Status: 22.09.2023, 21:00 p.m.
By: Rasso Schorer
"The district council asks the supervisory board and the management of the hospital GmbH to consider setting up emergency care (24/7) at the Schongau site." So it was decided. The Action Alliance had previously presented its "Variant 6". © Symbolic photo: Panthermedia/Sabine Schaefer
District – The fact that district council meetings are accompanied by demonstrations on the subject of the future of hospitals is no longer an unfamiliar sight. What was new today, Friday, in Hohenpeißenberg, was what could be read on the signs: "Variant 6 saves lives," held the this time rather small group of the action alliance in the air. The disproportionately more employees of the hospital GmbH, on the other hand, chanted: "no insolvency!".
This word "insolvency" was often used in the approximately five-and-a-half hours in the Hohenpeißenberg House of Associations. Would such a system be feasible? And which type of procedure would be the one with the best prospects? This was the subject of repeated speeches by the district councillors, some of whom showed flirtation or at least consideration of insolvency. The invited experts were already unanimous in their previous statements: "Avoid insolvency proceedings," recommended Dr. Mark Boddenberg.
"Your case is completely unsuitable for this," said the specialist lawyer for insolvency and restructuring law at the law firm Eckert from Hanover, referring to any expected costs as well as friction and control losses as well as dissolution. If the workforce is lost, "everything no longer makes sense". A migration can sometimes be intercepted by clever communication – but this train has left.
Boddenberg described a so-called protective shield procedure as "brutal, fast and efficient" – moreover, one or the other market participant is probably just waiting to grab some of the Weilheim and Schongau cake; "their case is known".
It is quite clear that something has to happen, but his colleague Dorit Aurich agreed. Otherwise, an insolvency scenario would be an inevitable reality in a few months. "If you don't decide today, the GmbH will have to file for insolvency," she said, looking ahead to the later vote.
The situation is difficult for hospitals throughout Upper Bavaria, reported Paul Auer, head of department at the government of Upper Bavaria. In the district, however, it is particularly dramatic, because there has been a considerable structural problem here for some time. "It's only the second time in 19 years that I've been to a district council meeting," he said. "We have been raising our fingers in admonition for many years."
The overall situation is deteriorating noticeably, summarized District Administrator Andrea Jochner-Weiß. "Today we need a clear decision for our hospital and a commitment to financing for the next twelve to 24 months."
In the end, the proposed resolution had to be tinkered with and supplemented in several places, but in the end 41:13 councillors agreed.
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The committee decided to avoid the initiation of insolvency proceedings for Krankenhaus GmbH. In addition, it decided to continue clinical care in the district through Krankenhaus GmbH as a subsidiary of the district and to take over the operating cost subsidies necessary after a restructuring.
Twelve million euros and an investment cost subsidy of three million as well as financial resources for the transformation process are to be included in the 2024 district budget for this purpose. According to the current status, the latter are eleven to twelve million, mainly for the social plan, because the workforce will be shrunk according to variant 5 (we reported). The fact that this social plan is financed by loans, she would support, the government of Upper Bavaria had already examined. In addition, according to Auer, it would provide an additional 1.5 million euros.
Beyond 2024, in the financial plan 2025 to 2027, the operating cost subsidies required according to the respective status of the restructuring are to be planned, the district council decided. For 2025, this amounts to another twelve million euros. From 2026 onwards, the specific amounts – the current status is an operating subsidy of six million for Weilheim and two million for Schongau – are to be decided by separate resolutions.
For this and for the naming of concrete figures in this part of the decision, several district councillors had successfully advocated. Otherwise, Susann Enders, Michael Marksteiner (both Free Voters), Markus Kunzendorf (ÖDP), Rüdiger Imgart (AfD), Josef Taffertshofer and Franz Seidel (both BfL), among others, had feared a "blank cheque" or "Persilschein" for the management and the supervisory board, in which one or the other committee member expressed a loss of confidence.
