Status: 31.08.2023, 19:29 p.m.
By: Andreas Schmid
CommentsShare
Karl Lauterbach during a hospital visit in September 2022. His clinic reform has been criticized. © picture alliance/dpa | Christophe Gateau//IMAGO/Rainer Weisflog (montage)
What does the hospital reform mean for hospitals in Germany? The head of the works council of the hospital group Asklepios speaks plainly.
Munich – For a long time, the federal and state governments have been discussing the future of German care. A few weeks ago, Health Minister Karl Lauterbach presented his hospital reform. In essence: away from the system of payment according to treated cases as well as a greater medical specialization. This means that not every hospital should offer everything. In the future, smaller facilities in particular should limit themselves to those interventions that they are good at.
What does this mean for hospitals and hospital staff? In an interview with the Münchner Merkur, Klaus Bölling gives an insight into the future of German hospitals. He is Chairman of the Group Works Council of Asklepios, the second largest private hospital group in Germany after Helios. Bölling predicts an "unplanned, cold clean-up of the hospital market" and speaks conspicuously often of compliance with collective agreements. When it comes to paying its nursing staff, however, Asklepios repeatedly blocks real improvement, which is why the head of the works council resolutely holds his own company accountable.
Mr. Bölling, after a long struggle, the basic features of the hospital reform are in place. Are you satisfied?
The reform is, at the very least, an approach that will make a difference in the hospital sector. It's a step in the right direction, but we still see some room for improvement. The reform is very economical, conceived from the point of view of hospital financing. We look at the matter from the point of view of the employees we represent.
What does the reform mean for hospital staff?
First of all, relatively little. The reform requires an improvement in the working situation in the clinics.
Above all, this can be achieved through higher wages.
Yes, especially. However, conditions must improve not only on the wage side, but overall. Due to the shortage of skilled workers, we have too few staff anyway. And this staff is massively overworked. That has to change.
Let's stay with wages for a moment: Why does Asklepios repeatedly oppose compliance with collective agreements?
This is the fundamental attitude in this Group, which we as the Group Works Council massively criticize. We see this as an economic risk for the Group. I think this is an ideological question within the group...
0
Also Read
ARD warning against Heinz Becker: Cabaret artist Dudenhöffer – "Satire should not be warned against"
READ
Aiwanger affair: Bayern vice-president apologizes first in statement – and then attacks in interview
READ
Trump pleads "not guilty" to Georgia indictment
READ
Aiwanger and the leaflet: The wording of the anti-Semitic diatribe
READ
Ukraine war: Why the T-64 tank could be more important than the Leopard for the counteroffensive
READ
Fancy a voyage of discovery?
My Area
Which won't change anytime soon?
We are trying to make progress with every possibility. But it's difficult. In Bavaria, for example, only Gauting and Lindau are bound by collective bargaining agreements.
The situation is similar in other regions. Where does this patchwork quilt come from?
Whenever there is a lot of pressure, something might happen in terms of collective bargaining. But across the board, they are trying to avoid that in the group. In Gauting and Lindau, this was done through the Association of Private Clinics and a collective agreement with Verdi. Elsewhere, the company unfortunately refuses to do so.
Klaus Bölling has been Chairman of the Group Works Council of Asklepios Kliniken since 2022. The trained nurse represents 68,000 employees. © fkn
"This is an unplanned, cold clean-up of the hospital market"
The opposition speaks of a hospital death. Do clinics now have to close as a result of the hospital reform?
You don't have to close directly through hospital reform. There are already massive economic difficulties in the clinics. There is a lack of liquidity. This is now to be improved by the reform, for example in the case of the lump sum for retention. But by the time it is implemented, of course, a number of clinics may have already disappeared. For economic reasons. This is an unplanned, cold clean-up of the hospital market.
The head of the German Hospital Association, Gerald Gass, assumes that every fourth or fifth hospital will not survive the next five to seven years.
Yes, it can happen.
Also at Asklepios?
Right now, there are no indications of this. But after the hospital reform, it will of course depend on how care orders are distributed and which clinics are assigned which service groups. Asklepios has to position itself with a promising portfolio.
There is to be a new evaluation scheme that classifies hospitals according to their quality. If Asclepius is convinced of his houses, there is little to fear, right?
Yes, the company certainly sees it that way too. But it's like any hospital: there's always room for improvement. We agree with the Board of Management that we need to set up our clinics well. There are certainly differences. For us, it plays a decisive role what the working conditions are like. This, of course, includes collective bargaining.
Fewer hospitals? "There's no way around it"
What does the hospital reform mean for the supply situation, especially in rural areas?
You have to look at the regions politically and ask yourself which hospitals you need. But there is also no way around a certain concentration in the hospital market. We have a shortage of skilled workers and there are already too few skilled workers to maintain performance in all clinics. There are some clinics that have closed entire departments because they don't have staff. However, this concentration must take place in a planned manner and not as it is now, when it is left to the market and it is seen which clinic becomes insolvent.
They appeal to the market. Should a hospital make a profit at all?
In principle, we trade unions are of the opinion that public services of general interest belong in the public sector. But politically, it is decided otherwise. We are a group works council in a private company and have to work with the conditions that prevail there. However, we think that a clinic – whether public or private – must comply with certain basic conditions. And that includes collective bargaining. A prerequisite for the payment of the lump sum should be that the clinics pay their staff in accordance with a collective agreement concluded with a proper trade union.
Interview: Andreas Schmid