Hospital reform: Warken presents draft law with far-reaching changes

Berlin. More exceptions and a "practical" design, as Nina Warken calls it: About a month after the federal-state meeting on hospital reform, the Federal Minister of Health (BMG) has presented the long-announced draft bill. The paper has been obtained by Ärzte Zeitung.

The association hearing on the Hospital Reform Adjustment Act (KHAG) runs until August 21. The cabinet draft is scheduled for September. The bill is expected to be passed in the Bundestag by the end of the year, as Warken announced after the meeting with the states in early July.

Demands of the states met

After this round, the CDU politician promised that the federal states' demands had been received and would be incorporated into the work of the Federal Ministry of Health. As the current draft bill demonstrates, the ministry has kept its word.

According to the draft, far-reaching changes are planned to the Hospital Care Improvement Act (KHVVG), which came into force at the end of 2024 under its predecessor, Karl Lauterbach, "to facilitate the practical implementation of the provisions of the KHVVG." The goal remains to "ensure high-quality, needs-based hospital care," which will be "further developed in line with practical requirements" from now on.

Exceptions significantly expanded

The focus is on the possibility of exceptions, which will be significantly expanded: In the future, the federal states alone will be able to decide which exceptions they allow when allocating service groups to hospitals – even if the hospitals do not meet the defined quality criteria.

The Federal Ministry of Health speaks of "greater scope for action," thus responding to one of the states' central demands. Critics see this as a weakening of quality standards at the expense of patient safety.

Stefanie Stoff-Ahnis of the GKV-Spitzenverband explained: "The proposed adjustments to the hospital reform are intended to allow the states to grant far-reaching exemptions. Such a weakening of the planned quality standards would permanently jeopardize the central goals of the reform – a nationwide, uniform and high quality of treatment for greater patient safety."

Greens complain about “consequential change of course”

The possibility for federal states to deviate from the uniform quality criteria for service groups opens the door to "arbitrary allocation of service groups." This would mean that hospitals could continue to offer services for which they lack the necessary personnel and technical resources or sufficient experience: "Such occasional care clearly comes at the expense of patients," emphasized the association's deputy chairwoman.

From the perspective of the Green Party parliamentary group, Warken's draft is "not a technical update." Rather, it is "a momentous change of course – away from clear control and toward structural arbitrariness. This is not a courageous structural reform, but a relapse into old patterns," wrote health policy spokesperson Dr. Janosch Dahmen on Platform X.

(gave/bwa)