Lauterbach’s reform aims to enhance patients‘ ability to gather information about hospitals prior to undergoing surgeries.

UTo clarify his intentions, the Health Minister has provided specific examples. On Wednesday, the Federal Cabinet in Berlin approved the draft of a Hospital Transparency Act. Karl Lauterbach (SPD) explained what this would specifically mean shortly after in the Federal Press Conference. For instance, if all cancer patients in Germany were treated in a hospital certified for the respective therapy, a total of 20,000 life years could be saved each year, according to Lauterbach.

Und wenn alle Patienten mit einem Schlaganfall in eine Klinik mit einem entsprechenden Schwerpunkt gebracht würden, dann könnten demnach jedes Jahr 5000 Menschen mehr als bislang gerettet werden. Dass Patienten nicht immer in die richtige Klinik gebracht würden, liege nicht an der fehlenden Erreichbarkeit, sagte Lauterbach. „Sondern daran, dass es an Transparenz fehlt.“

The German government plans to make it easier for citizens to recognize differences in treatment quality starting next year. If the Bundestag approves the bill, the Ministry of Health will launch an online tool called the Hospital Atlas on April 1, 2024. The Atlas aims to provide information on the number of cases each of the approximately 1700 hospitals handles for 65 different treatments. Additionally, it will disclose complication rates for selected procedures, taking into account the severity of cases. This is intended to prevent hospitals from achieving good results by primarily operating on less severe cases.

Lauterbach setzt seine Vorstellungen ohne die Länder um

At the department level, the atlas is intended to provide information on the ratio of specialist doctors and nurses to the number of patients treated. This will allow patients to quickly determine which hospital is suitable for planned surgeries. The atlas will also assign hospitals to different levels of care, a concept that Lauterbach failed to implement during the hospital reform negotiations between the federal government and the states in the summer.

Nun setzt er in einem Bundesgesetz, das seiner Darstellung nach nicht im Bundesrat zustimmungspflichtig ist, seine Vorstellungen ohne die Länder um. Die entsprechenden Daten lägen teilweise jetzt schon vor – es handele sich teils um Strukturdaten, die ohnehin erhoben würden –, seien jedoch nicht öffentlich zugänglich, argumentierte der Minister.

Some countries are not convinced by Lauterbach’s transparency offensive. Early on, there was criticism from the countries that the poor performance of a clinic could lead to patients staying away from the affected facility. Recently, Bavaria’s Minister of Health, Klaus Holetschek (CSU), criticized the „glaring weaknesses“ of the initiative, especially the additional bureaucratic burden it creates for hospitals. It is also questionable whether patients can accurately assess the quality of hospitals from the available data. Holetschek referred to the draft as a law from an „ivory tower“ on Wednesday.

Kritik des Krankenhausverbands

The German Hospital Association (DKG) criticized Lauterbach’s plan as an attempt by the federal government to indirectly influence the hospital planning of the states. During the negotiations for the hospital reform, the states successfully resisted attempts by the federal government to exert influence on the planning of clinics. Lauterbach does not want to accept the criticism of the project. „Transparency is not desired by many, that must be openly stated,“ he said. Lauterbach described such resistance as „ethically precarious“.

The DKG rejected the criticism that they do not want transparency. „For years, the data has been transparent and easily accessible online in the German Hospital Directory, which until a few weeks ago was the official directory on the ministry’s website,“ said Gerald Gaß, the CEO of the association, on Wednesday.

Es könne nicht sein, dass ein Krankenhaus nur deshalb bestehen bleibe, weil es weiterhin gelinge, schlechte Qualität abzurechnen. Der geplante Atlas werde „unmittelbar eine Bedeutung für die Entscheidung der Bürger haben“, welche Klinik sie im Fall einer geplanten Behandlung aussuchen.

The health policy spokesperson of the Union faction in the Bundestag, Tino Sorge (CDU), criticized that Lauterbach is taking the second step before the first with his reform. „Even before the major hospital reform is completed, it is pushing forward a new law. For hospitals and employees who already do not know when the hospital reform will come, this means less planning security than ever before,“ said Sorge.