The fact that Bavaria’s hospitals are in an extraordinary crisis can be seen from the deep red numbers, a huge shortage of staff or from the canceled emergency and children’s wards. Or you can take a look at the full press seats at this year’s general meeting of the Bavarian Hospital Society (BKG) on Friday in Munich. “I used to sit here alone,” says a reporter, while two TV crews are positioning themselves in the conference room and about half a dozen journalists are taking their places at the press table. “The problems have been known for a long time.”
But the situation in the clinics in Bavaria and throughout Germany has never been as dramatic as it is now in recent decades. Shaken by the state of emergency in the corona pandemic and exacerbated by rising energy and material costs, the clinic operators in the Free State are almost desperately calling for political help. These days there is also the overload in the children’s hospitals, which are reaching their limits due to a wave of serious respiratory diseases – and often no longer have a bed free. “RED alert – hospitals in danger” is written on posters around the stage. Which would set the tone of the gathering.
“We are in a catastrophe,” says Bavaria’s Health Minister Klaus Holetschek (CSU), for example, who uses large parts of his speech to attack the federal government’s health policy in the person of SPD politician Karl Lauterbach. Bavaria warned early on about the current problems, but Berlin did not want to acknowledge the crisis and “hesitated and procrastinated”. Holetschek does not mention that the CSU was in the federal government for 16 years until 2021 and that the health minister came from the sister party CDU in the last legislative period. Instead, he warns of a “cold structural change” in the hospital landscape if Berlin does not quickly pay out an aid fund of around six billion euros promised by Federal Health Minister Lauterbach to the hospitals.
“The hut is on fire,” says BKG chairwoman Tamara Bischof in her speech. And as if the District Administrator of Kitzingen had to underline her drastic message visually, she stepped up to the speaker’s desk in a fiery red blazer. The warning signals should not be ignored by anyone this Friday. As a representative of around 190 hospital operators with around 360 clinics in Bavaria, Bischof warns of bankruptcies and calls for quick help from politicians. She also makes the Free State responsible, from which she is demanding an increase in state hospital funding from 643 million to 900 million euros a year. In addition, impatience is growing among the clinic operators in view of the hardship fund of over 1.5 billion euros announced months ago by the state government – when it is to be paid out is unclear.
Health Minister Holetschek fears “centralism” from Berlin
There were no concrete statements from Holetschek on Friday, they wanted to wait for the decisions from Berlin first. The health minister prefers to tackle Lauterbach’s major hospital reform. On Tuesday, Lauterbach wants to present proposals from a commission of experts on the future of German hospital care, and it is expected that the financing of the clinics will be reorganized. Holetschek draws red lines as a precaution. There should be “no centralism, no planned economy” in which Berlin determines how and where hospitals in Bavaria should be operated.
He means the so-called advance financing, which could replace the current and faulty system of flat-rate financing. So far, to put it simply, hospitals have received money for each individual treatment – which, for example, leads to unnecessary operations. With advance financing, hospitals would instead receive a basic amount that would be linked to the number of residents on site – the Bavarian Hospital Society supports the system change. But Holetschek fears that Berlin will allocate the money centrally and thus decide on the future of smaller clinics. “I don’t want to close any hospitals,” emphasizes the CSU minister and demands sufficient leeway for the federal states.
Of course, Holetschek also knows that the system cannot remain as it is. He is currently experiencing it in his own state, where a decision will be made on the merger of two clinics in the Weilheim-Schongau district on Sunday. One of the two locations in Weilheim and Schongau would be lost, but opponents of this merger fear for the health care in the area. They fought for a referendum and want to keep both clinics. Holetschek is in favor of the merger – but what if the residents speak out against it on Sunday? The minister did not have a conclusive answer to this question on Friday.