Emergency medicine under pressure: Bundestag votes on reform

Everyday life in many emergency rooms: Patients who have arrived with the emergency services are queued up in the hallway. There is a lack of free beds and treatment rooms. There is hardly any opportunity for nurses and doctors to take a breath. Many people have also been waiting in the waiting area for hours. But not everyone with a runny nose, stomach ache or a twisted finger is a case for the emergency room.

Experts assume that around 30 percent of patients don't actually belong there. Federal Health Minister Carsten Linnemann does not blame the patients.

"It's us politicians who have made the regulation so that the control in the health system doesn't work," says Linnemann to the ARD capital studio. This reform is long overdue. In fact, the black-red coalition is the third government in a row that wants to implement emergency reform.

In the event of a real emergency, the ambulance will continue to come

The aim of the reform is to ensure that only those people who really belong there end up in the emergency room. That is why around 750 integrated emergency centers are to be created at hospitals. Patients should register at a central counter. There it is then decided whether someone really belongs in the emergency room or can be cared for in an emergency service practice.

Health Minister Linnemann calls the law an “emergency guide for patients”. This also applies on the phone. Regardless of whether someone with acute symptoms calls the emergency number 112 or the medical emergency service 116 117, a decision should be made based on uniform criteria as to how and where the caller can best be helped.

In the event of a real emergency, the ambulance will continue to come. In other cases, patients can also be sent directly to the emergency service practice or treated via video consultation. “As a result, the emergency rooms will once again be there for the people for whom they were made: namely for emergencies,” says the minister.

There is praise for the law from the opposition. Janosch Dahmen from the Greens is a rescue doctor himself and thinks a lot about the reform is right. There are significant improvements compared to the current situation. The black-red government adopted many of the traffic light government's ideas.

Paramedics are also allowed to care for patients at home

However, Dahmen criticizes the fact that the federal government is not saving as much money as it could with the law. Too many emergency patients still stay in the hospital overnight for whom this is not necessary for medical reasons because the hospitals have no other financing option for complex emergencies. “Here you have to accuse the coalition of leaving aside opportunities for savings.”

The reform will also change something for the emergency services. Paramedics and emergency doctors no longer necessarily have to take patients to the emergency room, but can also drive patients to an emergency practice or care for them at home. They will be paid accordingly in the future. Nevertheless, large aid and rescue organizations fear that they will run into financial difficulties.

The Secretary General of the German Red Cross, Christian Reuter, demanded on Tuesday that the law should not be allowed to pass through the Bundestag as planned. Otherwise it will be economically difficult for many rescue services. For patients, this means that a good rescue system becomes less safe.

Rescue services such as Johanniter-Unfall-Hilfe, Deutsche Luftrettung and Malteser had set up rescue helicopters and ambulances in front of the Brandenburg Gate to campaign for changes to the emergency reform.

Air rescuers worry about the costs

Krystian Pracz from DRF Luftrettung is also worried about money. He points out that the air rescuers do not have all the costs in their own hands and are dependent on international markets: "Everyone notices at the gas station how high the fuel prices are. We also notice that when it comes to kerosene for the helicopters."

Concerns that have reached the government. In the last few meters she adjusted the law again. The coalition has made improvements here, says Green MP Dahmen. This means that the rescue service will continue to be properly financed in the future. Emergency services would have to demonstrate their economic viability more transparently. “I think that’s feasible and appropriate,” said the Green politician.

A lack of specialist appointments could further strain emergency rooms

However, Dahmen sees another problem that is only indirectly related to the emergency reform. He fears that emergency rooms will continue to be overcrowded in the future because people will have to wait too long for regular doctor's appointments. Dahmen assumes that as a result of the savings package for the health insurance companies there will be fewer specialist appointments in the future. "We will see many people who, in desperation because they can no longer find a normal doctor's appointment, at some point no longer know what to do and then turn to the emergency rooms."

A lot of things in healthcare are interconnected. That is why the federal government is working on further structural reforms such as the primary care model. Today the Bundestag is supposed to pass the emergency reform first. The Federal Minister of Health is not the only one who thinks it is “long overdue”.