According to plans by Federal Minister of Health Karl Lauterbach (SPD), the financing of hospitals in Germany is to be freed from economic pressure. The Bundestag is to pass a first package of laws today with regulations that, among other things, should bring more money for children’s clinics and relief for the tense situation in care. Patients should be able to avoid unnecessary overnight stays in the hospital.
day treatments
In the future, certain clinical examinations should also be possible as day treatment without overnight stays. At the same time, this should create more capacity for the scarce nursing staff during the day when night shifts no longer have to be filled. That is why it should now be changed that billing for certain inpatient services for hospitals is only possible with overnight stays.
childcare
In 2023 and 2024 there should be 300 million euros more for children’s hospitals, and an additional 120 million euros each for securing obstetrics locations. Financing should also become more independent of the current, performance-oriented logic.
care key
In order to improve the work of nursing staff who are often under a lot of stress, a new instrument for staffing is to come and be implemented – based on calculated ideal staffing for the wards. A step-by-step introduction is then planned.
The Techniker Krankenkasse criticized that the instrument did not solve a single problem in care – on the contrary. CEO Jens Baas told the German Press Agency: “Instead of new colleagues, the planned nursing staff assessment will give the nursing staff a lot of additional bureaucracy.”
Lauterbach: “The beginning of a revolution”
The ministry sees the legislative package, which the Federal Council is also supposed to deal with, as a “small” hospital reform – Lauterbach then wants to present a large one next Tuesday. It is about the “beginning of a revolution” in hospital remuneration, as the SPD politician had announced. The aim is to systematically overcome the financing system via lump sums per treatment case.
This has now become so independent that it is at the expense of the quality of care, explained Lauterbach. And with a “hamster wheel effect”: Clinics could only maintain or increase their budget by increasing the number of cases. And those clinics made a profit that spent as little money as possible on services – higher effort and quality tended to mean losses.
Warning of pressure on doctors
Doctors’ representatives warn against misusing the planned regulations for overnight stays in hospital treatments for economic purposes. The goal is right to create practicable options for day inpatient treatment, said the chairwoman of the doctors’ union Marburger Bund, Susanne Johna, the newspapers of the Funke media group.
In some cases, such a regulation could relieve the nursing staff and also correspond to the patient’s wishes. However, there should be no pressure on the doctors. “We must be able to make decisions without being influenced by the economic considerations of commercial management. Economic expectations must always take second place to medical requirements.”
care system under pressure
The German professional association for nursing professions (DBfK) warned of a collapse of the nursing system in view of the shortage of skilled workers. “If we don’t get fundamental reforms quickly, nursing care in Germany can no longer be maintained,” said Chairwoman Christel Bienstein of the editorial network Germany. There have been nursing shortages in the past, for example in the early 1990s, but: “There has not been a comparable situation in the past 50 years.” It is currently assumed that there will be a shortage of 200,000 full-time employees.
The shortage of nursing staff has recently become particularly evident in the children’s hospitals, where some of the beds could not be operated due to a lack of nursing staff, according to the German Interdisciplinary Association for Intensive Care and Emergency Medicine. The federal government is planning to make it easier for skilled workers from abroad to immigrate to Germany.
