Berlin - In the area of general practitioners, the care of the chronically ill will in future be dependent on nurses taking on medical tasks both as delegation and as part of substitution.
That is what the rapporteur of the Union group said in the Bundestag for the area of "hospital", Lothar Riebsamen, the day before yesterday at an event of the Federal Medical Technology Association () in Berlin. These nurses would have to be trained in their training for these tasks beforehand, for example as part of an academic training.
The shortage of specialists in the health care system will also promote structural change in the inpatient area, Riebsamen continued. The lack of care alone will lead to further structural adjustments in the future.
Such dismantling of hospital structures is also not wrong because the absolute number of care workers in Germany is high in an international comparison.
Risk of increased workload in the medical field
Since the beginning of this year, nursing staff costs have no longer been integrated into the flat-rate per case. This was stipulated by lawmakers in the Nursing Staff Strengthening Act in 2018.
From Riebsamen's point of view, this can increase the workload for the medical profession. So far, the funds contained in the diagnosis-related flat-rate case fees (DRG) have also been used by the hospitals to compensate for the insufficient investment funds of the federal states, according to the CDU politician. This is no longer possible.
"The investments still have to be made," said Riebsamen. "There is risk that funds will now be generated from other areas and that the pressure there will then be even higher than it already is." These areas included, in particular, the medical costs.
Riebsamen did not accuse the federal states that they do not cover 100 percent of the investment costs for the hospitals: "They do this not because they do not want to, but because they cannot." That is why new type of investment cost financing is required.
Riebsamen spoke out in favor of “mixed financing”, in which 50 percent comes from the federal states and the other 50 percent is financed through the state base rates. While there was no majority for such an idea years ago, “I am currently feeling increasing movement here”.
Criticism of self-cost coverage
With the nursing staff -A strengthening law was also introduced that the health insurance companies must fully finance every nurse at the bedside. "I was not in favor of this regulation," said Riebsamen.
Because "if I were to cover my own costs, as the managing director of hospital, I would have the idea of adding as much as possible to the care and not worrying about how I could get by with fewer carers".
The issues of efficiency and productivity are no longer important. In addition, the self-cost recovery principle means that the hospitals "suck off" nursing staff from the care of the elderly or the rehabilitation area.
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