Initiative for strengthening nursing care: what happens next?
07 October 2026 | Comment(s) |
Luca Strebel
How can we bring about a lasting improvement in nurses’ working conditions without worsening the shortage or putting further pressure on insurance premiums? The second phase in the implementation of the “Nursing Care Initiative” seeks to strike this delicate balance. Here is an overview of the proposed measures, the National Council’s decisions and the next steps in Parliament.
What is it about?
The “Nursing Care Initiative” was approved on 28 November 2021 by 61% of voters and a majority of cantons. To address the nursing staff shortage, it pursues three objectives:
- to raise the status of the nursing profession in Switzerland;
- to ensure adequate training;
- to improve working conditions.
What is the current status of implementation?
A first phase has been in force since July 2024. It provides for:
- a drive to promote training in the field of nursing;
- the option for nursing staff to charge for certain services independently.
The Federal Council’s proposal
The Federal Council’s proposal is structured around two bills:
1.A specific law on working conditions in the nursing sector (LCTSI/BGAP)
The LCTSI/BGAP aims to bring about a lasting improvement in working conditions, strengthen worker protection and promote social partnership. In particular, it covers:
- limiting the maximum weekly working hours;
- setting a standard weekly working time;
- mandatory compensation for overtime;
- work at night, on Sundays and on public holidays.
2.A targeted amendment to the Health Professions Act (LPSan/GesBG)
The revision of the LPSan/GesBG provides for the recognition of the profession of Advanced Practice Nurse (APN). It responds to the increasing complexity of care and the need for new models of care. It also incorporates digital skills into the training objectives.
The challenges
The figures cited in the context of this reform illustrate the scale of the challenges:
- One third: the proportion of healthcare staff leaving the profession due to working conditions that are considered too difficult;
- 14,000: the current number of vacant posts;
- Thousands: the number of additional posts the sector would need if the weekly working hours of nursing staff were reduced;
- Billions: the potential additional costs.
Measures are therefore needed to improve working conditions. However, these measures must take into account their potential impact on the nursing staff shortage and on the level of compulsory health insurance (AOS/OKP) premiums.
The National Council’s decisions
For the National Council, the impact on insurance premiums is a major concern. It has therefore taken the following decisions:
- to maintain the maximum weekly working hours at 50 hours, rather than reducing them to 45 hours;
- to set the standard working week at a maximum of 42 hours. The Federal Council had proposed a range of between 40 and 42 hours.
Next steps
The Council of States must now vote on the bill. Discussions will therefore continue. The challenge remains the same: to bring about a lasting improvement in working conditions for nursing staff whilst preserving the healthcare system’s ability to recruit staff and keeping the impact on insurance premiums under control.
