Eastern European Women Bear the Brunt of Germany’s Care Crisis

Ms. Alekseva is one of the estimated four hundred thousand Eastern European migrants, overwhelmingly women, who care for senior citizens in Germany, one of the few countries in the world that has a separate pillar for long-term care built into its public social security system. And yet for decades, the country has struggled to provide such long-term care, due to, among other factors, a rapidly growing elderly population and labor shortages in the industry caused by the low wages and stress associated with care work.

In 2018, there were about three million elderly Germans receiving care at home and another seven hundred thousand living in nursing homes. The co-payments patients are expected to pay for such care are higher than the state support offered to the elderly. Wealthier people, of course, can simply choose to pay for home care themselves. But without adequate funding and labor inspections to regulate such employment, consumer choice comes at a cost for workers.

The sector already faces a labor shortage of thirty-six thousand workers, while the number of people in need of long-term care is expected to double by 2060. Instead of making the job more attractive by upping pay or improving working conditions, Germany’s strategy has been to exploit the vast gap in labor costs vis-à-vis its Eastern neighbors. As its elderly population grows, the country has resorted to simultaneously exporting thousands of elderly citizens in need of care to cheaper nursing homes in Eastern Europe, while importing a cheaper labor force from Eastern Europe to care for those who remain.

Yet while workers head West, Bulgaria itself is in dire need of carers, partly due to government austerity along with what the left-wing collective LevFem describes as the “institutionalization of the lack of care,” expressed in Bulgarian workers’ degradingly low pay among other things. Last year, a little over 28,000 people in need of long-term home care requested a personal assistant to be covered by the state-funded care sector. However, state funding in 2021 would cover only twenty-three thousand workers, leaving at least five thousand patients outside of the program’s scope. Moreover, despite a raise at the beginning of this year, care workers’ pay still amounts to €450 a month for an eight-hour workday.

The inequalities between the EU’s core and periphery in terms of available health and care services on the one hand and wages on the other are what allow recruitment agencies to ruthlessly exploit these workers in the first place. It keeps the sector in core countries running, while starving the periphery of quality care. Ms. Alekseva’s case is exemplary in this regard: had she been able to access proper care for her ailing husband, she likely never would have left Bulgaria in the first place.

Alienated and Overworked

Germany’s dependence on home care externalizes the costs of reproduction of labor onto individual workers. Many who care for children, the ill, or the elderly describe it as “slave labor.” This kind of work often instills a sense of servility in women workers, which is inevitably connected to a sense of guilt and prevents them from organizing — the industry “preys on the good nature of nurses and caregivers. They feel so guilty for not working extra, and it’s designed that way,” as one care worker told Jacobin.

For Ms. Alekseva, round-the-clock care work made her feel like “a prisoner at a minimum-security prison.” It meant submission to the German company, the Eastern European hiring agency, and the elderly she cared for and their families, along with performing a number of tasks that were not included in her contractual obligations.

For two years, she cared for an elderly woman at a nursing facility. As a posted worker in Germany, her contract was with a Bulgarian company in accordance with Bulgarian — not German — law. The family of the elderly woman contracted the German agency, which in turn subcontracted the Bulgarian company, just like it did Spanish companies before. Her initial gross salary was €1,600 a month for a forty-hour week. Later, the Bulgarian company shifted her contract to a subsidiary company without telling her in order to avoid transferring responsibility for her employment to the German firm.

The next contract, signed in 2015 without her knowledge, stated that she worked thirty hours per week for a gross monthly wage of €1,562 — just €950 after taxes. Her employer paid contributions to the Bulgarian public health system and social security funds on her behalf. The German families she worked for, however, paid more — around €2,000 a month — meaning the hiring agencies were pocketing up to 25 percent, or perhaps a bit less when they felt like covering her German health insurance.

Her employer paid for Bulgarian health insurance, but this was of little use in Germany, where she spent most of the year. Once, while the woman she was caring for was resting, she snuck out to get examined by a doctor and learned that she had pneumonia. She soon received a bill for the exam and some medical tests, which she could not afford. Enraged, she called her employer to demand they cover the costs. They ultimately did so, but only after asking her, “Why should we keep making insurance payments for you in Germany if you’re generally healthy?”

Ms. Alekseva was also expected to take her day off in “installments” — perhaps a morning on a Thursday and an afternoon on a Sunday. “I could not even get to Alexanderplatz and drink my coffee in peace in so few hours.”

Taking on the Bosses

For migrant workers to be able to stand up for their rights, they need to know what their rights are and what kind of organizations can help them fight. But even if these knowledge gaps are somehow filled, they still face other obstacles: Do they know other workers employed by the same company? Will they get blacklisted if their names become public? Will they be able to get a letter of recommendation from previous employers? Taking their employer to court is also tricky. Where home care is concerned, it is difficult to collect evidence. It is also time-consuming, and low-wage workers can hardly afford to waste time on a legal battle that they could potentially lose.

