Lauterbach had a government commission draw up proposals for a hospital reform that is to come into force on January 1st. The clinics are to be divided into three different levels of care: basic care, specialized care and maximum care. In addition, the remuneration system is to be changed.
The Augsburg legal expert Ferdinand Wollenschläger, who is responsible for the report submitted by the three states, explained that every federal regulation for hospital financing and care finds its limit where the federal government makes structurally relevant regulations.
This means that federal regulations that focus on controlling the supply structures of hospitals or excessively curtailing the planning leeway of the federal states for hospital care are inadmissible. Therefore, the currently available proposals are not compatible with the Basic Law. However, there are options for reform within the system of competences.
Bavaria’s Health Minister Klaus Holetschek (CSU) explained that the current reform concept means a significant intervention in the planning sovereignty of the federal states and must therefore be corrected. “We cannot go along with a reform centrally controlled from Berlin with a federal introduction of detailed levels with structural specifications and a predetermined rigid assignment of fixed performance groups to individual levels.”
North Rhine-Westphalia’s Health Minister Karl-Josef Laumann (CDU) said he was glad that Lauterbach had already announced that he would not be striving to implement the government commission’s proposals unchanged, but would instead be working on a joint draft law with the federal states. “On this basis we will now continue our talks.” He is “very confident” that in the end there will be a reform that can improve many things for the benefit of the patients.
Schleswig-Holstein’s Minister of Health, Kerstin von der Decken (CDU), explained that she also thinks that a reform of hospital financing is important – especially in order to put the necessary care in the area on a secure footing in the long term.
All three countries declared their willingness to base their future hospital planning on so-called performance groups. Holetschek explained, “however, the structural requirements for the groups should be coordinated between the federal and state governments. It must also be clear that the ultimate responsibility and the decision as to which hospital is assigned which service groups lies with the states.”
Von der Decken explains: “We don’t want to prevent a reform, but rather – on the contrary – enable the reform to be successful.” Therefore, a reform must be constitutional.
