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Berlin – Hospital reform is needed before the next federal election. Above all, planning security is needed. The Federal Medical Association (BAK), German Nursing Council (DPR), Marburger Bund (MB) and German Hospital Association (DKG) the members of the Bundestag drew attention to this in a joint letter. Yesterday’s letter is here German medical journal before.
According to the four stakeholders, it is urgent that the Hospital Care Improvement Act (KHVVG) comes into force during this legislative period, which runs until September 2025. “If this law fails, we will be threatened by a paralyzing phase of uncertainty in the development of hospital locations after the next federal elections,” the associations write.
Safety planning in the form of reliable framework conditions is necessary in order to develop the conditions in the form of personnel planning and investments for the respective performance spectrums of the future. With regard to the planned performance groups, the focus should be primarily on the 60 groups that have been developed in North Rhine-Westphalia (NRW).
“Controversial developments previously planned by the federal government, such as the introduction of minimum case numbers, additional performance groups or changes to the structural specifications of the performance groups, are to be examined in a second development phase together with the states from 2027 onwards,” the letter further says.
According to the associations, such a two-phase model in hospital planning offers the advantage of subsequently assessing whether additions to the NRW planning concept are necessary and, if necessary, aligning them specifically with it.
First, rely on established instruments
In the planned financial reform, BÄK, MB, DKG and DPR suggest that, as a first step, the development of already established financing instruments that are independent of the number of cases will be used.
These include emergency, security and centre level surcharges, as well as surcharges for paediatrics and obstetrics. This could support hospital locations that have special structural costs, for example in emergency care, it said.
In the opinion of BÄK, MB, DKG and DPR, anything beyond this should be prepared with self-administration following the hospital reform legislation. The four stakeholders also renew the demand to ensure a stable financial basis for hospitals in order to avoid cold structural changes with disorderly cuts in care and services.
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The associations go on to write that there must also be a reliable legal and financial framework for the planned cross-sectoral care facilities. These would have to be designed in a way that is fair to both hospitals and contracted doctors, in order to allow for regional, needs-based care.
The aspects of debureaucratization that were already on the table should also be incorporated into the KHVVG, he said. Today, the DKG presented current figures on the bureaucratic burden on medical and non-medical staff, as well as concrete proposals to alleviate the burden.
Hospital reform has already been approved in the Bundestag before the summer break discussed in first reading. The rapporteurs’ discussions will take place in the summer and amendments to the KHVVG will be worked on.
The public expert hearing of the Bundestag Health Committee is scheduled for September 25. The vote in parliament is scheduled for October. According to the current situation, the law is expected to come into force on January 1, 2025. © cmk/aerzteblatt.de