such as promoting health in old age or supporting family caregivers – can relieve the care system in the long run and improve the quality of life for those affected.

Highly Professional – Engagingly Moderated

The high level of expertise in the audience was particularly notable: representatives from health insurers, the Workers' Chamber, inpatient and outpatient care services, as well as numerous students and professionals from the healthcare sector, participated actively. This led to a lively and dialogic discussion that was driven not only by the panel but also significantly by contributions from the audience.

All in all, it was a highly interesting evening that brought together many perspectives and highlighted the diversity of both challenges and potential solutions. The traditional get-together following the panel discussion also saw continued intensive debate – a sign of how relevant and urgent the topic of nursing remains.

Event Series with a Long-Term Perspective

The event was part of the health policy colloquium of the Health Sciences Research Focus at the University of Bremen. The Alumni Association of the University of Bremen e.V. contributed actively to this first special event in the series and will continue to support it – driven by a strong belief in the importance of the topic. Further events are already in the planning stages.

Anyone interested in being informed about upcoming dates can be added to the mailing list by contacting Maren Emde, Coordinator of the Research and Transfer Focus in Health Sciences at the University of Bremen, at: gpk.sociumprotect me ?!uni-bremenprotect me ?!.de