Hamburg - Derin Hamburg finally passed numerous resolutions which, among other things, are directed at politics. A summary of the most important topics dealt with.
The delegates sharply criticized, among other things, the sanctions provided for in the . According to the law, these should take effect if the self-administration does not implement applications of the electronic health card (eGK) such as the master data management for insured persons within certain deadlines.
The pressure to meet politically motivated deadlines increases the risk that immature technology will be rolled out in practices and hospitals, warned the delegates. The Doctors' Day emphasized that the necessary preparatory work had long been carried out by the self-administration. It is not justified to hold the self-government organs accountable for scheduling and quality problems in the industry.
Basically, however, the Doctors' Day welcomes the alignment of the E-Health Act. “This can make it possible to correct the introduction of the electronic health card and TI, which has so far often been driven by technical aspects and administrative applications, in the direction of medical sensibility,” the resolution says. However, the delegates were concerned about the high costs for the eGK.
They also criticized the statutory health insurance companies. Before the eGK was issued, they had failed to check that the photo sent in and the insured's personal data matched. "For any secure electronic communication, however, the proof of secure digital identity by the issuing body is an indispensable prerequisite," clarified the doctors 'parliament.
In another resolution, the Doctors' Day voted in favor of the Further development of quality assurance to effectively use existing self-administration structures and to involve the medical associations intensively. The delegates pointed out that the introduction of so far hardly tested instruments such as the so-called quality indicators ties up considerable resources. In order to only be able to cope with the tasks to limited extent, the state offices for quality assurance and their steering committees in particular should be used, further developed and appropriately financed.
The delegates also emphasized that the focus is not on quality measurement but on quality improvement must lie. Among other things, minimum staffing standards in the clinics are necessary for this.
In addition, the 119th German Medical Association supports the development of “smart decisions” recommendations (KEE) for patient care appropriate to the indications. These recommendations could help to continuously improve the quality of care, said the delegates.
The Doctors' Conference demanded that people who were physically and mentally damaged or murdered during the period of National Socialism after the law for the prevention of genetically ill offspring of 1934 came into force, legally as victims of NS -Regimes are recognized. The German medical community wants to help ensure that these people receive the recognition they deserve for the suffering they have suffered, stressed the delegates.
The medical parliament also called on the federal government to smoke in cars to forbid if children and young people ride. The delegates pointed out that numerous scientific studies have shown clear connection between passive smoke exposure and serious health risks for children and adolescents. Due to the high concentration of numerous toxins, some of which are carcinogenic, smoking in vehicles is to be viewed as threat to the well-being of the child and serious risk to the health of children, the delegates emphasized to ensure compliance with the Working Hours Act . The entire on-call time must continue to be counted as working time, according to the doctors' parliament. A relaxation of occupational safety for doctors and nursing staff would not only endanger the health of employees but also patient safety. "Staff shortages must not be carried out at the expense of the employees," the medical day delegates made clear.
The medical day advocated the independence of the ethics committees . The delegates demand an affirmative opinion from the responsible ethics committee as mandatory requirement for the approval of clinical trial. The Doctors' Conference also demanded that the registration of the ethics committees be carried out transparently and without conflict of interests by an independent body, preferably to be determined in the respective federal state. As part of the parliamentary deliberations for fourth law amending pharmaceutical law and other provisions, the German Medical Association had issued detailed written position on the draft.
The 119th German Medical Association has called for the sovereignty of the member states guaranteed in the Treaty of Lisbon respect when designing their health and social systems and not regulate health systems through EU standards . Attempts by the European Committee for Standardization to standardize medical activities and health services are particularly to be rejected.With view to European decisions, the delegates have also asked the German government and the European Commission not to agree to any further extension of the approval of the weed killer glyphosate .
The Medical Congress delegates are calling for binding Personnel key for intensive and intermediate care wards . A nurse in an intensive care unit for adults should be allowed to care for maximum of two patients. For eight to twelve beds in an intensive care unit, at least seven doctor positions are required for 40-hour week, in addition to the position of the head and his loss compensation. According to the delegates, every clinic that is listed in the hospital requirement plan has to ensure with failure concept that these personnel keys are adhered to even in the event of short-term sick leave.
In the opinion of the medical profession, informed consent one of the essential conditions for the ethical admissibility of all medical treatment and research. Not everyone is equally able to exercise this right for themselves, for example children and young people, the mentally ill or people with intellectual disabilities. The 119th German Medical Congress called on the political decision-makers to support this claim of patients structurally and financially. The statement “Decision-making ability and decision-making assistance in medicine” published in the Deutsches Ärzteblatt on April 15, 2016 by the central ethics committee at the German Medical Association should point the way.
The delegates also dealt with the medical indication < / strong> of non-medical considerations and influences. They advocated keeping them free and strengthening their importance as core element of medical practice and identity, as well as normative corrective. The medical indication as an essential instrument for evidence-based, safe and efficient patient care is an indispensable prerequisite for medical action and core element of medical activity. In addition to the patient's consent, it is key prerequisite for medical measures.
In further resolution, the Federal Government was asked to ensure that surgical interventions in newborns, infants and children may only be carried out by doctor with effective sedation and pain relief.
In addition, the medical parliament advocated better conditions for general practitioners for general outpatient palliative care off. The focus of all efforts to improve palliative care must be the patient, who decides for himself where he wants to spend the last phase of life."As rule, patients will want to die in their home or familiar environment," stated the delegates. For this reason, it is necessary to expand the supply options in the outpatient area, especially through family doctors.
The medical profession also stated that there was need for improvement the specialized outpatient palliative care (SAPV). In addition to the palliative care physicians and specialized nursing services, the general practitioners would have to be included as network partners. In order to expect patients to change care providers as little as possible, the general practitioner must also be able to remain contact person for inpatient or semi-inpatient palliative care.
In addition, the MPs called for better structural framework conditions for the care of people with variants / disorders gender development (DSD). There is special need for the establishment and financing of competence centers for DSD. Such centers could provide somatic and psychological counseling, diagnosis and treatment in specially qualified, interdisciplinary team. The Doctors 'Day explicitly welcomed the Federal Government's initiative to initiate regulatory and structural measures for better care for people with DSD in an inter-ministerial working group.
Finally, the Doctors' Parliament Erfurt as the venue for the 121st German Medical Congress from May 8th to 11th, 2018.
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