Health Minister Karl Lauterbach wants to present his planned clinic reform on Tuesday. Before that, the criticism of the SPD politician becomes sharper – and more fundamental.
“Apart from the Chinese government, Minister Lauterbach seems to be the only one who has not found an appropriate way to deal with Corona. But while Lauterbach became obsessed with this virus, he forgot the youngest in particular,” said CDU Federal Secretary General Mario Czaja to the Tagesspiegel. “The situation in the clinics and practices for children is dangerous, the need is enormous.”
Increasing numbers of cases of small children suffering from respiratory diseases – mainly due to the RS virus and flu – are putting a strain on hospitals. As in the coronavirus crisis, planned surgeries are being postponed in many places to conserve staff and resources for RSV cases. Union politician Czaja, who was Berlin’s health senator from 2011 to 2016, joined doctors and hospital managers who are now calling for comprehensive reform from Lauterbach.
caregivers are missing according to the German Professional Association for Nursing Professions (DBfK).
On Tuesday, the commission of experts set up by the minister intends to present its plan for reforming hospital care. The main question here is what will replace the current system of case-based flat-rates. So far, the health insurance companies have paid the clinics a fixed sum for each treatment case – which is why there are lucrative, cost-covering interventions and those for which the clinics spend more than they receive funding.
Children’s departments in particular work with high personnel costs, from a formal business point of view many children’s hospitals would have to close. Nationwide, local and state politicians appealed to the traffic light government to support the hospitals.
Lauterbach’s party friend Steffen Krach, formerly Berlin’s State Secretary for Science and now President of the Hanover region, wrote: Because the RSV wave is causing the cancellation of adequately paid treatments, the clinics lack the cash funds they need. The care of the children affected by the RS virus is complex, the letter says: “Since the experts estimate that the RSV wave will last longer, it is urgently necessary to make a regulation.”
The often indebted hospitals could get into an acute liquidity crisis in four weeks for another reason. A rule introduced by the federal government in the coronavirus pandemic is due to expire at the end of the year – as of Sunday.
After that, the health insurers would no longer have to pay for the treatments within five days, but would have two months to do so. Small clinics would have payment difficulties, which is why in view of the rising costs for medicines, materials and energy, there is a risk of insolvency. “The federal government must act immediately, especially since that would be easy,” said Czaja. “The currently valid rule must be extended by regulation.”
The federal government must act immediately, especially since that would be easy.
CDU Federal Secretary General Mario Czaja
Just last week, Lauterbach introduced a law that he called a “revolution.” One wants, he said, to bring the necessary supply and the economy back into balance. The children’s hospitals are the first to no longer fall under the system of flat rates per case, and they will also receive an additional 300 million euros each in 2023 and 2024. The situation for the nursing staff should improve through fewer patient overnight stays and a new personnel assessment program.
Despite rising wages, there is a nationwide shortage of nursing staff; the German Professional Association for Nursing Professions (DBfK) recently spoke of 200,000 employees who needed more. Even if the clinics were obliged by law to always use more nursing staff in order to avoid massive stress and possible treatment errors, this does not mean that more staff would actually apply immediately. The Techniker Krankenkasse had also criticized that the planned assessment of nursing staff would bring additional bureaucracy to the specialists on site.
In Berlin, several pediatrician associations had complained in an open letter to Health Senator Ulrike Gote (Greens) before the weekend that little or nothing had happened in the care of children and adolescents in the capital’s clinics, despite constant references to the precarious situation.
In Berlin, children’s hospitals should postpone less urgent interventions if possible
The letter, which the Tagesspiegel first reported on, states that irresponsible conditions prevailed not only in the central emergency rooms, but also in outpatient and inpatient pediatrics. There are already days when “there is no longer a free bed to be found in any of the Berlin clinics” and parents cannot find a pediatrician for their newborn.
“An extremely quick solution is needed, especially as winter and the upcoming holidays will further escalate the situation – just wearing a mask will not help,” the doctors warn. “We see the health and also the lives of our children and young people under massive threat!”
Regarding the allegation that the health administration had not responded to a multiple request for an appointment, its spokesman told the dpa news agency on Saturday that Senator Gote was of course ready for further talks at short notice and would continue to work on solving the current challenges.
There was a meeting at the end of November with the chief physicians of the Berlin children’s clinics and the medical management of the rescue service. “It was jointly agreed that all children’s hospitals would postpone less urgent interventions if possible,” the spokesman continued. The aim is to significantly improve the care of critically ill children.
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