Hospitals | Setback for care

Nursing staff for hospitals continues to be recruited abroad. Photo: Unsplash/Curated Lifestyle The GKV Savings Act from July also targets care in hospitals with its measures. The current care budget is particularly under attack here. This construction has ensured that since 2020 all costs associated with care in hospitals have been reimbursed by health insurance companies. The self-cost coverage principle for direct patient care on wards with beds is now being watered down again.

Thanks to the nursing budget, clinics have stopped saving nursing staff. Previously, when care still had to be financed through per-case flat rates, this was at least “worth it” economically. With the care budget, the number of employees in this area rose to an all-time high by 2024. The health insurance companies' spending on this rose from around 15 billion euros in 2020 to over 26 billion euros in 2024.

Regardless of what employees achieve in their labor disputes, collective wage increases above the basic wage rate will only be refinanced by half.

This is now being softened. The changes are tied to formal data that have little to do with real needs: In this case, the possible annual care budget, which the health insurance companies finance, is tied to the previous year's budget and its growth is limited.

And: No matter what hospital employees achieve in their labor disputes, collective wage increases above the basic wage rate will only be refinanced in half. With the regulation, the state may be interfering with collective bargaining autonomy, but this will probably have to be fought out before the Federal Constitutional Court.

If the clinics cannot fill certain nursing positions, they face financial disadvantages. This could contribute to hospital management even more insisting that there should no longer be effective, professionally based staffing based on fixed guidelines. But only by eye - the management decides where nursing staff have to work so that the needs within the houses can always be met. This, in turn, would limit the willingness to specialize and undergo further training – and thus also prevent commitment to certain hospitals.

Such on-call work could also cause nurses to leave the profession or seek areas of work outside of hospitals. The Verdi union also sees it this way: the upgrading of the nursing professions and attractive collective bargaining agreements will become more difficult to finance under these conditions.

If clinics see any need to spend more money than before on nursing staff, they will have to counter-finance the increases internally. Overall, the burden on nursing staff could increase again - and with it potential risks for patient care. If the latter is provided in hospitals solely on a medical basis, that is only half of the care - without the appropriate care there can be neither improvement nor healing. As a result, the patients quickly return to the hospital.

The only relief effect for care could come from the number of hospital cases continuing to fall. This has been the case since the pandemic years.

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