Breakthrough in hospital reform
Countries decide where there are more hospitals
6/1/2023 5:02 p.m
The federal government around Health Minister Lauterbach is making a lot of concessions to the federal states in the planned hospital reform. There is a lot of praise for that. Agreements are reached on hospital financing and planning. However, there is still work to be done on other issues.
The federal and state governments have come closer in the debate on the planned hospital reform. Federal Health Minister Karl Lauterbach spoke of a “breakthrough” after consultations with his state colleagues in Berlin. The “basic structure” of the reform is in place, and in all likelihood it can now come into force as planned at the turn of the year. The rapprochement was also made possible by the fact that the federal government made a lot of concessions to the states in the disputed issues.
Lauterbach promised the states, for example, that they would be involved in the drafting of the bill – under the leadership of his ministry. The first cornerstones of the reform should be available by the end of June, and over the summer the federal, state and parliamentary groups should then work out a joint draft bill, which should form the basis for the later law.
According to Lauterbach, there was agreement in principle on the question of hospital financing and hospital planning. North Rhine-Westphalia’s Health Minister Karl-Josef Laumann emphasized that the federal and state governments had agreed on a clear division of tasks: hospital planning – i.e. the question of where there should be more hospitals and where not – is the responsibility of the states. The federal government, on the other hand, “has its hat on the question of how the operating costs of hospitals are financed,” said Laumann.
The federal and state governments now also agree on the introduction of the planned service groups, according to which the remuneration should be based on the provision flat rates. They should largely be based on the model that is already in force in NRW. “98 percent of the cases can be clearly assigned,” said Lauterbach. In the future, treatments should only be billed if the hospital has been assigned the appropriate service group. Precisely defined requirements must be met for this, for example in terms of personnel and equipment.
“Magic hour for our hospitals”
The federal and state governments did not reach an agreement on the question of nationwide hospital levels, which are intended to make the performance level of clinics more transparent. However, they agreed that the federal government would go ahead alone. “As a federal government, we will make the differences in quality that exist from clinic to clinic transparent,” said Lauterbach. “You have to be able to see where the intervention is being carried out on site and with what quality.” The federal government can also implement this legally without the states.
Lauterbach received praise for his cooperation from the state side. Hamburg’s health senator Melanie Schlotzhauer described it as a “great moment for our hospitals that the federal, state and parliamentary groups are working together on the draft law”. It is “really exemplary that the federal government is accommodating us so far at this point”. Baden-Württemberg’s Health Minister Manne Lucha said that the relationship of trust between the federal and state governments in the reform “made a significant push forward today”. However, some details still need to be “honed”.
Before the meeting, Lauterbach pointed out the difficult financial situation of many clinics. “Without the reform, we will have hospital deaths,” he warned on ZDF. “Many hospitals will not be able to survive without the reform.” The economic pressure is too high.