Berlin Karl Lauterbach is used to criticism. The message from Saxony’s Prime Minister Michael Kretschmer (CDU) was tough: The Federal Health Minister’s hospital reform should “under no circumstances become a reality,” he said before the two politicians met on Friday.
Kretschmer traveled with the other East German state leaders to Berlin for a special conference with the SPD minister, the topic was medical care. The Minister of Health is dependent on the goodwill of the federal states for his reform – the reform law should also expressly require the approval of the Bundesrat.
However, Lauterbach still has a lot of convincing to do. The mood in other federal states led by the Union is also bad in view of the reform plans, with Bavaria and North Rhine-Westphalia in particular having registered protests.
According to Lauterbach, the goals of the reform are to improve medical quality and the services of general interest in the clinics. For this purpose, the remuneration system is to be changed via flat rates for treatment cases. In order not to be dependent on more and more cases, clinics should be rewarded with a larger share simply for providing services.
The focus is also on classifying the clinic network into three levels of care and financing them accordingly – from basic care close to home, through a second level with other offers, to maximum care providers such as university clinics. The federal states fear that smaller hospitals in particular will be closed.
Federal states warn of hospital closures
There is plenty to talk about. But Lauterbach was able to at least dampen the anger a little. When he and Kretschmer appeared in front of the cameras together with the Mecklenburg-West Pomeranian Prime Minister Manuela Schwesig after a two-hour conversation, the Saxon head of state sounded different.
At this stage, one cannot say that one can agree with Lauterbach’s plans, he said. “But we have to make sure we get there.”
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The devil is in the details, the resentment is still great. In Saxony, said the CDU politician, up to ten of the 120 locations would be threatened with closure as a result of the reform plans.
“We know the discussion when departments and clinics are closed, what that does to the population,” said Kretschmer. “That’s why we need to deal with the topic very sensitively.” And if a patient has to drive 50 to 60 kilometers to the nearest hospital in the country, “the acceptance is gone”.
However, Kretschmer praised Lauterbach for the approach that the federal states have to agree to the planned reform law. “That sets you apart from many other politicians who think par ordre du mufti you could do it.”
Reform is work in progress
Lauterbach uses the opportunity to approach the country heads. He said he shared the view that an agreement would be reached. “Reform is work in progress”.
He presented the reform proposals as they are currently being discussed in the federal-state working group, he said. There is still no common proposal, so there is nothing to correct.
Calculations will be made for the individual federal states. At the present time, the effects at the level of the federal states are not yet easy to assess.
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However, he considers the fears of a hospital death to be unfounded. “I can only say that clinics will disappear if we don’t make the reform.” It is intended to maintain and strengthen clinic locations. “There are no closure plans.”
According to Lauterbach, the reform will rather lead to reliable financing of the hospitals. There will be more outpatient treatments in the future. The hospital planning and securing remain with the federal states.
All the reforms in the federal states would go hand in hand with the federal reform. In the future, quality criteria will be uniform nationwide. “It is a very central concern of the new federal states that there is the same quality everywhere. The people there have a right to that.”
Lauterbach made it clear that the reform could also give states and municipalities in the east in particular the opportunity to provide outpatient care, which is otherwise difficult to maintain, in part through hospitals.
Prime Minister Schwesig attested to the great achievements of the hospitals. “Even though this good work is being done in our hospitals, our hospital system is sick. It’s sick because far too much the economy, maximizing profits, plays a role instead of the patient and the staff.”
The staff suffer from the fact that there is economic pressure and the focus is less on the patient. You have to get away from the case flat rates, which would have ensured economization.
With agency material.
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