Ricardo Lange: Billions are flowing into new weapons systems, but there are no air conditioning systems in hospitals

The German healthcare system is suffering from a lack of investment. This is a scandal that doesn't affect politicians. A column.

Heat is making life difficult for nurses. David Munoz via www.imago-images.de

A heat break: That would be more than appropriate with temperatures exceeding 30 degrees Celsius (86 degrees Fahrenheit) in the corridors of many German hospitals. But of course, that's not possible: Patients want to be cared for even in record temperatures, surgeries must continue, and we nurses have to make it through our shifts – even if the sweat is literally pouring down our backs.

Even though summer has been a long time coming this year, the fact that it's getting so hot in our hospitals isn't solely due to the weather. It's the result of years of political ignorance and a massive investment backlog. This can sometimes lead to water dripping from the ceiling of the entrance hall in some hospitals during heavy rain. The "solution"? Put out buckets! Welcome to German high-performance medicine.

Heat in the hospital is no trivial matter

In 2025, we'll still be talking about the same problems as all the years before: outdated buildings, dilapidated technology, and a lack of air conditioning. While the news outside is talking about record heat and climate adaptation, inside the patients are slumbering in their own sweat – often in stuffy rooms with no way to cool down. If you're lucky, there are a few fans, and even those often have to be carried back and forth between rooms. I still remember a tense situation from my time as a leased nurse: A woman over 60 with COPD was in our intensive care unit. COPD is a serious lung disease – and high temperatures are pure poison for these patients. That day, the thermometer in the ward climbed above 30 degrees. Even for me, as a healthy person, this heat was unbearable. Air conditioning? None.

The woman panicked, gasping for air, tried to climb out of bed, and ripped her clothes off. She was scared to death! In the end, we had to give her morphine to calm her down. Moments like these are seared into our memories—literally. And they show that heat in a hospital is no small matter; it can quickly become life-threatening.

The many defects

And no, such cases are not exceptional. I can go home after my eight-hour shift, shower, and cool off in the shade. My patients, on the other hand, lie in this heat for days—often for weeks. For seriously ill people, elderly patients, or those with heart or lung disease, this can end badly. The current criticism from experts about the lack of heat protection and air conditioning in hospitals and nursing homes is therefore more than justified.

What's also under-discussed: The structural deficiencies don't stop in the summer. In winter, patients and nursing staff freeze because old windows and missing insulation don't retain heat. The heaters then blast on all cylinders to keep the rooms reasonably warm. Add to that the problems of burst pipes, clogged sewers, and aging electrical systems that simply fail. And we're not talking about remote provincial hospitals, but large clinics in major German cities.

Billions are flowing into new weapons systems

We haven't learned anything from the coronavirus pandemic. Back then, the message was: The healthcare system must not be overloaded. We won't accept that people are dying – we want to be prepared. Today, the world is different: billions are flowing into new weapons systems or being burned on the expansion of the Chancellery. Healthcare staff and patients get, at best, an ice pop in hot weather – instead of a large-scale renovation and modernization campaign. The friendly reminder to drink more in hot weather is included free of charge! The fact is: Heatwaves like these are no longer an outlier; they are becoming more frequent, longer, and more intense. This is not only the German Meteorological Service (DWD) saying this, but also science. Politicians have known this for years. Nevertheless, there has been an enormous investment backlog for ages. The federal states are responsible for investments in hospitals. They have demonstrably failed to adequately fulfill their obligations under the Hospital Financing Act for years. In Berlin alone, the investment backlog amounts to hundreds of millions of euros – and yet the already inadequate funding is regularly cut. What is needed now are not more "pilot projects" or "round tables." What is needed are craftsmen, construction plans, and the political will to invest a lot of money. Everything else is hot air. And we have more than enough of that in German hospitals right now.

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