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Large hospitals in Germany on the brink of financial collapse

2024-03-25 09:08:00, Kosova & Bota CNA

The financial situation of many German hospitals is not good: In the minutes of an internal meeting at the University Clinic Regensburg, UKR, the financial situation of the hospital is described as before bankruptcy and it is only the guarantee of the partner, the Bavarian federal state, that saves it from bankruptcy. "Due to... worrying deficits accumulated in the current economic plan 2024-2028, urgent action is needed." The projected deficit for 2024 amounts to more than 45 million euros.

The dangers of clinics

Asked later, the University Clinic of Regensburg relativized this figure. UKR director Oliver Kölbl said it was a deliberately made risk scenario, "so a worst-case scenario". The clinic has calculated how its situation would be if several risks were combined; further high energy costs, the lack of refinancing of fee increases, the decline in the number of patients and the increase in general material costs. Such risk scenarios are not uncommon. Kölbl clarifies that there is also a realistic scenario: in it the calculation comes out with a minus of 3 million euros. But the clinic does not mention the realistic scenario in the protocol.

Kölbl admits that the presentation of the risk scenario was intended to further increase savings efforts at the university hospital in Regensburg. "The goal was also to show the employees that the efforts of all professional groups are necessary, in order not to reach the worst scenario, to motivate everyone and cooperate." Kölbl says everyone got the message.

Closure of pavilions

The example of the Regensburg University Clinic shows that even clinics that have had good financial conditions are currently under pressure. According to Andreas Kestler, executive director of a hospital in Regensburg, "Barmherzige Brüder" it is becoming more and more difficult to achieve a balanced financial balance than in previous years. His hospital had to close a ward for the rehabilitation of the elderly to improve its financial situation.

Expenses higher than earnings

Expenditures for hospitals have increased greatly due to rising prices and staffing costs. And compensation for services has not increased at the same rate, according to Andreas Kestler. The gap is getting deeper and deeper. The planned reform of the clinics should improve the financial condition of the clinics, Kestler urges.

Another point of criticism remains the huge bureaucracy in German hospitals. This further aggravates the condition of the clinics. On Friday (22.03), the law on hospital transparency was debated in the Federal Council, but critics say that it does not bring any added value to patients and even increases the bureaucracy.

The Institute of German Hospitals, DKI regularly asks hospitals about their economic situation. In the last survey of 2023, 78% of clinics accounted for the previous year with a negative balance. In the survey, it became clear that large hospitals with more than 600 beds rate their situation very badly. For the year 2024, three out of four such hospitals expect deterioration.

Clinics are trying to save. University Clinic of Regensburg eg. is trying to further reduce energy and material costs. The medical director, Kölbl, admits that there are also savings in personnel. Since last year we decided to increase the number of patients per nurse, he emphasizes. A decision that the unions see with a critical eye. Heinz Neff from the ver.di union in the Obepfalz region sees the increase in the number of patients per nurse as "irresponsible". Security is needed for both patients and staff, says Neff. "Good treatment, good health care needs to have the right number of staff and cannot be guided by the lowest possible limit." Second, with the increase in work load, the nursing profession does not become attractive. /DW