As in other sectors, there is a significant pay gap between Eastern and Western countries for those working in elder care. “In Hungary, average wages in the social sector are the lowest, with a net average of around 200,000 forints (around €550),” says Andrea Gyarmati, a sociologist who researches elderly care. She adds that the much lower average wage reported by the National Bureau of Statistics was calculated by including the approximately 100,000 public sector workers in the social sector.
In Germany, where many Hungarian nurses and carers migrate to work, the starting monthly wages reported to Investigate Europe are between €1,300 and €1,500 (HUF 470-540,000). According to the Hungarian nurses we spoke with, this significant wage gap — and worse conditions in Hungary compared to the West — contributed to their decision to leave the country. But leaving Hungary didn’t necessarily mean a better life for them.
“Everything was so terrible that we escaped under the cover of night. We ordered a carpool and only signed our resignation when we got home,” says one nurse, Emese, recounting the story of how she and her daughter Orsolya left their jobs at a German care home (all careworkers asked only to be identified by their first names).
“The problem with care homes is that there are so many residents and so few nurses. We were working an awful lot, almost without a break. I started smoking again because I realised that as long as you smoke, you can take breaks,” explains Emese, who is in her sixties. She had previously worked for 19 years as a specialist nurse in surgery in Hungary. She says she isn’t easily fazed by challenges, but changing the diapers of a hundred old people several times on one night shift was too much for Emese.
Her daughter Orsolya also faced similar challenges. After she and her mother ran away from their previous job at night, Orsolya worked at a new facility. This one belonged to Kursana, which runs 98 care facilities in Germany. But things weren’t much better here. “They found out that I was fast and I could take on a lot of work: at first they just asked me to help out a little here and there,” she recalls. “At first, they only gave me five people, then seven or eight, then 10, then 20, and finally I had to do a whole floor on my own. When I asked for help, they looked at me like a murderer.”
And residents inevitably suffered, she says. Sometimes you had to transfer nappies from one patient to another,” shares Orsolya. “I was there [at Kursana] for about a year and finally quit because the last months were worse than hell and I couldn’t take it anymore, my health was failing. Every time I worked overtime, my payslip always said I had minus hours. I was happy if I got €800, which was not even the minimum wage. I earned the least here, and I had to go to work almost every day,” The last straw, she says, was when “the nurse found out it was her dog’s birthday and she had to go. She left me alone with 40 people to administer the medicine, the insulin, to bandage this or that hand or foot. I put everyone to bed alone.”
When Investigate Europe reached out to Kursana for comments, press spokeswoman Michaela Mehls said, “We take each allegation very seriously and follow it up. One employee for 40 residents in care does not correspond to staffing standards.” She added that the company would look into the allegation and come back with a response.
In search of a better life
After many years of working in Hungarian nursing homes, in 2012, Erika decided to try her luck in Austria, and eventually, Germany. “The conditions at the homes got worse and worse, even the night cleaner was dismissed, the night nurse had to clean,” she says about her experience in Hungary. ”There were times when I had to wash 10 people with one sponge, but it was forbidden to talk about it.”
The conditions in Germany, she concedes, were better. “You can’t compare Germany with this; the patients were given three meals, they could choose from three menus.”
Mónika, who spent decades in Hungarian care homes, also emigrated to Germany, to work for a small for-profit home in Bavaria. She says the standard of care in the facility (where she still works) was okay, but even here, there were 20 residents for every three careworkers. Her main problem is that “the physical safety of the carers is not properly protected. Dementia patients are sick, of course, and you can’t blame them, but they are very difficult. There’s an old lady who kicks, scratches and bites me, even though I only change her nappy. That’s why this [monthly salary] of €2,010 is not enough, and I have €1,130 left in my current account, after paying the accommodation fee. That is not enough for the fact that they hit, kick and bite me.”
Mónika also adds that the majority of the careworkers in her workplace are not German. This was confirmed to us by other interviewees. “The real Germans who are there are all middle managers,” she says. On the national level though statistics show that the majority of care workers in Germany are, in fact, German.
Csilla works for Augustinum Residenz, a luxury apartment complex that operates as a care home. Residents pay thousands of Euros a month for the service. “Professionally, there are things that make me want to scream because sometimes people who need hospital treatment are still here. I don’t think it’s ethical because it’s very money-driven,” explains Csilla, who says the facility keeps people until they die, purely for profit.
Augustinum Residenz did not respond to our request for comments.
Nurses who have many years of experience are also bothered by the fact that they are treated as if they are newcomers to the profession, even after their qualifications are recognised in the country. “I’ve taken more blood pressure than all of them here, but I can’t do what I’ve learned well. Even a nurse’s aide feels empowered to check me because they don’t accept my qualifications,” says Mónika.
This stress is compounded by the fact that these migrant care workers have to live far from their families. For most of them, emigration was a result of necessity (foreign currency loans, supporting the family, covering major expenses). Emese, for example, only wants to stay until her youngest son finishes his degree in economics at Corvinus, but every day is a struggle for her “If the family circumstances at home hadn’t been such that I had to come out, I would never have come, and if I didn’t have to support the people at home, I would have stopped a long time ago, because it’s a soul-crushing experience,” she admits. “What it’s all caused here is not something you can put a price on.”
Falling short of standards
How and why do these migrant workers, who go in search of a better life, face such challenging working conditions? The answer is quite simple, and yet perplexing. Governments across Europe seem to think that they are doing enough at the national level and that the market will sort it out. This is evidenced by the lack of resources for inspecting nursing homes. In the Turin area in Italy, there are only one or two inspectors looking after 400 elder care facilities. For Galicia, Spain, as a whole, there are just seven. But even in Norway, which has largely served as a positive example, a facility operated by commercial firms in Stavanger was reportedly inspected only once over a period of 14 years.
When they are inspected, facilities are often given ample notice And if problems are found, in many places including Hungary, enforcement does not always happen.
“We would like to see more attention paid by policymakers to the working conditions of carers, because generally speaking, if a carer is poorly paid, under-trained, or doesn’t have enough time for the people they care for, they will be unable to provide good quality care,” says Matt Egan, a representative of the UK trade union, Unison.
The perversity of the situation is that multinationals make profits by providing the same service, often at a lower cost than the state, but at a lower standard. And European governments applaud this. Instead of taking the burden on their own shoulders, they are handing out public money to companies to make a profit, while millions are left without care. And even at this level, it is only thanks to the exploitation of Eastern European and immigrant labour that the care of the elderly works as it does.