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Nuremberg – A content-based change to the hospital reform will be inserted into the Medical Research Act (MFG). This is foreseen in a change that… German medical journal is present. This approach provokes clear criticism from the medical profession, as well as from clinics.
It is currently expected that hospitals will send quarterly data to the Hospital Remuneration System Institute regarding the number of beds and intensive care beds installed, as well as the number of doctors on duty (InEK) must be transmitted. This transmission was first provided for by law on January 15, 2024. This regulation was introduced with the Hospital Transparency Act.
A first draft of the Hospital Transparency Law of August 2023 stipulated that hospitals would have to report quarterly not only the number of doctors, but also the groups of services, including assigned treatment cases. However, according to the law that came into force, the reporting of performance groups is no longer mandatory quarterly, but only annually. Furthermore, it was previously planned to be independent of the number of doctors.
Now, through an amendment to the MFG, quarterly transmission of data on the number of doctors employed, broken down by groups of planned services, will also be carried out. Hospital reformwhich, like the MFG, is currently in the parliamentary process, envisages the introduction of 65 uniform performance groups at national level.
They set standards for the personnel and technical equipment that must become absolutely necessary for certain services. Countries should be able to use the service groups for their hospital planning. The aim is to improve the quality of hospital care. The reform is expected to come into force in early 2025.
Change comes through the back door
The professional association of German anesthetists (BDA) clearly. Markus Stolaczyk, head of the BDA’s health policy department, complained that the legislature was ignoring critical voices and wanted to introduce the regulation through an amendment to the MFG, i.e. “virtually through the back door”.
Anesthesia and intensive care medicine are complex specialized areas in which physicians occupy important interdisciplinary and intersectoral interfaces for almost all specialized areas. “A detailed allocation of time for duty groups is not feasible in practice and would cause even more pressure on anesthesiology specialists,” Stolaczyk said.
He explained that performance groups are not intended for staffing planning. There is currently no evidence that staff can be effectively allocated to patients’ medical needs through service groups. “Here you can do that instead German Medical Association ÄPS-BÄK personnel assessment tool be used as a suitable method for determining personnel needs in individual specialist areas,” suggests Stolaczyk.
The tool is based on the staffing needs calculation tools originally developed by the BDA, which were developed to calculate medical staffing for anesthesiology and critical care workplaces. “If we want to find out whether there is an oversupply or undersupply of personnel in individual specialist areas, we should consult the ÄPS-BÄK Federal Medical Association “and not on medical stays that require documentation,” explained Thomas Iber, who originally co-developed the BDA tool and serves on the BDA executive committee as secretary.
Additional dreaded documentation requirements
Furthermore, there is already a huge amount of time spent on administrative tasks, which not only affects the medical care of patients, but also leads to increased workload and work-related stress. Given the shortage of skilled workers, this doesn’t help anyone. “We need doctors at the patient’s bedside, not behind a desk with additional documentation requirements,” Stolaczyk made clear.
Both the German Hospital Society (DKG) as well as the Hessian Hospital Association recently criticized the planned regulation. The service groups, which will form the basis of hospital planning from 2027, are much more differentiated than the specialist departments, and a doctor can work in several service groups, writes the Hesse Clinic Association.
“This regulation once again shows the exaggerated theoretical approach Federal Ministry of Health“Where there is obviously no knowledge of the practical work and organization in the hospital,” said Achim Neyer, CEO of the Hesse Clinic Association. Accurately allocating time from medical activities to service groups is an incredible bureaucratic effort and, in fact, impossible.
German medical journal printout
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The managing director of the Hesse Clinic Association, Reinhard Schaffert, also criticized the procedure. “I consider the introduction of controversial regulations into parliamentary procedure through amendments with an extremely short comment period to be a deliberate method by the Federal Ministry of Health to keep the discussion small,” Schaffert said.
Of course, parliamentary procedure exists to discuss the wording and change it to improve it. “But the fact that the relevant regulations are not deliberately included in the draft law itself, but are only introduced later as an amendment, as can be seen between the lines of some statements made by officials of the Federal Ministry of Health, is, in my opinion , opinion, a questionable understanding of democracy,” Schaffert said.
He continued to criticise this approach, as well as the growing tendency to define bills as urgent and to get them through the Bundestag as quickly as possible, which ultimately leads to poorly drafted laws.
The Medical Research Law is expected to be approved next week Bundestag will be decidedsaid Federal Health Minister Karl Lauterbach (SPD) yesterday at the congress in the capital (HSK). The aim of the reform is to improve the framework conditions for the development, approval and production of medicinal products and medical devices in Germany by accelerating and reducing bureaucracy in clinical trial approval procedures and approval procedures. © cmk/aerzteblatt.de