The rescue service in Germany is in a “systemic crisis”. The federal and state governments are only inadequately fulfilling their obligation to provide emergency medical care. This is the result of a report by former Federal Constitutional Judge Udo di Fabio, which has now been presented in Berlin.
Not everything is “catastrophic” – the rescue system is working in many regions of Germany, di Fabio emphasized. However, there are significant differences in quality across the area and between the city and the countryside. The infrastructure has not been maintained for years and aid does not arrive quickly and adequately for the specific emergency in all places.
Constitutional lawyer: The state must have a functional bailout system
The federal government has a duty to ensure that there are sufficient rescue personnel and good facilities so that emergency patients have the best possible chance of survival. This duty of protection of the State arises from the fundamental right to life and physical integrity.
While the states are primarily responsible for organizing the rescue service, the federal government can specify framework conditions and thus create uniform standards. It should do this too, recommends constitutional lawyer di Fabio.
Emergency medical services in developing countries
The report was commissioned by the Björn Steiger Foundation. Its chairman, Pierre-Enric Steiger, criticises the fact that the structures of the German rescue system are now on a par with those of developing countries. “The situation is now so precarious that we can say very clearly: in Germany, people die every day because of the system.” A good 20 years ago, the Federal Republic was still considered a model worldwide.
Steiger sees a problem primarily in the lack of networking between individual emergency services. “The blockers are at the local level. Everyone insists on having their own control center.” The result is a multitude of different systems and a lack of data exchange.
It’s “absurd” that “we have emergency services districts that have a wall that’s thicker and stronger than the Berlin Wall used to have,” Steiger said. If you don’t know if an ambulance from another neighborhood is closer to the scene of an accident, you’re losing valuable time saving lives.
Bavarian Interior Ministry: Control centers are networked
In Bavaria, there are a total of 25 integrated control centres (ILS) that accept emergency calls. The Ministry of the Interior does not share the criticism of the lack of networking. The control centres are interconnected, the exchange of operational and location information is automated, “independent of existing administrative boundaries”, according to a BR24 survey.
The President of the German Red Cross, Gerda Hasselfeldt, herself originally from Bavaria, sees the rescue service in the Free State as generally well-positioned, but complains about the lack of personnel and equipment. A reform is therefore “necessary and overdue”, she emphasizes in an interview with BR24.
The rescue service will be reformed by the beginning of 2025
On Wednesday, the federal cabinet had a Emergency care reform project adopted. This will still have to be approved by the Bundestag in the autumn. Federal Health Minister Karl Lauterbach (SPD) would then like to submit further suggestions for improvements in the area of emergency services to parliament. What exactly these are is not yet clear.
Janosch Dahmen, a member of the Green Party in the Bundestag and himself an emergency doctor, stressed that the federal and state governments should come together to reform the emergency services. “I do not see any conflict here, but rather a common mission, which is once again underlined by the report.” The reforms are due to come into effect early next year – at least that is the plan.