Federal Minister of Health · since 29 July 2026
Economy → Work → Social Security → Health → Reform
Health ministry · Workforce
More people work in German healthcare than ever before — yet doctors’ practices report vacant seats, care homes report unfilled posts, and almost one practising doctor in four is 60 or older. The workforce question is a question of hours, age and geography, not only of headcount.
The health sector is one of Germany’s largest employers. Its growth has not kept pace with the hours that an ageing population needs.
At the end of 2024 almost 6.2 million people worked in the German health sector, 102,000 or 1.7% more than a year earlier, according to the Federal Statistical Office (Destatis). It was the first increase of more than one per cent since 2021. Because so many of these jobs are part-time, the 6.2 million people corresponded to roughly 4.4 million full-time equivalents. Set against about 46.0 million people in employment in 2025, health accounts for roughly one job in seven (the two statistics are compiled differently, so the ratio is indicative).
Growth was uneven. Employment in inpatient and day-patient facilities rose by 3.0%, the ambulatory sector by only 1.3%. Nursing staff in hospitals, rehabilitation clinics and care services grew by 49,000 (3.4%), with nursing assistants (+5.2%, to about 485,000) growing faster than registered nurses (+2.6%, to about one million). Employment in physiotherapy, occupational therapy and other therapeutic professions rose by 2.4%; staff numbers in pharmacies were unchanged.
These figures are why Carsten Linnemann’s two professional worlds meet in this policy area. As an economist he spent years arguing about labour supply, working hours and the labour market; as Federal Minister of Health since 29 July 2026 he is responsible for a system whose capacity depends on exactly those variables. In his first Bundestag speech as minister, on 10 September 2026, he made the workforce the third of his guiding principles:
„Ärzte und Pflegekräfte sollen Zeit für ihre Patienten haben und nicht für Formulare verwenden.“
Reading the numbersHeadcount and capacity are different things. A rising number of doctors can coincide with fewer available appointment hours if more of them work part-time — which is what the professional bodies report.
Selected professional groups, with their own reference dates. The age split shows how many practising doctors are approaching retirement.
SourceDestatis, health personnel 2024 (press release 030/2026) and hospital statistics 2024 (398/2025); Bundesärztekammer, physician statistics 2025. Nursing counts include hospitals, rehabilitation and long-term care. Hospital doctors refer to 2024.
SourceBundesärztekammer, Ärztestatistik 2025. Under-60 share calculated as the remainder of the 23.4% reported for 60+.
The physician statistics for 2025 show growth in numbers and a structural shift in how medicine is practised.
The Bundesärztekammer (BÄK), the federal umbrella of the Länder medical chambers, counted about 446,000 practising doctors at the end of 2025. Growth came mainly from hospitals (+2.4%) and from employed doctors in ambulatory care (+6.7% in one year). The number of self-employed doctors in their own practices fell by 1.3% in 2025 and by about 8% over five years. The traditional model — a doctor who owns a practice and works long hours in it — is giving way to medical care centres and salaried posts, which younger doctors often prefer.
The BÄK reports average working time of 40.3 hours a week, and a part-time share that has roughly doubled over a decade. The National Association of Statutory Health Insurance Physicians (KBV) draws the consequence: although there were slightly more general practitioners in 2025, the full-time-equivalent capacity in general practice fell, and about 5,000 GP seats were unfilled nationwide. Its chair, Andreas Gassen, warned that practices are “not an infinitely available resource”.
Retirement is the second pressure. 60,826 practising doctors were aged 60 to 65 at the end of 2025 and another 43,444 were older than 65 — together 23.4%. Many of them run single-handed practices in small towns, where a retirement without a successor can remove a whole practice from the local map. Because younger doctors are more likely to work part-time, the KBV argues that replacing one full-time retiree will often take more than one new doctor.
Under-supply is formally determined in the Bedarfsplanung, the needs-based planning system run jointly by the Associations of Statutory Health Insurance Physicians and the health insurers in each Land. In 2025 it found under-supply in 40 planning areas and impending under-supply in 173, mostly in general practice. At the same time, 958 planning areas exceeded the 140% threshold for over-supply in the fourth quarter of 2025 — evidence that Germany’s problem is distribution as much as total numbers.
04 / Nursing, therapy, pharmacy
Doctors are the most visible group, but most health workers are nurses, therapists, assistants and pharmacy staff.
About one million registered nurses and 485,000 nursing assistants worked in hospitals, rehabilitation and long-term care at the end of 2024 (Destatis). A Destatis projection from January 2024 expects demand for nursing staff to rise by a third to 2.15 million by 2049, with a possible gap of between 280,000 and 690,000 depending on the scenario. The detailed picture is on the nursing page.
