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Berlin Current plans for a new federal public health institute are on shaky ground. Following the suggestions of the Federal Ministry of Health (BMG) to leave not just criticsbut also the opposition and the FDP hardly have good hair.
The SPD, the Greens and the FDP agreed on a new federal institute for public health in coalition negotiations. The objective: to increase prevention and information about cancer and dementia, as well as cardiovascular diseases.
Currently, the Chamber of Federal Health Minister Karl Lauterbach (SPD) planned, in a bill from October last year (a more recent bill is not yet available), to create the Department of Epidemiology and Health Monitoring (Department 2) from the Robert Koch Institute. (RKI) to be outsourced and incorporated into the new authority.
The new federal authority will be called the Federal Institute for Prevention and Enlightenment in Medicine (BIPAM). During the transformation phase, later this year, legislation for the new institute will begin. However, it is not yet certain whether BIPAM will end up as previously planned or whether the RKI will actually be divided, as the statements from the traffic light coalition show.
“I am aware that many people are not happy with the plans to separate Department 2 from the RKI,” Nezahat Baradari, rapporteur responsible for the SPD, told German medical journal. But it is also wrong to simply subordinate BZgA or BIPAM to the RKI. The experts had the last one in one Hearing of experts in Parliament stimulated.
The new federal institute should not weaken the RKI, but rather support it, said Johannes Wagner, rapporteur responsible for the Greens in the Bundestag, to German medical journal. Close cooperation with the RKI is important for success.
There will certainly be interfaces between the new federal institute and the RKI. The fact that the institutes work in close collaboration and trust is an important basis for the public health landscape in Germany to take a leap forward.
According to Wagner, the traffic light agreed with the creation of a federal public health institute, where the activities of the public health sector, the DG network and federal health communication should be located. The BZgA should be incorporated into this institute.
No one would be helped if BZgA simply continued to operate under a new name. Instead, we now have to analyze what other tasks and areas need to be placed in the new federal institute to effectively strengthen public health and, above all, to support local health authorities, said Wagner.
It is important for him that the new federal institute operates in accordance with the latest scientific standards. Prevention is not just the task of medicine, but must be understood transversally, in accordance with the principle of health policies for everyone. That’s why what’s crucial is what the institute is working on and how the tasks are being implemented, he said.
FDP wants changes to parliamentary procedure
When questioned, the FDP clearly criticized the ministry’s plans. She has little to gain from the ministry’s previous ideas. BIPAM, in the version now under discussion, is not what we imagined in the coalition negotiations, said FDP health policy spokesman in the Bundestag, Andrew Ullmann, to German medical journal.
The aim is to strengthen the scientific independence of the RKI and draw conclusions from the weak role of the Federal Center for Health Education (BZgA). Now, however, the plan is to reduce the RKI. At the same time, the BZgA should be converted into a strengthened BIPAM within the scope of the Federal Ministry of Health.
“This is exactly the opposite of what we planned,” Ullmann explained. The separation between communicable and non-communicable diseases is also not understandable at any level. We will work hard in the parliamentary process to ensure we have a federal public health institute that follows a modern approach to public health, Ullmann announced.
Opposition criticism
The left in the Bundestag sees the situation in a similar way. The entire project, including the nomenclature, reflects an outdated understanding of prevention that no longer corresponds to scientific discoveries, Kathrin Vogler, a Left health policy spokeswoman, told German medical journal.
The decision to divide prevention according to disease types is particularly serious. Instead, greater attention needs to be paid to the link between poverty and health, warns Vogler.
She emphasized that the RKI has proven itself to be a highly competent scientific institute during the corona pandemic. Breaking up is a completely absurd idea, says the left-wing deputy. A federal public health institute, which must be independent of political instructions, but also and above all from the influence of pressure group interests, should instead be created under the aegis of the RKI.
For the Union’s health policy spokesman in the Bundestag, Tino Sorge (CDU), the process of creating BIPAM is proceeding in typical Lauterbach style. First there are big announcements, then everyone involved is alienated and in the end all that is left is a scorched earth, he told her. German medical journal.
Unnecessarily, Department 2 should be removed from the RKI. This creates great unrest in the institute. Alternative options, such as a full agreement with the RKI or completely new forms of cooperation between authorities, were apparently not discussed with those involved, or not discussed enough, and this is now taking its toll, says Sorge.
The appointment of the new institute is also viewed critically by parliamentarians. However, opinions also differ here. In the US, a well-established brand has been created with the Centers for Disease Control and Prevention (CDC), explained Sorge.
Whether this will be successful with the fictional character BIPAM remains to be seen. Employees may find it difficult to identify with their institute. Here too they could have been more involved, for example, in a contest of ideas among the future workforce. This opportunity was lost, said the CDU politician.
“I would prefer that in the name of the institute, in addition to public health, social medicine would also appear, which has been criminally neglected in Germany in recent years”, explains left-wing deputy Vogler.
A personality like Alice Salomon would really fit in, so for the first time a federal health institute would be named after a woman who distinguished herself by her humanistic worldview and her commitment to neglected, marginalized, and poor women and their children as as well as through his scientific work against all resistance. Vogler follows a suggestion by Raimund Geene of Alice Salomon University in Berlin, which he made during the expert discussion in the Bundestag.
The name, of course, has a signaling effect, explained Wagner, from the Greens. If our coalition members are interested, I am personally open to talking about it again. He explained that giving it a woman’s name would have a lot of charm. It is surprising that many existing federal institutes are named not just after people, but mainly after men.
In my opinion, the discussion about the nomenclature was exaggerated from the beginning, says SPD deputy Baradari. The content is important, not the packaging. Furthermore, the abbreviation BIPAM has already established itself in everyday language. I don’t see why this should be played again. © may/aerzteblatt.de