When Ms. Alekseva insisted on compensation for her previous unpaid vacations, the hiring agency finally fired her. Aware that her employer was systematically violating her rights, she asked a Bulgarian friend who lived in Berlin for advice. “My friend said that the only ones who could help me were the trade unions.” This brought her to Faire Mobilität, who listened to her story and told her it was riddled with labor law violations.

According to European regulations, an employer registered in a European member state can be sued by the employee either in that state or in the state where the work is carried out. Since Ms. Alekseva had been working in Germany for three years, she chose to sue her employer at a German court, where her chances of success were likely higher and she could make a bigger impact.

With the help of Ver.di and Faire Mobilität, she took up two identical court cases for the two years of her employment, demanding that the employer provide her with fair remuneration for her twenty-four-hour workdays. Legally, Ms. Alekseva is entitled to this, as the European Court of Justice has ruled that idle time where the worker needs to be present has to be remunerated at the minimum wage.

An initial lawsuit was dismissed in 2016, but Ms. Alekseva kept fighting, and in August 2019, the Berlin Labor Court ruled that her employer owed her almost €40,000. Her employer appealed the decision, which was again upheld at a regional court and is awaiting a ruling at the Federal Labor Court later this year. Justyna Oblacewicz, an adviser at Faire Mobilität, told Jacobin that a ruling in Alekseva’s favor could “put an end to this exploitation” and force employers to “remunerate this work fairly and give it the respect it deserves.”

Fighting for What’s Right

Ms. Alekseva is not particularly optimistic about the prospects for social change in her homeland. But having witnessed the problems in the German care sector firsthand, she knows that care for both the elderly as well as the carers themselves needs to improve. “German laws have to change and state that migrant workers are entitled to the same rights and privileges as German citizens. We do the same work! We both need days off and paid vacation.”

She lays the blame for unfair wages and treatment on the recruitment agencies and the reluctance of the state to regulate employment: “If Germany needs care workers, the state should advertise vacancies at hospitals and nursing homes. And all of them should have German contracts. The intermediaries are superfluous — all they do is take half your salary. It’s unfair to the families, too.” Faire Mobilität agrees that there is no need for intermediaries. The pressure they put on all workers, migrant or not, leads to the erosion of standards of work. Private home care for the elderly is expensive and often fails to provide the round-the-clock professional care patients need.

One way to ensure a dignified existence for those in need of long-term care would be not-for-profit nursing homes funded through taxes or social security contributions (rather than private long-term care insurance policies), or care homes that are part of a wider community, thereby also addressing housing issues. They must rely on well-paid, qualified care workers who are unionized, rather than on forced overtime or cutting labor costs. This would eliminate the need for intermediary hiring agencies and drastically reduce the exploitative practices of round-the-clock care provided by a single worker.

Now in her late sixties, Ms. Alekseva is thinking about going back to work. She is currently taking care of her grandson back in Bulgaria, but her daughter’s job at a car part supplier in Germany is at risk, as supplies have been interrupted by COVID-19–related restrictions. “I was hoping the hiring agency would pay out my compensation soon, because I barely make ends meet — we rely on my pension alone. But it seems like it’ll take a while.”

When it became clear early on in the pandemic that the elderly were much more vulnerable to the effects of COVID-19 and thousands were dying in nursing homes, care workers turned out to be “essential workers” — but were also extremely exposed to the disease themselves as they often were not provided with PPE. It would have been shortsighted — not to mention deeply cruel — for governments to not make the proper arrangements to ensure the safety of patients and care workers alike.

Irregularly employed migrant workers at private homes in Germany (roughly 90 percent of all care workers) and those with part-time jobs were the worst-hit. Yet in some parts of the continent, workers began to fight back. Thrust into the spotlight by the pandemic, care workers in South and Eastern Europe organized and won hazard pay provisions in a campaign supported by UNI Europe’s Central Europe Organizing Center. It was also extremely important that Ver.di managed to negotiate bonuses for the carers on full-time contracts from the German Federal Association of Employers in the Care Industry (BVAP). Yet these do not compensate currently unemployed or irregularly employed care workers. Improving working conditions will require EU-wide reforms to ensure an upward social convergence of member states, which in turn will only happen with more organizing in Central and Eastern Europe, and an end to the practice of advertising low wages as a competitive advantage in the West.

Should the Federal Labor Court rule in Ms. Alekseva’s favor, it will constitute a big victory for migrant workers across Germany. But as she knows from experience, it will be up to workers themselves to make sure their rights are actually enforced: “All workers need to keep in mind that they have duties, but they also have rights. Demand you have your days off, demand you have your vacation days paid for, and everything to which you are entitled. We have to fight for our rights and our survival.”