Berlin - 3,466 new seats for contract doctors will soon be available in Germany. With the new requirements planning, which the responsible Federal Joint Committee () decided unanimously today, 1,446 additional family doctor seats, 476 new seats for neurologists, 401 for new pediatricians and 776 additional seats for psychotherapists can be approved.
" This future-oriented further development of the demand planning instruments is an important decision with which we enable medical care that is even closer to home and adapted to the different burden of illness in the individual regions, ”explained the impartial G-BA chairman Josef Hecken after the meeting.
With the new planning, the number of open contract doctor seats increases to total of 6,906, of which 4,192 are unoccupied family doctor seats and 879 seats for Psychotherapists nationwide. Strong growth in new doctor's offices is to be expected in Bavaria, Baden-Württemberg, North Rhine-Westphalia and all eastern German states. The exact figures for each specialist group per federal state can only be calculated in cooperation with the relevant statutory health insurance associations, according to the G-BA.
Hecken emphasized in the plenary that the G-BA can identify the seats. "But with this guideline we are not baking single new doctor." He also referred to letters from state governments and local administrations that are addressed to the G-BA in this context.
Kassen satisfied
< p> “The specifications of the G-BA for requirements planning are only the general framework. Checking and adapting on site is essential, because it is not possible from Berlin to make binding and tailor-made regulations for every district and every municipality in Germany, which can be completely different in structure, ”says Hecken. He pointed out the flexibility that state governments and municipalities now have.With the Appointment Service and Supply Act (TSVG) there are more options for administrations to have say in on-site supply. The National Association of Statutory Health Insurance Physicians () made it clear today that “more planning does not increase heads”, said KBV Vice-President Stephan Hofmeister.
The health insurances were satisfied with the new regulation. "Thanks to the new requirements planning guideline, we can now react even faster to changes," said Johann-Magnus von Stackelberg, deputy chairman of the. “The numbers from 1990 are finally history. If more doctors are needed, the guideline will be adapted accordingly. ”
For the patient representation in the G-BA it was important that in future the barrier-free access of practice will also play role in the requirement plans. We also welcome the "regular adjustment and the consideration of the morbidity factor", explained Ursula Faubel, spokeswoman for the patient representative in the subcommittee on requirements planning.
This is made possible by the new distribution mechanism and the new calculation structure, which includes age and Consider patient morbidity. Whereas the pure ratios of residents per doctor and psychotherapist were previously calculated, further calculations will be added to this method in the future. The basic figures are divided into four age groups, gender and disease burden per region.
"The calculated regional ratios then reflect whether more or fewer doctors are needed in planning area than the national average," says the G -BA. These calculations now take place at the KV regional level. With the changes in the directive, however, the additional seats for pediatricians, neurologists, psychotherapists and internal specialists have already been established. The basis for these regulations is an expert opinion by the LMU Munich, which was created by working group led by Leonie Sundmacher.
Under-quotas for internists
There are also new regulations on under-quotas for internists. In future, upper limits can be set here for individual specialist groups such as cardiologists or gastroenterologists. Hecken had called for this several times, and "after four years the legislature finally has an ear here," said Hecken.
This is also intended to ensure that vacant internistic doctor's offices have to be filled with clear sub-specialist groups. For example, more seats should be allocated specifically for rheumatologists. For this internal specialist group, for example, minimum quota of eight percent is set. For cardiologists, on the other hand, the maximum percentage is 33 percent and for gastroenterologists 19 percent. Hecken emphasized that existing practices are grandfathered. He will “expropriate nobody”.
Criticism from the Federal Chamber of Psychotherapists
While the health insurers praise the regulation and the AOK Federal Association is now calling for “innovative regional care offers” to combat the shortage of doctors, the Federal Chamber of Psychotherapists criticized () the G-BA decision violently. In press release it is said that the reform falls short of expectations.
The chamber has also identified culprit: "The health insurance companies blocked even one additional practice from the start," explained Dietrich Munz, BPtK -President."With this destructive strategy they blocked the G-BA and prevented an appropriate solution," said press release. In Sundmacher's report, the chamber sees need for more than 2,400 additional seats for psychotherapists.
G-BA chairman Hecken resolutely countered this criticism: “After all, from the KBV to the patients and even the country representatives who voted in favor of reform, bank in the G-BA does not have to be insulted in such way and indefensible accusations made ”, explained Hecken.
The accusation of the BPtK that waiting times for appointments would be increased nationwide with this reform, Hecken rejected. "We should rather ask why in centers like Freiburg with coverage rate of 300 percent the waiting times are just as high as in other regions."
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