A wave of infections in Germany is pushing hospitals and their staff over the edge. Adding to the strain of the coronavirus pandemic, now in its third year, seasonal illnesses due to influenza and respiratory syncytial virus (RSV) have added to the health care burden. Children’s hospitals, in particular, are being pushed to the wall and can no longer cope with the current wave of RSV infections.
The dire situation is the result of the government’s disastrous healthcare and pandemic policies. Its rigorous policy of mass infection, recently pushed to the extreme with the lifting of the most minimal protective measures – such as the wearing of masks in public spaces and the compulsory isolation of infected people – as well as the opening of schools and nurseries without any mitigation measures, intensified seasonal infections and greatly increased the risk of multiple re-infections. This particularly affects children.
RSV is a virus that affects the upper and lower respiratory tract. In principle, this disease can be contracted at any age, but it is one of the most common pathogens in infants and young children. The incidence of RSV disease worldwide is 48.5 cases and 5.6 severe cases per 1,000 children in the first year of life.
Children, as well as adults with immune deficiency or pre-existing lung and heart conditions, are particularly affected by severe developments. Over the past few weeks, doctors and health experts have warned of a sharp rise in RSV infections in children. As a rule, the cold season does not begin until the beginning of December. The peak of the wave of infection is therefore yet to come.
The situation in children’s hospitals has been dire for years and continues to worsen. A major problem is the lack of personnel on the one hand and the lack of intensive care beds in children’s hospitals on the other. Michael Sasse, Senior Physician Responsible for Pediatric Intensive Care at Hanover Medical School, summed up the deadly consequences saying: “Children are dying because we can’t take care of them.
A survey conducted at the end of November by the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) described the situation as follows: “Out of 110 children’s hospitals, 43 establishments no longer had a single free bed in the regular duty. A total of only 83 vacant beds remain in pediatric intensive care units across Germany, or 0.75 vacant beds per hospital.
According to the survey, one in two out of 130 children’s hospitals said they had been unable to admit at least one child in the past 24 hours following a request from the ambulance service or the service emergencies. As a result, seriously ill children have had to seek out available intensive care beds at other children’s hospitals, traveling long distances and wasting vital treatment time.
According to the general secretary of the DIVI, Florian Hoffmann, the situation is getting worse from year to year to the detriment of seriously ill children. The healthcare system has been “pushed to the wall” for years, explains Jakob Maske, federal spokesperson for the Professional Association of Pediatric Doctors (BVKJ).
The chairman of the German Child Welfare Association (DKSB), Heinz Hilgers, also blames the dire situation on “decades of negligence” on the part of politicians. “Due to the purely commercial orientation of the system, which is designed for full capacity use,” no improvements were attempted, he said.
Three pediatrician associations and several hospital doctors criticized the “irresponsible conditions” in Berlin in an open letter to Berlin Senator for Health Ulrike Gote (Green Party). The letter states, “The health and lives of our children and young people are at massive risk.”
This is the reality in the German capital, governed by a coalition of Social Democrats (SPD), Left Party and Greens. Many days Berlin’s hospitals are completely short of free beds and parents cannot find pediatricians for their newborns. In addition, emergency rooms are heavily overcrowded. On January 24 of this year, the initiative sent a first urgent letter and on September 20 a second to Gote and Federal Health Minister Karl Lauterbach (SPD).
It’s no surprise that these calls are falling on deaf ears. The current situation is the result of a deliberate policy pursued for years and decades by the established parties.
It was after all the federal coalition government of the SPD and the Greens from 1998 to 2005 that created this miserable situation in the healthcare system with the introduction of lump sum payments per case (DRG system). An architect and proponent of the introduction of flat rates per case was Karl Lauterbach himself.
Dominik Schneider of Dortmund Hospital describes the consequences of this system for children’s hospitals as follows: “Over the past 30 years, including the introduction of the DRG system in Germany, the number of children’s hospitals has decreased by one-fifth and the number of beds one-third. At the same time, the number of children requiring hospital treatment has increased by around 10%.
As a result of the dire situation in children’s hospitals, Lauterbach cynically calls for nursing staff from other hospital departments, already working at their limit, to step in to help children’s hospital intensive care units. Jakob Maske rightly criticizes this staff transfer proposal as a “total farce”, because the assignment in the pediatric ward requires special skills.
In addition, Health Minister Lauterbach plans to suspend the nurse staffing limit, which will lead to even greater understaffing in the wards and amount to a further overload of nurses. Due to staff shortages and the transfer of existing nursing staff to pediatric wards, many health facilities are postponing scheduled surgeries.
Last week, the federal coalition of SPD, Greens and Liberal Democrats (FDP) passed a legislative package to ease the burden on healthcare workers and hospitals. The result is a new instrument for setting staff numbers in clinics, which remains unclear and will only be implemented in 2025. The Verdi union, which in recent negotiations has locked in the precarious situation of nursing staff for years to come with so-called collective relief agreements in several federal states, played a key role in drafting the bill.
In addition, a small financial aid for children’s hospitals has been provided for by law. These establishments will receive an additional 300 million euros in 2023 and 2024. This is nothing more than a proverbial drop of water since pediatric hospitals and services have been bled dry for decades.
Lauterbach recently announced, to great media fanfare, that the case fee system in children’s hospitals would be abolished. “In the future, it will no longer be economic constraints but medical necessity” that will determine treatment in clinics. He himself called his reforms a “revolution”.
In fact, the opposite is happening. The DRG system will not be affected, and the central element of the reform is the reduction of hospital stays. This means not only a decline in the quality of care, but also a deterioration in the financial situation of small and medium-sized hospitals. In the end, therefore, even more “economic constraint” will prevail.
The disregard given to the life and health of the people by the federal and state governments is illustrated not only by the more than 158,000 deaths caused by the unscrupulous profit before life policy pursued during the pandemic, but also by the 2023 budget adopted by the federal government. While military spending will rise from just under 50 billion euros to 58.6 billion euros, the health budget, temporarily increased during the pandemic, will drop from 64.3 billion euros to 24, 5 billion euros.
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