Düsseldorf – In the middle of summer, the North Rhine-Westphalian hospitals are preparing for an ice-cold autumn and winter. Because the federal government is still not paying enough inflation compensation, many houses are in a financial imbalance that threatens their very existence. With a nationwide action day of the campaign “RED ALERT – Hospitals in Need” on June 20th, 2023, the hospitals warn of unforeseeable consequences. Many clinics in North Rhine-Westphalia are taking part with their own campaigns. “The constantly growing deficits of the NRW hospitals are piling up to an overwhelming burden that many hospital operators can no longer shoulder,” says Ingo Morell, President of the North Rhine-Westphalia Hospital Association (KGNW). “For the clinics in the most populous federal state alone, the deficit clock, which has been counting since the beginning of 2022, has already shown an accumulated minus of around 1.6 billion euros. And it increases month by month by another 140 million euros. Unless the federal government intervenes quickly and effectively, it will accelerate the downward spiral already in place for hospitals. But instead of taking action and preventing uncontrolled hospital deaths, the Federal Minister of Health laments the disaster he himself caused by doing nothing. He could stop it, but he would have to want it. It is in the hands of this federal government to maintain services of general interest for the citizens or to allow them to plunge into an uncontrollable crisis.”
Nationwide, the deficit of all hospitals will reach the ten billion euro mark if nothing is done. In North Rhine-Westphalia alone, there will then be more than two billion euros of uncovered inflationary burdens on the deficit clock, which is now running on the KGNW website (www.kgnw.de). The aid granted by the federal government is already included in these sums. After all, she had promised six billion euros in the aid package for the consequences of the war in Ukraine for the hospitals. 1.5 billion euros were distributed across the board, but the federal government has hidden the remaining 4.5 billion euros behind insurmountable hurdles. Now she wants to heal this mistake and pay out another 2.5 billion euros by 2024. This sum is also already taken into account in the deficit calculation, because only the legal implementation is pending. Morell emphasizes: “This is an important help for the hospitals. But in view of the deficit that has accumulated nationwide, it is not enough to stabilize the hospitals.”
Sufficient refinancing is a legal obligation of the federal government
The KGNW President refers to the current economic planning in the hospitals for the coming year, for which most managements have to reckon with high losses: “Many hospital operators now have to deal with insolvency law because they can no longer shoulder the expected minus”, warns Morell. “Since the beginning of last year, we have warned the Federal Government and in particular the Federal Minister of Health about the cold structural change that is now evident. The need for action is clear, the opportunity for action is clear. The Federal Minister of Health‘s tale that only his hospital reform could save the clinics from imminent insolvency gives the public a delusion. By the time a reform could take effect in a few years, many hospitals – including large locations – are likely to have gone off the grid.” At the same time, Morell points out that if there is a threat of the withdrawal of independent providers, the cities and municipalities have a duty to provide services of general interest maintained for its residents. “The prognosis in the new Hospital Rating Report that four out of five hospitals – 80 percent – will achieve negative financial results in the coming year underscores the need for an interim law: It must provide adequate refinancing for the hospitals in the short term. Ensuring this is the statutory duty of the federal government. That’s what it’s all about. The approved plan hospitals are currently required by the state. The federal government must not thin this out with an ice-cold structural change,” explains the KGNW President.
When the health ministers of the federal and state governments negotiate a joint hospital reform at the end of the month, the foreseeable emergency situation of the hospitals must also be put on the agenda, Morell demands. “The dangerous pull of the downward spiral cannot be stopped for much longer. Act now, Minister Lauterbach!”
background information
The hospitals cannot react to the enormous price increases for energy, food, medical products or services by adjusting their remuneration. An expected cost increase is set for them in advance, which then remains unchanged for a year. A cost increase of 2.32 percent was assumed for 2022, inflation averaged 6.9 percent for the year. However, in the area of hospitals, which are energy-intensive companies, the increase in costs was in some cases well above the national average. This will also continue in 2023: hospitals can still claim 4.32 percent higher costs, but inflation at the beginning of the year was twice as high at 8.7 percent (source: Destatis).