More efficient time management and better financing should relieve nursing staff in clinics.
(Photo: dpa)
Berlin On Friday, the Bundestag passed a comprehensive package of laws on hospitals, which should bring more money for children’s hospitals and relief for urgently needed nursing staff. Health Minister Karl Lauterbach (SPD) spoke in advance of a “small hospital reform”.
“In the future, medical necessity should no longer decide on the treatment in the clinics,” said Lauterbach on Friday. Patients should be able to rely on being cared for by qualified staff – and that they only have to stay overnight in the hospital if this is really necessary.
The legislative package essentially comprises three areas:
- Maintenance key: In order to improve the work of nursing staff who are often under a lot of stress, a new instrument for staffing is to be introduced and implemented, based on calculated ideal staffing for the wards.
- child care: In 2023 and 2024 there should be 300 million euros more for children’s hospitals, and an additional 120 million euros each for securing obstetrics locations. Financing should also become more independent of the current, performance-oriented logic.
- Day treatments: In the future, certain clinical examinations should also be possible as day treatment without overnight stays. At the same time, this should create more capacity for the scarce nursing staff during the day when night shifts no longer have to be filled. That is why it should now be changed that billing for certain inpatient services for hospitals is only possible with overnight stays.
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The chairman of the German Hospital Society (DKG), Gerald Gass, said on Friday that the new care key could certainly initiate a positive development in the industry. However, key points of criticism remained, such as the finance minister’s right of veto. “In the future, no federal government will be able to afford to ignore an objectively measured need for nursing staff,” said Gass.
Gass described day treatments as a “real paradigm shift”. However, it remains to be seen whether these “pieces of reform ultimately fit into the big picture”. Doctors’ representatives, on the other hand, warned that the planned regulation for overnight stays at home could be misused for economic purposes. The statutory health insurance companies also fear an increase in benefits, which will ultimately cost more than the reform is intended to save.
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The ministry sees the legislative package as a precursor to a major hospital reform that Lauterbach intends to present on Tuesday. It is about the “beginning of a revolution” in hospital remuneration, as the SPD politician had announced. The aim is to systematically overcome the financing system via lump sums per treatment case.
This has now become so independent that it is at the expense of the quality of care, explained Lauterbach. And with a “hamster wheel effect”: Clinics could only maintain or increase the budget with higher case numbers. And those clinics made a profit that spent as little money as possible on services – higher effort and quality tended to mean losses.
The shortage of nursing staff has recently become particularly evident in the children’s hospitals, where some of the beds could not be operated due to a lack of nursing staff, according to the German Interdisciplinary Association for Intensive Care and Emergency Medicine. The federal government is planning to make it easier for skilled workers from abroad to immigrate to Germany.
With agency material.
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