German coalition pushes stricter sick-note rules sparking nationwide doctor and union backlash

German government’s health-cost crackdown sparks nationwide row as coalition pushes stricter sick-note rules
Berlin, 06.07.2026 – Chancellor Friedrich Merz’s black-red coalition has triggered a political firestorm by forcing employees to obtain a doctor’s certificate on the very first day of illness, scrapping the long-standing rule that had allowed workers to stay home without paperwork until the fourth day. The move, announced last week and now enshrined in a draft health-savings package, is intended to curb Germany’s soaring absenteeism, but doctors, unions and even parts of the chancellor’s own party immediately condemned it as bureaucratic overreach that will swamp surgeries and do little to address the root causes of sick leave.
Under the new framework, employers will still be able to negotiate exceptions with staff, but the default position is a same-day medical certificate. The change is part of a broader €250 million savings package aimed at reining in the €80 billion annual bill for wage-replacement payments that German companies foot when staff fall ill . “We need to bring the sickness rate down,” Merz told reporters on Friday, adding that doctors would still have discretion to backdate certificates in exceptional cases, but only up to three days and after careful review .
The backlash is fierce. The Christian Democratic Union’s own labour wing, the CDA, accused the coalition of “completely unnecessary” meddling. “Most people we’ve spoken to are appalled by the idea of a mandatory doctor’s visit on day one,” said CDA vice-chairman Christian Bäumler. The doctors’ lobby is equally scathing: the National Association of Statutory Health Insurance Physicians (KBV) estimates at least 30 million extra GP appointments a year, consuming an additional 208,000 workdays just for ten-minute consultations . “That’s a logistical nightmare,” KBV spokesman Andreas Gassen told the *Handelsblatt*.
The political optics are worsening. The coalition’s health spokesman, CDU general-secretary Carsten Linnemann, insisted the law would merely set a statutory floor that could then be tailored in collective agreements, but even within the SPD—the junior coalition partner—voices are urging caution. “The framework must be workable,” one SPD negotiator told the *Tagesspiegel*.
Meanwhile, the health-savings package is racing through parliament. Coalition negotiators confirmed late on Sunday that they are still haggling over the final €250 million figure, with Linnemann calling the original sum “far too low” to stabilise rising costs . The bill is scheduled for a first reading in the Bundestag on Friday, with the Bundesrat expected to follow shortly after.
The controversy comes as hospitals across Germany adjust to sweeping reforms that are already reshaping care. In Potsdam, two major hospitals announced immediate cuts: the Ernst von Bergmann Klinikum will no longer offer orthopaedics or vascular surgery, while the St. Josefs-Krankenhaus will close its neurology and obstetrics units, citing the nationwide hospital restructuring plan aimed at cutting costs and improving quality . Brandenburg’s regional government insists a basic level of care will remain available everywhere.
Critics argue the twin measures—tighter sick-note rules and hospital closures—risk overburdening an already strained system. “We’re piling bureaucracy on patients and providers alike,” said Green MP Katharina Dröge. “The government should be investing in prevention and staffing, not erecting more hurdles.”
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