Study calls for closure of over half all health clinics in Germany

Tino Jacobson & Markus Salzmann

A study by the Bertelsmann Foundation, which promotes “reform processes” and “the principles of entrepreneurial activity” to build a “future-oriented society,” proposes closing more than half of all clinics in Germany. Less than 600 of the current 1,400 hospitals would be maintained under the plan, according to the report, published on July 15, commissioned by the Berlin Institute for Health and Social Research.

With the grotesque argument that only the closure of clinics could achieve more staffing, better equipment and higher quality, the report also calls for further reductions in hospital stays and an even greater focus on generating profits.

According to the authors, around 5 million people a year in Germany stay unnecessarily in hospital. They could just as well be treated as outpatients, reducing the number of hospital stays to 14 million a year.

The reduction in the number of clinics is justified by the fact that “many hospitals are too small and lack the necessary equipment and experience to handle life-threatening emergencies.” By reducing the number of clinics, the report’s authors claim, a variety of complications and deaths could be prevented. In the future, the focus would primarily be on the quality of hospitals with accessibility no longer a top priority.

Brigitte Mohn, a board member of the foundation, funded privately by the Bertelsman Group, one of the world’s largest mass media companies which is also active in the service sector and education, summed up the goal of “future hospital care” with undisguised cynicism, “The reorganisation of the hospital landscape is a question of patient safety and, above all, has to pursue the goal of improving the quality of care.”

On patient care, Mohn added, “If a stroke patient reaches the nearest clinic after 30 minutes but does not find a suitably qualified doctor and the medically necessary specialist department, it would be better to drive for a few minutes longer to a well-equipped clinic.”

Mohn is a member of the family that owns Bertelsmann. Her mother, the company matriarch Liz Mohn, is one of the richest women in the world, with a fortune of around three billion euros. Brigitte also sits on the supervisory board of Rhön-Klinikum AG, an operator of private clinics that would benefit from the closure of municipal hospitals. Among others, Rhön-Klinikum AG operates the University Hospital of Marburg and Giessen, where hundreds of workers protested against low wages and poor working conditions earlier this year.

The consequences of decreasing the accessibility of clinics is obvious. More complications and deaths will occur because patients cannot be treated quickly enough. In addition, ambulances, emergency physicians and paramedics will face a significant additional burden.

The argumentation of the study is extremely mendacious. The Cologne / Leverkusen region was selected as a model, which is one of the most densely populated areas in Germany. According to the Bertelsmann study, 24 out of a total of 38 hospitals should be closed in this region by 2030.

Even here, the study estimates that about ten percent of residents would require more than 30 minutes to reach the nearest hospital after the proposed shutdowns. According to the study, this could be reduced to about three percent if a different “speed model” were used. In plain language, this means that ambulances would face completely unrealistic higher speed assumptions in order to increase accessibility.