Serdar Yüksel spent two decades as a nurse before 15 years in North Rhine-Westphalia's state parliament, and now represents the SPD on the Bundestag's Health Committee. He discusses the jump from state to federal politics, the SPD's push to stabilise health insurance contributions fairly across government, insurers, providers, industry and patients, where he thinks the pharmaceutical industry should do more — from AMNOG to drug shortages —, what the sector still misjudges about frontline healthcare workers, and his priorities for strengthening primary care and prevention.
After 15 years in state politics and two decades working as a nurse, you joined the Bundestag’s Health Committee during this legislative term. What is the Committee’s day-to-day work like, and does it correspond to what you expected based on your experience at state level?
Honestly, the transition was greater than I had anticipated. In a state parliament, people know one another, communication channels are shorter, and many things are handled more personally. The Bundestag operates on an entirely different scale, not least because of the sheer volume of draft legislation, statements and hearings taking place simultaneously. What consumes most of my time is not the meetings themselves, but the preparation: studying ministerial drafts, speaking with professional associations and assessing the feedback coming from my constituency.
What has positively surprised me is how much professional experience matters. I worked shifts for more than 20 years, many of them in intensive care. When the Committee discusses minimum staffing levels or the shift towards outpatient care, I am not speaking from theoretical knowledge, but about something I have experienced myself. I bring that perspective to every meeting, and I can see that it is needed.
The SPD wants to stabilise contribution rates without placing an excessive burden on insured people or compromising the quality of care. Where will the money come from if not from patients or healthcare providers?
That is the crucial question, and there is no easy answer. One thing is clear: a system cannot be stabilised over the long term by repeatedly placing the burden on the same people; whether insured individuals through higher contributions or healthcare workers through increased pressure. For us, fairness means that all those capable of carrying part of the burden should do so.
For me, this means two things in particular. First, the federal government must fulfil its responsibilities—for example, by adequately funding health insurance contributions for recipients of Bürgergeld, which currently do not cover the actual costs. This is a responsibility for society as a whole and should not be borne solely by contributors to the statutory health insurance system. Second, a great deal of money within the system itself is not being used optimally: duplicated structures, avoidable hospital admissions and insufficient prevention. Intervening earlier saves money later. That sounds simple, but implementing it is a major undertaking. I have no illusions: there is no painless solution. However, it makes a difference whether we begin by cutting healthcare services or by first addressing efficiency and responsibility for financing.
The SPD says that the burden must be distributed fairly among the state, health insurance funds, healthcare providers, industry and patients. In which specific areas should the pharmaceutical industry contribute more than it currently does?
First of all, I appreciate the contribution made by the pharmaceutical industry. The pandemic demonstrated just how important innovative capacity and a strong domestic pharmaceutical sector are. I do not wish to downplay that—quite the opposite. A reliable pharmaceutical industry in Germany is also an important element of security of supply.
Where I believe we share responsibility is in maintaining the balance between innovation and affordability. New therapies must reach patients while remaining sustainably affordable. This involves fair pricing, transparency regarding costs and ensuring that genuine innovation is rewarded rather than mere variations of existing products. The AMNOG process provides the right framework for this. We should continue developing it, rather than dismantling it.
There is also one issue that is particularly important to me as a practitioner: shortages of essential medicines. When an antibiotic or a children’s fever medication is unavailable, that creates a genuine healthcare problem. I would like us to work with industry to build more resilient supply chains and crisis-proof production capacity in Europe. This is not about opposing interests, but about a shared objective.
You worked in intensive care for more than 20 years before entering politics. What does the sector—including healthcare providers, health insurance funds and pharmaceutical companies—still fail to understand about the professionals on whom it depends?
Ultimately, healthcare is always about people, not numbers in a spreadsheet. A nurse is not a flexible resource whose capacity can be stretched indefinitely. When one colleague is missing from a ward, that is not merely a statistical absence. It means that someone is missing at the patient’s bedside, that personal attention cannot be provided and that the risks increase for everyone. I experienced nights when we were understaffed but still had to keep everything running. That stays with you.
What is often underestimated is that people rarely leave the profession because of money alone. They leave because they can no longer meet their own professional standards and because there is not enough time to provide good care. This is a question of dignity—for both healthcare workers and patients. Anyone seeking to address the shortage of skilled professionals must therefore improve working conditions, not merely adjust salary scales. Reliable schedules, less bureaucracy and genuine appreciation are essential. These measures come at a cost, but that cost is lower than that of a system from which experienced professionals continue to leave.
You have identified primary care and prevention as key priorities. What would be required to genuinely strengthen primary care in Germany?
For me, it begins with a change in perspective: moving away from asking how we treat illness and towards asking how we preserve health. Prevention is not a peripheral issue. It is the key to an affordable healthcare system and, above all, to improving people’s lives. In a region such as mine, the Ruhr area, this is visible every day: people living in more difficult social circumstances become ill earlier. Health is also a social issue.
In practical terms, I believe three things are needed. First, we need accessible, community-based care close to where people live, particularly in areas where medical practices are disappearing. Models such as health kiosks or municipal health centres are promising because they reach people whom the conventional system would otherwise reach too late.
Second, we must strengthen the healthcare professions and give them greater responsibility. Nurses, midwives, therapists and other healthcare professionals can contribute much more if we enable them to do so.
Third, prevention must begin where people are: in nurseries, schools, workplaces and neighbourhoods. It should not be delivered in a patronising manner, but offered as something accessible and supportive. This is a major undertaking, but it is precisely the work I entered the Bundestag to pursue.
