Hospital.Help

Berlin – The German District Association is concerned about the current considerations from the Federal Ministry of Health (BMG) on reforming the emergency service. The government factions have been saying for weeks that the new regulations should be integrated into the parliamentary process as part of the emergency law.

The German District Association sees the request as a “lack of legislative competence” since “organizational and content-related requirements for the rescue service” lie with the states according to the Basic Law.

In a letter to the State Secretary in the Federal Ministry of the Interior, Juliane Seifert, the district council also criticized the idea of ​​incorporating the rescue service into “social security law and thus also the quality of services”. The writing is that German medical journal before.

The reason for the criticism from the district council is an overview paper on the status of the planned regulations for the emergency services, which, according to information from the German medical journal should come from the Federal Ministry of Health. In terms of content, it corresponds to the considerations regarding the rescue service, which have also been reported from the circles of the three traffic light factions for months.

The paper on the “rough structure” of the emergency service points out that emergency medical care should be included as a service segment in the Social Security Code V (SGB V).

This is an “essential prerequisite” in order to achieve the goal of “cross-sector organized, well (also digitally) networked and functioning pre-clinical care for those seeking help,” says the paper. In the future, the area should be referred to as “medical emergency rescue” and thus provide corresponding uniform criteria for the quality of emergency care.

The paper explains planned changes. There should be a new paragraph 30 SGB V, in which the scope of services of “medical emergency rescue” is defined. Emergency management, emergency medical care and emergency transport should also be described in more detail.

For management in an emergency, networking with other care offerings such as nursing should also be ensured. When it comes to emergency transport, it is expressly mentioned that in addition to the hospital, it can also be transferred to other medical facilities – such as a nursing home.

The new paragraphs 133 are intended to regulate the provision of medical emergency rescue services, patient transport and medical trips. In further changes, an “Emergency Rescue Quality Committee” is to be located at the Federal Ministry of Health. The National Association of Statutory Health Insurance Funds and four federal states are to become members of this new committee.

“Specialist societies and relevant leading organizations must be heard,” the paper continues. The committee is developing a catalog of recommendations for structural and process quality parameters for emergency management, emergency treatment and emergency transport. The future digital emergency documentation should also take place here “with the involvement of the KBV and the DKG”.

These plans from the “rough structure” must be formally reformulated into amendments in order to be discussed in the Bundestag Health Committee at the hearing on emergency care on November 6th.

“The paper takes a far too one-sided medical-related view,” says the district council about the projects. “A ‘high zone’ at the federal level in SGB V is therefore not only unnecessary, it means an intervention in state competencies and also carries the risk that inconsistencies may arise in the future with individual changes at the federal and state levels.”

The German District Association does not see the current providers of the emergency services, the districts and independent cities, as “service providers in the one-sided medicine-related language of the SGB V,” it continues. Rather, the cities are demanding that the emergency services continue to be reliably financed. “This is the only way the proven system can continue to exist and be further developed,” it says in the letter.

The municipalities also reject a joint committee in the BMG for emergency rescue. “Here, an illegitimate committee at the federal level is intended to decide on relevant organizational, planning and qualitative requirements, the dimensions and implementation of which cannot be estimated.”

The four country representatives on the committee are not authorized to decide for everyone else. However, it is already common practice in other health policy committees for two or four representatives from the federal states to be sent to present the – usually joint – position of the states.

This argument, that common quality standards can also be set by the federal states in the emergency services, is taken, for example, from a report by the former constitutional judge Udo Di Fabio from the summer of this year.

On behalf of the Björn Steiger Foundation, Di Fabio had certified that the rescue service was experiencing a “systemic crisis”, as there were no uniform regulations across Germany, particularly when it came to quality standards and a functioning digital rescue chain.

According to his assessment, one can certainly argue that the differences in quality in emergency care do not fulfill the basic right to physical integrity, a duty of protection of the state. Di Fabio’s report is intended to “encourage the federal government to take on greater responsibility for control here.” © bee/aerzteblatt.de