Plans for Federal Institute continue to be criticized

Plans for Federal Institute continue to be criticized

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Berlin The current plans for a new Federal Institute for Public Health are on shaky ground. Not only critics, but also the opposition and the FDP have little to say about the proposals of the Federal Ministry of Health (BMG).

In the coalition negotiations, the SPD, Greens and FDP agreed on a new Federal Institute for Public Health. The aim: to strengthen prevention and information on cancer and dementia as well as cardiovascular diseases.

Currently, the office of Federal Health Minister Karl Lauterbach (SPD) has proposed in a draft bill from October last year (a more recent draft is not yet available) to spin off the Department of Epidemiology and Health Monitoring (Department 2) from the Robert Koch Institute (RKI) and integrate it into the new authority.

The new federal authority is to be called the Federal Institute for Prevention and Medical Education (BIPAM). During the transformation phase in the course of this year, legislation for the new institute is to be put in place. However, it is not yet certain whether the BIPAM will end up being called as previously planned or whether the RKI will actually be split, as statements by the traffic light coalition show.

I am aware that many are not happy with the plans to separate Department 2 from the RKI, said Nezahat Baradari, the SPD’s reporter, to the German Medical JournalBut it would also be wrong to simply subordinate the BZgA or the BIPAM to the RKI instead. The latter was suggested by experts in an expert hearing in parliament.

The new federal institute should not weaken the RKI, but support it, said Johannes Wagner, the Greens’ rapporteur in the Bundestag, to the German Medical JournalClose cooperation with the RKI is important for success.

There will certainly be interfaces between the new federal institute and the RKI. The fact that the institutes work together closely and trustingly is an important basis for the public health landscape in Germany to take a leap forward.

According to Wagner, the traffic light coalition has agreed to set up a Federal Institute for Public Health, which would house public health activities, the GD network and federal health communication. The BZgA would be incorporated into this institute.

It would not help anyone if the BZgA simply continued to operate under a new name. Instead, we must now look at what other tasks and areas need to be located in the new federal institute in order to effectively strengthen public health and, above all, to support local health authorities, says Wagner.

It is important to him that the new federal institute works according to the latest scientific standards. Prevention is not just the task of medicine, but must be understood in a comprehensive manner according to the principle of health in all policies. That is why the most important thing is what the institute is working on and how the tasks are implemented, he said.

FDP wants changes in parliamentary procedure

When asked, the FDP expressed clear criticism of the ministry’s plans. It has little to gain from the ministry’s previous ideas. The BIPAM, in the version currently being discussed, is not what we had in mind during the coalition negotiations, said the FDP’s health policy spokesman in the Bundestag, Andrew Ullmann, to the German Medical Journal.

The aim is to strengthen the scientific independence of the RKI and to draw conclusions from the weak role of the Federal Center for Health Education (BZgA). Now, however, the plan is to cut back on the RKI. At the same time, the BZgA is to be transformed into a strengthened BIPAM in the area of ​​responsibility of the Federal Ministry of Health.

“That is exactly the opposite of what we planned,” explained Ullmann. The separation of communicable and non-communicable diseases is also not understandable at any level. “We will do everything in our power in the parliamentary process to ensure that we get a Federal Institute for Public Health that follows a modern public health approach,” announced Ullmann.

Criticism from the opposition

The Left Party in the Bundestag takes a similar view. The entire project, including the naming, reflects an outdated understanding of prevention that no longer corresponds to scientific findings, said Kathrin Vogler, health policy spokeswoman for the Left Party, to the German Medical Journal.

The decision to divide prevention according to types of disease is particularly serious. Instead, the connection between poverty and health must be given greater attention, warns Vogler.

She emphasized that the RKI has proven itself to be a highly competent scientific institute during the corona pandemic. Breaking it up is a completely absurd idea, says the Left Party MP. A Federal Institute for Public Health, which must be independent of political instructions, but also and above all of the influence of lobby interests, should instead be set up under the umbrella of the RKI.

For the Union’s health policy spokesman in the Bundestag, Tino Sorge (CDU), the process of establishing BIPAM is proceeding in typical Lauterbach style. First there are big announcements, then all those involved are alienated and in the end there is only scorched earth left, he told the German Medical Journal.

Department 2 is to be separated from the RKI without any need. This is causing great unrest in the institute. Alternative options, such as a complete relocation to the RKI or completely new forms of cooperation between the authorities were apparently not discussed with those involved or not discussed sufficiently, and this is now taking its toll, says Sorge.

Many parliamentarians are also critical of the naming of the new institute. However, opinions differ on this too. In the USA, a well-established brand has been created with the Centers for Disease Control and Prevention (CDC), explained Sorge.

Whether this will be successful with the fictional character BIPAM is anyone’s guess. It will be difficult for employees to identify with their institute. Here too, they could have been more involved, for example with an ideas competition among the future workforce. This opportunity was missed, said the CDU politician.

“I would prefer that the name of the institute should include not only public health but also social medicine, which has been criminally neglected in Germany in recent years,” explains Left Party MP Vogler.

A personality like Alice Salomon would actually fit in here, so that for the first time a federal institute in the health sector would have the name of a woman who distinguished herself through her humanistic world view and her commitment to neglected, marginalized and poor women and their children, as well as through her scientific work against all odds. Vogler is taking up a suggestion made by Raimund Geene of the Alice Salomon University in Berlin, which he made at a specialist discussion in the Bundestag.

The name naturally has a signaling effect, explained Wagner of the Greens. If our coalition partners are interested, I am personally open to discussing it again. Naming it after a woman would certainly have its charm, he explained. It is striking that many existing federal institutes are not just named after people, but above all after men.

In my opinion, the discussion about the name was exaggerated from the start, says SPD MP Baradari. What is important is the content, not the packaging. In addition, the abbreviation BIPAM has already become established in everyday language. I don’t know why we should touch on it again. © may/aerzteblatt.de

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