Sharp criticism of the law reforming emergency care

Sharp criticism of the law reforming emergency care



Berlin – The draft bill for a law to reform emergency care (Emergency Act) has been met with much criticism from doctors. The plan counteracts efforts to make the health system more efficient by creating unnecessary duplicate structures in hospitals and practices, while ignoring the fact that the existing shortage of doctors is leaving less and less room for maneuver, warned the chairman of the Hartmann Association, Klaus Reinhardt.

“The Minister of Health has just praised the Health Care Strengthening Act (GVSG) as an instrument that will massively increase the attractiveness of outpatient care – especially of GP work. Now requiring the KVs to provide telemedicine and emergency outreach services 24 hours a day, seven days a week, or suggesting that established practitioners participate in so-called cooperative practices is definitely not an invitation to set up a practice,” Reinhardt stressed.

The order of the day is to sensibly coordinate the existing, increasingly scarce capacities. This requires intelligent patient management that ensures that people receive the best possible medical care at the right place at the right time, even with limited resources, in emergencies, says Reinhardt. We owe this not only to the patients, but also to the doctors who have been working “at the limit for a long time” in practices and clinics.

The Hartmannbund chairman is now hoping that the members of the German Bundestag will help. They must now be convinced that the law needs to be corrected accordingly.

The board of the Association of Statutory Health Insurance Physicians in Lower Saxony (KVN) also sharply criticized the draft bill. KVN board chairman Mark Barjenbruch called the draft “an unsuitable reform proposal to the detriment of practicing physicians and the associations of statutory health insurance physicians.” In principle, the KVN supports a reorganization of emergency and acute care – but not in this form.

Thorsten Schmidt, deputy chairman of the KVN board, clearly rejected plans for an on-call service and telemedical services seven days a week and 24 hours a day. “This will thin out the regular basic outpatient care provided by doctors and is not affordable in terms of personnel.” Even if non-medical assistant professions are integrated into emergency care, a parallel all-round care system to the existing outpatient and inpatient system cannot be established. The personnel resources are simply not available.

No regulations to the detriment of contracted doctors

The KVN is also critical of the planned establishment of an emergency center, which will partially replace the nationally known appointment service under the KVs’ telephone number 116117 and will be networked with the emergency control centers. “Close cooperation between the statutory health insurance physicians’ on-call service and the emergency services in the state makes sense. However, it must not only aim to relieve the burden on the emergency services and the inpatient structures in the hospitals, thereby coming at the expense of the statutory health insurance physicians,” warned Schmidt.

Solely controlling citizens via integrated control centers is unrealistic. “Patients go directly to the hospital emergency rooms and do not call the control centers first to be directed to a care level,” says Schmidt.

The draft bill basically attempts to regulate emergency care down to the smallest detail, right down to the content of cooperation agreements. “This smacks of state medicine that has to be administered by the KVs,” concludes Barjenbruch.

Although the draft law provides for higher requirements for the accessibility of 116117, according to Dominik von Stillfried, Chairman of the Board of the Central Institute for Statutory Health Insurance (Zi), the statutory health insurance companies are only to bear 50 percent of the overhead costs for the improved service.

The legislator would thus “generously order additional services for the insured community, but only make them pay half of them” – because the remaining expenses would have to be covered by contributions from contracted doctors to the KVen. This does not apply to the emergency services or to the hospitals, criticized the Zi boss. “This unequal treatment is met with incomprehension.”

Von Stillfried also pointed out that a 24/7 transport service and the expansion of home visits in the on-call service to include practice opening hours will quickly reach its limits in times of staff shortages. Even with a limited deployment of 116117, a significant amount of additional staff would be needed – in competition with practices, emergency services and hospitals. © aha/

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