Physiotherapy, occupational therapy, speech therapy and other therapeutic professions grew by 2.4% in 2024, faster than doctors’ practices (+0.5 to 1.0%). Training for several of these professions is regulated federally but delivered by schools that the Länder supervise; reform of the training laws has been discussed for years.
Germany had 16,601 community pharmacies at the end of 2025, 440 fewer than a year earlier and the lowest number in almost 50 years (ABDA, as reported). The pharmacy reform passed in 2026 lets experienced pharmacy technicians run a pharmacy temporarily and simplifies branch pharmacies — measures aimed at staffing as much as at economics. See pharmaceutical policy.
The local public health offices (Gesundheitsämter) are run by the Länder and municipalities. Their staffing became a national topic during the pandemic and is closely tied to health security and prevention.
Without international recruitment, the workforce would already be shrinking in several professions.
SourceBundesärztekammer, Ärztestatistik 2025.
The BÄK counted 71,480 foreign doctors in 2025, 16% of all practising doctors and 5% more than a year earlier; growth came almost entirely from outside the EU (+7.6%), while the number from EU states was flat. In 2025, 5,448 of the new registrations with the medical chambers were foreign nationals, against 10,203 German citizens.
Recognition is the gateway. In 2025 the authorities issued about 86,600 positive recognition decisions for foreign vocational qualifications — a record, according to Destatis — and health professions dominated: about 32,000 for nursing professionals and 13,900 for doctors.
For doctors, dentists, pharmacists and midwives the route has been slow and document-heavy. A law passed by the Bundestag on 26 March 2026 and approved by the Bundesrat on 8 May 2026 makes the direct Kenntnisprüfung — a knowledge examination — the standard route for applicants from outside the EU, with the document-based equivalence check as an option. It enters into force on 1 November 2026. Recognition itself is carried out by Länder authorities.
As CDU Secretary-General, Linnemann framed migration as a question of labour-market entry rather than access to social benefits. As minister he has not yet made a specific statement on international recruitment of health workers; the ministry’s line is the inherited one. The ethical question of recruiting from countries with their own shortages remains open, and the WHO maintains a global code of practice on the international recruitment of health personnel.
Every item carries a status. Most workforce measures in force were decided before Linnemann took office on 29 July 2026.
Inherited from Nina Warken. Bundestag 26 March 2026, Bundesrat 8 May 2026. Knowledge examination becomes the default for third-country doctors, dentists and pharmacists; procedures are to be digitised and harmonised. Implementation lies with the Länder authorities.
The Gesetz zur Befugniserweiterung und Entbürokratisierung in der Pflege (Bundestag 6 Nov 2025, Bundesrat 19 Dec 2025, in force 1 Jan 2026) allows registered nurses to perform tasks previously reserved for doctors, according to their qualification.
Passed in May/June 2026. Lets experienced pharmacy technicians temporarily run a pharmacy, allows shared management of branch pharmacies and extends vaccination by trained pharmacy staff.
Draft bill promised for November 2026 (government question time, 23 September 2026). Patient steering through GP or primary-care practices would change workloads across the profession; how capacity in general practice will be secured is one of the open questions. See health system.
At the ministry’s hospital summit in September 2026 Linnemann said a planned Bürokratierückbaugesetz should reduce duplicate inspections and introduce risk-based controls. No draft had been published by 8 October 2026. See bureaucracy reduction.
Universities and study places are a Länder matter. Under the 2017 Masterplan Medizinstudium 2020, Länder may reserve up to 10% of places for students who commit to rural practice; eleven Länder had introduced such a quota by October 2024. The federal ministry can set training content through the licensing regulation but cannot create study places.
Where the minister has made no specific statement, the questions are described rather than answered.
Part-time work and salaried employment are rising across medicine and nursing. Policy instruments — fee structures, practice models, childcare, flexible contracts — influence how many hours people choose to work. An economist’s focus on labour supply suggests that hours, not headcount, will be the relevant metric; the ministry has not published a target.
Electronic prescriptions, the electronic patient record and secure messaging are meant to cut paperwork. Professional bodies report that unstable systems cost time instead; the ministry itself counted an average of 25 telematics disruptions a month in 2025. See digital health.
The legal levers are spread across Bund, Länder, physicians’ associations and insurers: needs-based planning, study-place quotas, local subsidies and the option for municipalities to run medical care centres. Primary-care reform will test whether these levers can be coordinated.
Nurses gained new competences in 2026, pharmacists can vaccinate and, in defined cases, dispense without a prescription. Doctors’ organisations have generally argued for care to remain under medical responsibility; nursing and pharmacy bodies argue for more autonomy. The balance is unsettled.
Germany relies on doctors and nurses trained abroad. Faster recognition helps applicants already in the country; whether and how Germany should actively recruit from countries with their own shortages is a political and ethical question on which the new minister has not spoken.