In Data: Migrant medics plugging gaps in Germany's health service

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BRUSSELS - Migration has emerged as a top issue in Germany's upcoming election in February as right-wing parties call for a crackdown on newcomers even as the economy is heavily reliant on foreign-born workers.

Thousands of people protested in Berlin in February against plans to limit immigration proposed by opposition conservatives and supported by the far-right Alternative for Germany (AfD).

Industries from manufacturing to construction rely on foreign workers in Germany, but this dependence is particularly evident in healthcare.

The sector is facing an acute labour shortage as the number of doctors retiring outstrips the number of people going into the profession in a country with an ageing population.

A November study by the Bertelsmann Foundation found that without immigration, Germany's workforce would fall by 10% by 2040 as the population ages. Economists say labour shortages can slow down entire sectors of the already sluggish economy.

Here's what you need to know:

What is the current immigration debate in Germany?

Germany, under its Social Democrat chancellor Olaf Scholz, reintroduced immigration checks at all its land borders last September, a move that drew criticism from neighbouring countries which said it breached the European Union's principle of free movement.

The move was in response to public concerns amid a spate of violent incidents involving people with an immigrant background, which has stoked support for the far-right AfD party, and led some other politicians to toughen their stance on migration. These incidents included a car-ramming and deadly knife attack.

Leading in the latest polls, the opposition Christian Democratic Union (CDU) and the AfD have called for a stronger crackdown on migration policy, including permanent border controls, increased detentions of "illegal immigrants", outsourcing asylum processes to non-EU countries and resuming deportations to Syria and Afghanistan.

Two-thirds of the German public support stronger immigration rules, a recent poll showed. But another poll showed that voters' main concerns included the economy and high prices.

What is driving the labour shortage in healthcare?

Demand for doctors is a pressing issue. A study from the government-backed Competence Centre for Skilled Workers, showed that around 47,000 positions in the healthcare sector, ranging from physiotherapists to dental assistants, were unfilled in the 12-month period between July 2023 and June 2024.

Germany's healthcare sector is experiencing a twin pinch of low numbers of medical graduates entering the profession, and high numbers of doctors reaching retirement age.

Compared to neighbouring EU countries, Germany has one of the lowest rates of medics graduating with 12.4 graduates per 100,000 inhabitants in 2022.

Adding to the pressure of fewer graduates is the ageing workforce. Germany had Europe's highest share of physicians aged 55–64 years at 36.1% in 2022.

The ageing population is also placing increased demands on already strained healthcare services. The number of people aged 65 and older is projected to almost double, from 16 million to an estimated 24 million by 2040, according to Germany's statistical office.

Skilled migrant workers are crucial to keeping the health service running in future, according to a 2023 report from the Expert Council on Integration and Migration, a Berlin-based research body.

How many foreign-born doctors are working in Germany?

Foreign medics make up about 14% of the healthcare workforce, according to a 2023 report from the German Medical Association.

The number of foreign-born doctors reached a new high in 2023 at almost 64,000, double the 30,000 registered in 2013. Thirty years ago, there were around 10,000 foreign doctors working in Germany, according to the German Medical Association.

Around 10,000 Syrians work in German hospitals, making them the largest group of foreign doctors in the country, according to the Syrian Society for Doctors and Pharmacists in Germany.

Former chancellor Angela Merkel's decision in 2015 to welcome over one million asylum seekers, predominantly from Syria, was controversial in Germany, while some political analysts have blamed it for contributing to the rise of the AfD.

After the fall of the then Syrian president Bashar al-Assad last December, some German politicians suggested it was time for Germany's Syrian refugees to consider returning home.

However, the chairman of the German Hospital Federation (DKG) said that if large numbers of Syrians left, they would leave "noticeable gaps" in the provision of care, although he said the service wouldn't collapse.

So how is Germany responding?

Germany has relaxed some rules to attract skilled foreign workers. It introduced the Skilled Workers Immigration Act in 2020 and expanded the law in 2023 with the aim of broadening access to the labour market for non-EU nationals, in many cases by simplifying and fast-tracking visa applications.

However, the centre-right CDU, whose leader Friedrich Merz is widely tipped to become the next chancellor, and far-right AfD party opposed the 2023 law, arguing that the law's definition of skilled labour was too broad.

Germany has signed or is in the process of signing migration partnerships with 10 countries, including Kenya, India and the Philippines, to allow skilled workers from these countries to live and work in Europe's largest economy.

(Reporting by Joanna Gill; Editing by Ana Nicolaci da Costa.)