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The German national healthcare system is the oldest in the world, but many are asking if a service created in the 19th century is meeting the needs of the 21st.

A major focus on speedy surgeries, short waiting times and easy access to doctors and specialists diverts money away from long term care at a time when Germany's elderly population is growing rapidly.

At one of the capital's biggest and busiest hospitals, Helios Berlin-Buch, we see the side of health care this country is best known for.

Efficiency has literally been built into the structure of the building. Operating theatres have been constructed next to each other so doctors can move between them and carry out multiple surgeries.

Hidden corridors allow seriously ill patients to be transported quickly away from the bustle of visitors. And here, you'd struggle on almost any day of the year to see patients waiting in the corridors for beds.

"It happens very seldom," the medical director tells me. "The odd day every two years or so."

Professor Doctor Henning Baberg is proud of the fact that in his hospital operations you could wait weeks, even months for in the UK are done in days.

"No we don't have these problems. We don't have long wait times. We invest, we build, we get bigger if needed."

Reflecting on the UK he says: "What I always hear and see when I am in the UK is there is not enough investment in the system. You need to put money into a hospital to keep it running and modern and get new machinery."

Like other hospitals in the German capital Helios has extra capacity and beds set aside for critical periods so even at busy times patients get treated quickly.

In fact almost too quickly for Dirk Conrad, a patient we met while recovering from a non-emergency heart procedure. He had barely got used to the idea of having surgery before he was on the operating table.

He laughs as he says: "I was at home waiting for a week. I could have waited longer. But this way it is behind me. So the appointment was OK."

'It happened too fast' is not an observation you'd hear in all national healthcare systems.

And the speed of surgery is thanks in large part to a well-funded health system in Germany.

Part of almost every worker's salary goes to national health insurance, the total contribution of 15% of pay is split between employee and employer.

Around 10% of people, the self-employed or very well off, are on private insurance.

But with an ageing population there is now increasing debate about where that money is focused.

"Our strength is that we have full coverage of 90% of the population. And these people pay a contribution to a sickness fund and it is mandatory. But the way that money is spent is not convincing," says Professor Doctor Klaus Hurrelmann who is a public health expert at the Hertie School of Governance.

"Our system really likes to act and for example to operate whenever the opportunity is there. So we do have the highest level of substitutes for knees, for hips, for parts of hearts. So the system is very eager to be active.

"But everything which is connected with long term care is a very weak point. And we have real difficulties to keep step with the huge amount of people in need of care and nursing.

"We have a horrible shortage of nurses. The nurses do not earn enough money. The job is not very attractive."

And the statistics tell the story. Ver.di, one of Germany's main trade unions, says more than 70,000 skilled workers are already missing from nursing nationwide.

The German Nursing Council forecasts there will be a shortage of 300,000 nurses by 2030, 200,000 in geriatric care alone.

At Pflegetiger (Care Tiger) in Berlin they are trying to do something to change that. The young start-up pairs nurses with patients living close to them via a smartphone app. The nurses can schedule jobs to suit them and travel to jobs on bicycles. We rode out to meet one of them, Christin Heinze, on her rounds.

Christin tells me that she worked as a nurse in hospitals for years but she found the job difficult to balance with her young daughter. Plus she says the pay is poor. She understands why people aren't attracted to the job.

"The time, the hours, the pressure, the money. You cannot complete the family and the job. And it is a big pressure to help the patients. You get not so much money, not so much time and no time for your family being a hospital nurse."

At Pflegetiger she says things are very different.

"We have so much time. More time with my daughter and more time for the patients."

But it will take more than local private initiatives like Pflegetiger to solve an impending nursing crisis in Germany. It will take investment and some say Germany should look to the UK for inspiration.

Doctor Christian Sibiliski, a Stuttgart GP who spent ten years in the north of England, says in the UK nurses do more and have better career prospects.

"In the UK minor illnesses are being treated by nurse practitioners for example. And there are prescribing nurses. You can delegate drugs, vaccinations. This is what I lack here. A person I can delegate to."

He believes if nurses in Germany were rewarded financially for taking on more responsibility then more people would be attracted to the job.

But he warns the system is very rigid in Germany and slow to change. It will have to if the needs of the elderly are to be met in what is one of the oldest populations in the world.

Long term care presents one of the biggest challenges for the health system in Germany. But investing in it could involve painful decisions and cuts in other areas.

Could the halcyon days of no waiting to see a doctor, specialist or have an operation be over?