Hospital.Help

In doing so, she defended herself against the criticism expressed by some quarters about the often poor quality of patient care in the inpatient area. Doctors work around 60 million hours of overtime every year because the system is designed for that, she explained

She firmly rejected self-confident negative blanket judgments about our work in the clinics and outpatient areas. The 2024 hospital report from the AOK Scientific Institute (WIdO) recently pointed out, among other things, inadequate heart attack care. According to Johna, these statements are a deliberate misleading of the public. Federal Health Minister Karl Lauterbach (SPD) has also repeatedly said that care in Germany is often only average or that life expectancy in Germany is significantly behind comparable countries in Western Europe. According to Johna, one cannot make any more general and unfair judgments about the work of doctors.

Accusations not helpful

However, she did not deny that there must be improvements for the benefit of patients. In particular, more cooperation and focus formation are needed. However, these self-confident negative blanket judgments about the work of doctors are not helpful.

Instead, the average bed occupancy rate in hospitals of 69 percent can be explained primarily by a lack of staff, says Johna. The lack of capacity utilization is often used as an argument to reduce capacity as part of the planned hospital reform. However, this reduction in the number of service providers must be carefully examined beforehand using a needs analysis and impact assessment, demanded Johna. This is important in order to see what complex consequences the reform will have on patient care.

The hospital reform provides for the introduction of 65 service groups. Uniform federal criteria should determine for which services hospitals must have the appropriate personnel and technical equipment. This is intended to improve the quality of patient care. Reserve financing is also planned. With this, the clinics should receive 60 percent of the operating costs as a flat rate, even before they provide services. The remaining financing will continue to come from diagnosis-related flat rates (DRG). A corresponding draft of the Hospital Care Improvement Act (KHVVG) is already available.

There is no bold reduction in bureaucracy

One of the most important measures regarding the reform is the de-bureaucratization and the associated relief of doctors, emphasized Johna. Lauterbach announced a courageous reduction in bureaucracy at the last general meeting of the MB in Berlin. With regard to the planned hospital reform, only a few small steps can be seen in the right direction, which are being overcompensated by a significant increase in bureaucracy elsewhere, explained the MB chairwoman.

The Annual General Meeting today passed a motion that calls on Lauterbach to present a courageous law to relieve bureaucracy. This should lead to immediate and noticeable relief, particularly for medical and nursing staff.

Johna also takes a critical view of the planned retention fee. This will not reduce the economic pressure on hospitals. She criticized that neither the distribution of the reserve funding nor the payment to the hospitals was designed to be case-independent. Instead, there is a need for case-independent reserve funding that counter-finances the patient-related staff on a one-to-one basis, she demanded. The MB delegates also spoke out in favor of this. The medical personnel assessment system of the Federal Medical Association (PS-BK) must be used to calculate the staff, said Johna.

There is also a lack of financing security, for example because it is not yet clear what the minimum reserve numbers should be for each performance group. In addition, it is not known how the planned performance groups will be precisely defined. These regulations are not due to be set by the Federal Ministry of Health (BMG) until 2025.

Dismantling the double specialist track would shake up the system

Johna also criticized the statement presented yesterday by the Government Commission on Hospitals, which, among other things, recommended dismantling the double track of specialists. This would have the consequence of shaking the supply like a Lego house and being surprised if the house could no longer stand in the end, says Johna.

The head of the hospital policy department at the MB Federal Association, Susanne Renzewitz, also warned of the effects of the planned concentration processes on the doctor’s workplace. It is difficult to meet the intended quality criteria for the performance groups, simply because there are not enough staff. In addition, it is questionable whether medical staff could be exchanged when service groups are exchanged between hospitals. She further criticized the fact that the reform would impose additional documentation and reporting obligations on doctors.

Johna also warned against reducing too much capacity in the healthcare system. Once they disappear, they won’t come back anytime soon. But it is good to have reserves in the system. Especially in large infection situations or other catastrophe scenarios, it is important if many people can be cared for. You shouldn’t make the mistake of planning health care structures only for nice weather, says Johna.

Build effective disaster protection

Delegates today also passed a motion that calls on the federal government and the federal states to determine the necessary resources and capacities for effective disaster protection. This should be done as part of the hospital reform. Accordingly, additional structural precautions would have to be planned and financed.

In addition, the general meeting of the MB adopted a motion that calls on the legislature to preserve the independence of the Bundeswehr’s medical medical service. It says that there should be no qualitative or quantitative compromises in the training and further education of medical staff as well as in cooperation within the framework of national health care. The background is that Federal Defense Minister Boris Pistorius (SPD) announced at the beginning of April that the medical service would no longer be a separate organizational area of ​​the Bundeswehr.

Among other things, the MB also called for a de-budgeting for all medical specialties and a move away from quarterly billing and prescriptions. © cmk/aerzteblatt.de