This article considers training and qualifications in the long-term care sector inGermany, Japan and the UK. Each country has similar challenges of coping withincreasing demand and securing staff for quality and cost-effective care. However,the three countries organise training and qualifications in very different ways. Takingthe level of training and qualifications for formal care workers, there is a hierarchy,with Germany at the top, Japan in the middle and the UK at the bottom. However, ifthe composition of the workforce is taken into account, Germany has developed adualistic structure with both highly and lowly trained and qualified workers; Japan hasdeveloped a relatively large proportion of moderately trained and qualified workers;and the UK workforce consists of a relatively large proportion of lowly trained andunqualified workers. Explanations and implications are considered.