Hospital.Help

Berlin – A hospital reform is necessary before the next federal election. Above all, planning security is needed. The German Medical Association (BÄK), the German Nursing Council (DPR), the Marburger Bund (MB) and the German Hospital Association (DKG) drew the attention of the members of the Bundestag to both of these issues in a joint letter. Yesterday’s letter is available to the German Medical Journal before.

According to the four actors, it is urgently necessary to bring the Hospital Care Improvement Act (KHVVG) into force in this legislative period, which lasts until September 2025. “If this law fails, we face a paralyzing phase of uncertainty in the location development of hospitals beyond the next federal election,” the associations write.

Planning security in the form of reliable framework conditions is required in order to develop the prerequisites in the form of personnel planning and investments for the respective performance spectra of the future. With regard to the planned performance groups, the focus should be primarily on the 60 groups that have been developed in North Rhine-Westphalia (NRW).

“The controversial further developments planned by the federal government so far, such as the introduction of minimum case numbers, additional benefit groups or changes in the structural specifications for the benefit groups, should be examined in a second development phase together with the states from 2027,” the letter continues.

According to the associations, such a two-phase model in hospital planning offers the advantage of being able to later assess whether additions to the NRW planning concept are necessary and, if necessary, to specifically align them with it.

First rely on established instruments

In the planned financing reform, BÄK, MB, DKG and DPR propose that, as a first step, the further development of already established case number-independent financing instruments should be focused on.

These include emergency level, security and center surcharges as well as surcharges for pediatrics and obstetrics. This could support hospital locations that have special structural costs, for example in emergency care, it was said.

According to the BÄK, MB, DKG and DPR, anything beyond this should be prepared with the self-administration following the hospital reform legislation. The four actors also renewed their call to ensure a stable financial basis for hospitals in order to prevent cold structural change with uncoordinated cuts in care and services.

The associations also write that the planned cross-sectoral care facilities must also have reliable legal and financial framework conditions. These must be designed fairly for both hospitals and contracted doctors in order to enable regional care to be provided in line with needs.

Aspects of reducing bureaucracy that are already on the table should also be incorporated into the KHVVG, it said. The DKG today presented current figures on the bureaucratic burden on medical and non-medical staff as well as concrete proposals for easing the burden.

The hospital reform was already discussed in the Bundestag in its first reading before the summer break. In the summer, rapporteur discussions will take place and amendments to the KHVVG will be worked on.

The public hearing of experts in the Bundestag’s Health Committee is planned for September 25. The vote in parliament is to take place in October. According to current information, the law is to come into force on January 1, 2025. © cmk/aerzteblatt.de