Hospital.Help

Berlin – Which laws and projects of the former government coalition of SPD, Greens and FDP can still be implemented with the Union in the remaining time is currently being intensively discussed.

Although it remains unclear whether a law can be passed from the health policy projects that have not yet been completed, the Health Committee discussed projects with experts today. The Health Care Strengthening Act (GVSG) is intended to implement a whole range of projects, including the de-budgeting of general practitioners.

“We experienced a lot of irritations and unexpected things this week. The committee is still working, because in this law things are to be decided that are of fundamental need for the care of the population,” said Kirsten Kappert-Gonther (Greens), the acting chairwoman of the Health Committee in the Bundestag at the beginning of the meeting. ” That’s why we want to discuss it with the experts today. We’ll see what else can be decided.”

Several appeals to conclude at least individual parts of the proposed law followed – for example from Ferdinand Gerlach from the University of Frankfurt, former chairman of the Advisory Council on Health and Care, who was questioned about this by the Greens.

“The measures proposed in this bill are overdue for care close to home. Family practices and specialist practices close every day because they cannot find a replacement. The patients then turn to other practices, where they are often not accepted. The need for older patients in rural regions is particularly great,” Gerlach told the committee.

“The mood in practices is also bad among medical assistants. How would patients feel if sensible measures that had been planned for years were now put on the back burner?” Gerlach asked the MPs. In his view, all of the projects discussed in the hearing could not be concretely implemented by a new government until 2026 at the earliest. “This is far too late,” Gerlach continued.

He emphasized that he did not have a party register and that, as chairman of the Advisory Council, he had worked with six different federal health ministers from different parties. “I still assume that you as MPs want to prevent harm to the population. Therefore, they can and should pull themselves together and implement the things they want to implement.”

Tino Sorge, health policy spokesman for the Union parliamentary group, pointed out that many of the proposed laws address important points in health care. However, he criticized the fact that many other amendments to the law had only been circulated the evening before.

“In a final act of final panic, the SPD and the Greens are trying to get their hodgepodge of health policy leftovers from three unsuccessful traffic light years through parliament. They completely ignore the fact that there is no longer a majority for this,” Sorge said in a statement following the meeting.

Time-critical issues will be addressed “quickly after a change of government,” Sorge continued. “But the Union is not available to provide the majority for the last red-green health policy convulsions.”

De-budgeting of general practitioners is an important issue

In the debate about the proposed law, which the members of the committee were dealing with, the MPs asked the experts primarily about the issue of de-budgeting general practitioners.

The continued lack of financial regulations for further training for psychotherapists was also a key issue. Questions were also asked about health regions, primary care centers and health kiosks. There are regulations on this in the GVSG.

When debudgeting, the family doctors’ association emphasized the urgency. “The situation in the practices is precarious, so regulation must come immediately,” demanded co-chair Markus Beier. In his view, however, the regulation provided for in the draft still needs improvements and more precise formulations as to exactly which family doctor services should fall under the debudgeting.

If such a regulation only comes in 2026 or 2027, it would be a “deterrent” for older general practitioners who would retire earlier and for younger doctors who would not then want to set up practice, Beier predicted. The diabetologists warned that they would be excluded from care in the future under the regulations presented.

Promote the de-budgeting of specialists

When asked, the German Medical Association (BÄK) also emphasized that there must be a quick regulation for general practitioners, said BÄK President Klaus Reinhardt.

When asked, the National Association of Statutory Health Insurance Physicians (KBV) advocated de-budgeting: “We are of course urgently waiting for this for general practitioners. But the budget for specialists has also been in effect for 30 years, so we need that as quickly as possible.”

Dirk Heinrich from the umbrella association of specialists (Spifa) called for debudgeting to be implemented quickly for specialists as well. “Not debudgeting specialists is a mistake, because the long waiting times are one of the problems with the ever-increasing use of emergency rooms in hospitals,” says Heinrich. Health care reforms need to be thought through together here.

When asked by the FDP parliamentary group, the National Association of Statutory Health Insurance Funds emphasized that it did not see any improvement in care through debudgeting, especially not in rural areas. The association representative particularly emphasized the possible additional costs of around 400 million euros, which, from the health insurance companies’ perspective, would go towards expanding services for existing patients rather than the care of new patients.

Another key topic of the survey was the lack of funding for further training in psychotherapy. This should be regulated by the GVSG. However, the draft lacked a binding financing commitment or a corresponding model.

Representatives of several associations pointed this out. It is a great burden for students not to know how their further training will be financed in the future. Experts assume that 2,500 young people finish their studies every year and have no prospects.

“We need the regulations now, otherwise we will lose an entire generation of skilled workers,” emphasized Felix Kiunke from the Psychology Faculty Conference. The Federal Chamber of Psychotherapists also sees a blatant lack of supply by 2030 at the latest, as there will then be hardly any young people who could take over the practices.

Barbara Lubisch, deputy federal chairwoman of the German Psychotherapists Association, emphasized that outpatient further training also needs to be strengthened, as the clinical outpatient clinics do not have enough places. Psychotherapist Adriane Satorius explained that around 2,000 further training positions are needed, of which 1,500 are in outpatient care.

In addition, experts – such as the AOK Federal Association – were often questioned about health regions or health kiosks as well as regional care approaches. However, this topic was a major point of contention between the former traffic light coalition until recently. It is therefore unlikely to be included in any possible further legislative process in this legislature. © bee/aerzteblatt.de