Supply: Are the federal states slowing down the emergency reform?

A law stipulates that patients should be guided more specifically to the right place if they have urgent concerns. Are the federal states still stopping it - and with it other important new regulations?

In the states, there are concerns about the federal government's legislative authority when it comes to regulations on emergency services, which is generally a matter for the states. (Symbolic image) Photo: Julian Stratenschulte/dpa

Berlin. Resistance is forming in the federal states against the reform of emergency care decided by the Bundestag with greater control of patients for appropriate treatments. The leading Health Committee and the Interior Committee of the Federal Council recommend sending the law to the Mediation Committee. It will come to the state chamber at the next meeting on November 20th. It then votes on whether to adopt the committees' position.

A mediation process would also slow down the implementation of changes to the austerity package for stable health insurance contributions in the new year, which the black-red coalition attached to the law. Among other things, spending limits for psychotherapists are to be relaxed from the beginning of 2027. The clinics are to receive 550 million euros more than initially planned. A recently overturned obligation for health insurance companies to inform their members about increases in additional contributions is to be reintroduced.

Reform is intended to relieve the burden on emergency rooms

The objections of the Federal Council committees are not directed against these points, but rather the actual emergency reform. The Interior Committee makes clear concerns about the federal government's legislative competence when it comes to regulations on emergency services, which are generally a matter for the states. They should therefore be limited “to what is necessary and constitutionally permissible”. The Health Committee insists that the states responsible for hospital planning can decide on location decisions.

The emergency reform aims to ensure that patients with urgent complaints are better guided to appropriate treatment options instead of going to overcrowded hospital emergency rooms. This is to be achieved via central contact points in hospitals and via a nationwide telephone hotline. For this purpose, “integrated emergency centers” are to be created at selected clinic locations, where you can receive an initial assessment and, depending on the urgency, be referred – to the emergency room or a nearby emergency service practice.

Countries with objections

Lower Saxony's Health Minister Andreas Philippi told the German Press Agency: "For the planning security of hospitals, it is important that the states determine where the emergency centers will be located." In addition, it is “absolutely not affordable” for states and municipalities to take on the refinancing of emergency services. The consequence would be a significant loss of quality, especially in air rescue, warned the SPD politician, who will chair the Conference of Health Ministers until the end of the year.