Berlin Clemens Schreiber is the master of gas and electricity at Vivantes, Germany’s largest municipal clinic operator. Last year, the nine hospitals in Berlin required 220 gigawatt hours of energy – that’s about as much as 10,000 households use. Vivantes spent 22 million euros on this, this year it will already be around 30 million due to the gas surcharge – and in 2023 “we expect drastic increases,” he says.
The situation is no better in most clinics in Germany. They are heading for high additional costs for their gas and electricity supply and are pushing for billions in aid in view of the higher prices for energy, food and medical goods. Overall, the additional costs of the clinics would be six billion euros.
The chairman of the German Hospital Society (DKG), Gerald Gass, tells the Handelsblatt: The shock hit “all clinics equally”. Therefore, the supply is endangered across the board. In connection with the stresses caused by the corona pandemic, the “perfect storm” is brewing.
A survey conducted by the German Hospital Institute on behalf of the DKG shows that gas suppliers have increased their prices or announced increases in 59 percent of the hospitals.
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In even more clinics (62 percent), electricity prices have already increased this year, or this is about to happen. The survey is available exclusively to the Handelsblatt. On average, price increases in this area are almost 60 percent, with a maximum of 225 percent.
More than half of hospitals have to pay more for electricity and gas
Hospitals also pay higher prices for materials such as bandages and implants. According to the survey, the prices for every second facility have risen by ten to 20 percent. External service providers increased their prices by around 17 percent, including laundry, groceries, cleaning and IT support.
“The increased costs meet state-regulated prices,” says Gass. An increase of only 2.32 percent was planned for 2022. “The clinics can never compensate for the increased costs,” he explains. According to the survey, however, almost all clinics (96 percent) cannot finance the additional costs from their revenues.
And every second hospital is already in financial difficulties. “There are loud cries for help,” says Gass. “These clinics are thinking about giving up their locations.” Either the municipality jumps in because of its responsibility to ensure that a new provider cannot be found – or the location has to be closed. Nobody could want that.
In addition, the austerity appeals in the clinics are not so easy to implement. “Our facilities need heat, lighting, air conditioning and air conditioning,” says Vivantes energy manager Schreiber. Clinics are therefore also excluded from the federal government’s energy saving plan.
>> Read here: All current developments on the subject of energy in the news blog
It is possible to repair leaking windows, remove the wedge at the front door or raise awareness among employees – “for example by turning off the light when it is not needed”. But there are also limits. “We cannot ask a nurse or our patients to put on a sweater, or our surgical teams to operate in the dark,” explains Schreiber.
Worry about the blackout
In view of the situation, there are also fears in some clinics that go beyond the rising prices. “What worries me is the hopefully unrealistic possibility that energy peaks will cause an overload with an actual power failure and thus a real blackout,” says Jochen Werner, head of the Essen University Hospital.
Werner explains: “Such a scenario would of course also bring the hospitals to the limit of their operability within just a few days.” Werner also says these are so “exorbitant” that the burden could not be borne by savings and income from operations.
DKG boss Gaß is therefore demanding quick help in the form of inflation compensation as an invoice surcharge on the flat rate per case. The hospitals use this to calculate their costs. But since this would then end up with the health insurance companies, the federal government should relieve them with a higher subsidy. “The hospitals are in need like many other energy-intensive companies,” says Gass. To make matters worse, all corona aid expired in the summer.
The traffic light coalition is well aware of the problems, but does not yet want to promise any concrete help. “The traffic light is idly watching the cost increase,” says the Union’s health policy spokesman, Tino Sorge (CDU).
>> Read here: Winter tires and snow chains – which corona rules apply in autumn
The invoice surcharge demanded by the hospitals could “come into force soon”. If the situation worsens, the federal government would even have to introduce new special payments for clinics and agree on an appropriate burden sharing with the states.
Traffic light coalition promises help
The calls for help from the clinics fall in the middle of negotiations on a third relief package. The SPD had suggested in a paper that clinics should also be taken into account. The deputy leader of the parliamentary group, Dagmar Schmidt, also refers to this.
One is in constant exchange with the DKG and the Federal Ministry of Health. “We therefore know how the increased costs are affecting hospitals, which were already in a difficult economic situation,” she says. “It is clear to us that health care must be guaranteed throughout Germany.”
The health policy spokesman for the Greens, Janosch Dahmen, is even clearer. “I believe that in view of the development we do not have much time, but we should act quickly – preferably in the context of the current discussion about further relief,” he demands.
However, these would have to be based on specific needs and not benefit all clinics across the board. “In the end, however, we must all be clear that federal health policy can only act within the budgetary guidelines set by the Federal Minister of Finance,” says Dahmen. “Anyone who is now possibly asking for a lot of money, for example to save the hospitals, with good reason, will also have to convince the Federal Minister of Finance where this money should come from.”
The FDP-led Ministry of Finance had also significantly reduced the planned federal grants for the ailing health insurance companies in view of the tight budgetary situation. The health policy spokesman for the FDP, Andrew Ullmann, says in view of the situation in the hospitals: “Compliance with the debt brake is a requirement of the constitution.”
In addition, flat-rate government spending programs or one-off payments could further fuel inflation – “however, the state must not become a driver of inflation itself”. In addition, Ullmann points out that hospital financing is primarily a matter for the federal states and health insurance companies. “Before the federal government intervenes with a rescue package, it’s up to others to do it,” he says.
More: Hospital company boss warns of clinic bankruptcies – “The perfect storm is brewing”