Germany’s Care Emergency: 1.38 Million Recipients in NRW, Up 137%, as Fee and Budget Battles Intensify
Published on 07/19/2026 at 08:23 | Redaktion boerse-global.de
The number of people receiving nursing care in North Rhine-Westphalia has hit 1.38?million, a jump of 137?percent since 2013, according to the state’s Pflegekammer (nursing chamber). Compared with 2021, the figure rose by 16?percent. Chamber president Sandra Postel sounded an urgent warning: in some districts, three times as many nurses are retiring as are entering the profession. A public-awareness campaign has been running since the end of 2024 to highlight the looming shortfall.
While the demographic pressure mounts, a separate dispute over funding threatens to strain the system further. The draft of the Pflegeneuordnungsgesetz (PNOG), published in June 2026, includes two new budgets — one for relief services and one for social-space care. But nursing associations argue that the accompanying GKV-Beitragssatzstabilisierungsgesetz would undermine those gains by capping the overall care budget from 2027 onward.
Vera Lux, president of the German Professional Association for Nursing Professions (DBfK), called the cap “irresponsible.” She warned that limiting the budget could create financing gaps: tariff-related wage increases would only be partially refinanced. At major institutions such as Berlin’s Charité hospital, an estimated seven percent of nursing positions could be at risk.
Private home-care providers in the Rheinisch-Bergisch district are also pushing back. They complain of unequal treatment compared with union-bound providers. Private services, they say, cannot refinance wage increases above a general adjustment rate in the same way. An open letter to federal policymakers has already been submitted.
Adding a layer of administrative tension, members of the Pflegekammer can now formally contest their fee assessments. The chamber has released a model objection form based on Section?119 of the Heilberufsgesetz (Health Professions Act). Anyone filing an objection must meet specific deadlines and ensure that their grounds existed by the assessment reference date of 1?February. The process carries a financial risk: if the objection fails, a fee of 70?euros is charged. For those unable to pay the original contribution, a hardship application is available.
The convergence of rising demand, contested reforms, and a fee revolt underscores the pressure on care services in one of Germany’s most populous states. Postel’s campaign, launched in late 2024, continues to push for broader public awareness of what she describes as a looming supply crisis.
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