Care manifesto for good care and support

Swiss geriatric nurses describe what needs to change

Interview with Samuel Burri (UNIA), questions and introduction: Matthias Neumann

The Swiss trade union UNIA published a care manifesto in 2025, which can be ordered here. It begins by identifying the problems in the country's long-term care sector, which is increasingly facing a dramatic care crisis due to a vicious circle of underfunding, pressure on working conditions and pay and the resulting shortage of skilled workers. The manifesto was written by around 20 employees in the long-term care sector, supported by academics from the University of Applied Sciences of Southern Switzerland.

The text of the manifesto comprises three parts. The first part identifies the impending supply crisis and its causes. Although there are major institutional differences, particularly in the area of social infrastructure, and findings cannot easily be transferred between countries, many things are familiar from a German perspective. The economisation of care, too little time for needs-based, supportive and relationship-building care, too little say in everything from the planning of operations to measures for the people being cared for, breaking down the care process into individual tasks, etc. The text, which is written both precisely and forcefully, makes it clear how much the employees suffer not only from the intensification of work. Not being seen, not being consulted as experts, being curtailed in their ability to act, not being allowed to provide good care - this criticism runs through the manifesto. The first part contains the appeal: "We simply demand: Let's just do our job! Let's organise care in this country ourselves!"

This is also the starting point for the second part, which develops a vision of "good care and support for all in 2035". The 35 key elements defined address broad contexts such as the fact that care should benefit everyone "regardless of their living situation, age or financial resources" or that "care work ... should be seen as an important contribution to society". However, they are also very specific when it comes to the abolition of shared services or a reduction in paid working hours for care workers to a maximum of 32 hours per week, with the aim of reducing paid working hours for everyone to a maximum of 25 hours per week and at least eight hours of unpaid care or voluntary work. In this section, too, the care workers repeatedly emphasise: Let us contribute our motivation, give us freedom of action, respect and use our expertise!

Finally, the third part deals with how this vision can become reality. Four starting points are mentioned: Firstly, mobilisation that allows everyone involved to contribute their views and skills. Secondly, trade union organisation and "civil society alliances". Here, however, it is striking how much the development of power is localised with the employees, while the alliances are credited with gaining public support, among other things. However, the manifesto also emphasises that nobody should speak for the employees; they should be put in a position to speak for themselves. The third lever: Needs-based care requires more autonomy for staff in the care organisation. Finally, according to the authors, better care requires better working conditions: shorter working hours, higher wages, an end to precarious employment.

At the beginning of February, Economiefeministe organised a seminar in which the manifesto was presented and trade unionists, academics and activists from the feminist movement discussed how the analysis of the situation in long-term care can be used as a basis for joint action. Here, the impression gained from reading the manifesto was confirmed: even in the rather dry setting of an online seminar, the vigour and anger with which the authors claim visibility, agency and autonomy were palpable. Secondly, the care attitude expressed in the manifesto was also palpable: the empathy not only towards colleagues in the same situation, but also towards carers who cannot currently be cared for according to their needs, was audible. Thirdly, it was noticeable: Unlike employees, family carers were not addressed as subjects of care work, independent subjects of change and experts in their situation. This was also a topic of discussion: on the one hand, it is a very important step to clearly demand that employees be recognised as subjects of the reorganisation of care. However, this does not automatically mean that the second step of recognising family members as having such an active role in home care has been taken. Fourthly, it was about the alliance perspective. On the one hand, it was clear that the trade unions do not simply call for action, but that a process of organising the workforce is required, and also a process in which an alliance grows together in which all those involved contribute their own perspectives. The feminist strike on 14 June 2027 was also a shared vanishing point. Participants from all perspectives emphasised this: We all need each other as contributors and fellow strikers!

We are delighted to have the opportunity to ask Samuel Burri, UNIA sector manager, co-editor of the Care Manifesto and speaker at the Economiefeministe seminar, questions about the Manifesto:

Samuel, you are co-editor of the manifesto. There is a tremendous amount of anger behind the text, but also relief that what needs to be said is being said out loud. In your opinion, what is the greatest burden for care workers and how does this contribute to the shortage of skilled labour?

What we experience with our members is great despair: they try to be there for their residents every day with too few colleagues, to provide them with professional and humane care. Nevertheless, they go home after their shift with the feeling that they have not done justice to those in need of care. In addition to the challenging working hours and constant stress due to staff shortages, this drives many carers to give up their profession.

In the discussion, you emphasised that the care crisis affects or will affect everyone. To what extent is this an issue in Switzerland, and do you sense a desire on the part of other organisations to become active together with you?

Yes and no. Politicians and authorities are ignoring the looming care crisis. Despite calls for action from carers, scientists and the institutions themselves. However, there is a change among pensioners and those who will be directly affected in the future. We are noticing that many older people are starting to get involved, partly because as carers and family members - whether for their very old parents or for their partners - they can see how dysfunctional long-term care in Switzerland is.

In Germany, 86% of all people in need of care are cared for at home, mostly without the involvement of outpatient carers. The overburdening of caring relatives is just as much a source of the care crisis as that of care workers. What is the situation in Switzerland and are there any links between trade unions and organisations of unpaid carers?

The greater the gap in professional care and support, the more family members are stretched to their limits. This is a human and social disaster. In Switzerland, the issue of 'family carers' has now also become a business model, which dominates the debate about their situation. Profit-oriented companies employ family carers and charge their services to the health insurance companies without ensuring adequate care for the relatives. As a result, the additional costs are at the forefront of the political discourse and not the burden on relatives. Unfortunately, the connections and co-operation are not yet as deep as they could be. We are convinced that if we want to actively tackle the care crisis, we need broad and multi-perspective alliances.

It became clear in the manifesto and in the seminar that putting care at the centre also means talking about funding. Where should the money for your vision of good care come from?

We are committed to ensuring that we, as a society based on solidarity, are well funded by the public purse, i.e. through taxpayers' money. This is the only way to guarantee fair social distribution and ensure accessible, high-quality care and support.

What is the evidence that a movement for good care and support can be successful? What can we do together?

Many people are living longer, which is great news. However, this also increases the need for everyday support, care and nursing. Political decision-makers have slept through or ignored this development. At the same time, however, the number of people affected, as care recipients, as relatives or as care workers, is increasing. Everyone is in the same boat, we need to bring the different realities together and turn those affected into participants in a broad movement for good care and support. We need to build broad alliances. If we succeed in doing this, we can move care work, whether paid or unpaid, to the centre of social action.

Thank you very much!