From left to right: Christoph Dahmen, Béla Anda, Christof Chwojka, Pierre-Enric Steiger, Udo Di Fabio /Carsten Koall
Berlin – The federal and state governments are only partially fulfilling their mandate to provide quality-assured care in emergencies. According to a Legal opinion According to former Federal Constitutional Judge Udo Di Fabio, the German rescue service is in a “systemic crisis” because there are no equal quality standards or a functioning digital rescue service system.
Emergency services are increasingly used for minor illnesses and control centres are often inadequate to meet needs. There are also significant regional differences in quality between cities and rural areas.
As a result of these differences in quality, Di Fabio does not see the basic right to physical integrity, a duty of protection of the State, being fulfilled. The State is therefore obliged to provide this protection with a functioning emergency services system.
With the report released by Björn Steiger Foundation Di Fabio wanted to “encourage the federal government to take on greater responsibility for control here,” the lawyer told journalists in Berlin. He should also enforce this despite resistance from the states, also with a view to financing by health insurance companies.
The chairman of the Björn Steiger Foundation, Pierre-Enric Steiger, also complained about the precarious situation: In his view, people die every day in Germany “because of the system” and their relatives know nothing about it. After the rescue service was world leader for 20 years, it has steadily declined in quality in Germany; no federal state has a “good” rescue service, with the exception of individual lighthouse projects.
Organizational structures are now “at the level of a developing country,” Steiger said. None of the 240 control centers in Germany have digital systems designed to communicate with other systems in the area. The walls between districts are often “thicker than the Berlin Wall ever was,” Steiger continued.
There is often a “small state mentality” in municipalities that does not allow exchanges across municipal borders. The foundation, which dates back to his brother, who died in 1969, wants to be intensively involved in the political debate on the reform of emergency services.
A reform of the emergency service should now be submitted for parliamentary deliberation as soon as possible, together with the reform of the emergency service. Janosch Dahmen, the Green Party’s health policy spokesman, emphasized this at the press conference in Berlin.
Specifically, the members of the Bundestag now want to achieve this with amendments to the emergency reform law approved yesterday by the Federal Cabinet. The rescue service should be part of the Social Security Code V and quality standards could thus be prescribed by the federal government.
In addition to the standards, Dahmen also wants to enact nationwide first aid apps, telephone resuscitation instructions and joint control centers into law. According to him, there is broad consensus among experts that a reform with larger control centers and quality-assured processes is needed.
However, the law should not require approval by the Bundesrat, Dahmen emphasized. The specifications of SGB V are used to prescribe quality standards according to which statutory health insurance money (GKV) flows. This means that the federal legislature does not specify any organizational requirements that are the responsibility of the states. If the federal government wanted to intervene here, co-determination in the Federal Council would be necessary.
Constitutional lawyer Di Fabio does not consider this approach questionable. It is a sign of “vital parliamentarism” if Parliament continues to implement the government’s legislative initiatives. The planned project will have “influence” in the federal states to improve the quality of emergency services. The federal government has counted on “funding as a motivation”, Di Fabio emphasized. © bee/nfs/aerzteblatt.de