The 45 million investments at both locations in order to develop Weilheim into a specialist supplier and Schongau into an outpatient centre in accordance with variant 5 must be dealt with again separately. A shareholder loan of 2.5 million, which would have matured at the end of 2024, was extended until the end of 2027 and increased by 2.6 million.
With this, the cow is temporarily off the ice. How thin this has become was made clear by Thomas Lippmann, Managing Director of Krankenhaus GmbH. In the audit of the annual financial statements for the 2022 financial year, the auditing firm did not issue an attestation because it lacked the secure going concern forecast without the commitment of the district council. After a period of observation shortened to four months due to corona, the financing of companies must now be secured again for at least twelve months. "We didn't have that view," says Lippmann.
Liquidity, already affected by inflation and price increases, among other things, is now also secured again. If the payment term for health insurance companies has been five days since Corona, it could be back to a deadline of 21 days at the end of the year. "That would tear another financial hole of three to four million euros overnight," says Lippmann. With regard to the situation of hospitals in Germany, he stated: "The whole system is broken." Similar observations are made by Dr. Boddenberg. "We used to do two to three hospitals a year," says the specialist lawyer for insolvency and restructuring law. "Now we haven't done anything else for five months."
Health or education?
Wolfgang Scholz (CSU) saw it pragmatically among the numerous speeches: You could spend the money now for variant 5 or for a probably not cheaper insolvency in the end. "We can't afford insolvency," said his parliamentary group spokesman Peter Erhard.
However, Armin Jabs (BfL) and Dr. Kerstin Engel (Greens) feared that variant 5 would not be financially viable in the long run. Jabs sees the Weilheimer Haus as a focal point supplier as oversized in view of the given possibilities. Engel once again thought he was insufficiently informed: "We have to keep turning new loops because we can only make half-baked decisions here."
He had the feeling of losing control, Marksteiner confessed. "I'm only in the district council to nod off millions – I don't like it." One becomes a wobbly dachshund, Elke Zehetner agreed, the hospital is a bottomless pit. The Penzberg corner of the district is actually well supplied – and yet it is part of it. The price is high. "If we are committed to health, there is a shift in the shaft somewhere else." The hospital is cutting off all opportunities to tackle other issues of the future, said Josef Taffertshofer. The expected further increase in the district levy will deprive the municipalities of the air to breathe, feared Schongau's mayor Falk Sluyterman (SPD) as one of several district councillors.
The decision to keep the hospital alive lies with the district councils, government representative Auer had stated before the vote. "But then they forego other design options," he said, citing the topics of school and public transport, among other things.
Option 5: Schongau on the way to becoming a regional health centre
District Administrator Andrea Jochner-Weiß sees variant 5 and the future role of the Schongauer Haus as a regional health center as a "very good solution".
In the meantime, however, a variant 6 had been worked out by the Action Alliance Pro Hospital Schongau. This includes emergency care around the clock, said its spokeswoman Daniela Puzzovio – there is no longer any talk of a real emergency room. This should be feasible via a so-called portal outpatient clinic in Weilheim, which takes over services in Schongau at night and on weekends.
"Extremely difficult to represent," said Dr. Norbert Trapp, deputy chief physician in Weilheim, in his assessment. In addition to the financial aspect, he stated: "You won't find staff for it." Nevertheless, at the insistence of the mayor of Schongau, Falk Sluyterman, the list of resolutions was supplemented by one point: "The district council asks the supervisory board and the management of the hospital GmbH to consider setting up emergency care (24/7) at the Schongau site." She couldn't promise anything, Jochner-Weiß said several times.
Meanwhile, the location is becoming more and more of an economic financial burden than it already is, said Managing Director Thomas Lippmann. He spoke of a "massive slump" in patient numbers; occupancy is only reaching 50 percent in some cases – and the trend continues to fall. The Weilheim staff helps to a great extent to keep Schongau running at all. On the subject of emergency care, he explained that the still existing Schongau emergency room currently treats an average of four cases per night between 20 p.m. and 0 a.m. and from midnight to six a.m. of those two. The serious cases are directed to Weilheim anyway.