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Health ministers want to strengthen patient orientation

July 2019 | Germany's federal and state health ministers want more patient orientation in health policy. After all, a health system is not made for doctors, therapists, hospitals or health insurance companies, but for patients.

A year ago, the Conference of Federal and State Health Ministers (GMK) decided that “patient orientation as an element of a future-oriented health policy” should be strengthened. The 15-page document counts 17 points which aim to strengthen the patient's position. Keywords of the measures that we consider individual Strengthening patients are, for example, health literacy, accessibility, structuring the relationship between patient and doctor, passing on information and quality transparency. However, some points also relate to the collective Involvement of patients in shaping the health system.

Two of these 17 points are of particular interest to patient advocates.

With point nine the Involvement of patient representatives be strengthened in health policy decisions:

“The GMK advocates further strengthening the structure of patient participation in all health care committees. The GMK sees the need to involve patients in the further development of the health system in order to be able to contribute their own expertise to the decision-making processes. Patient participation is an element of strengthening patient rights and contributes to improving the quality of health care. This also requires the provision of adequate resources to enable patient participation. "

The reason for this:

“An essential prerequisite for a patient-oriented further development of the health system is that patients can regularly bring their perspectives, competencies, needs and needs into the design of care and actively participate in this design. It is therefore necessary to further develop the structures of the health care system in such a way that patients can acquire freedom of action and thus have more options for decision-making.
Another step is the further development and strengthening of collective patient participation. Even today, the tasks in the various participation structures can often not be performed due to a lack of human, structural and financial resources. Therefore, an upgrading of the collective patient participation is also linked to the expansion of the available support and infrastructure (e.g. through further training, coaching). "

Here the health ministers go beyond the previous legal situation in several places. First, aim at patients all Health care bodies are more involved. So far this has only been the case in a few areas. Second, it is explicitly stated that participation requires “adequate resources”. This should primarily mean the financial support of business or coordination offices in the countries, which is currently the greatest obstacle to the broader participation of patients.

Another requirement of the GMK is still rather new in the nationwide discussion. Point 15 wants Patient involvement in other institutions anchor:

"From the point of view of the GMK, the out-of-court arbitration for allegations of malpractice needs to be improved through appropriate participation of patient representatives in all expert commissions and arbitration boards."

The reason for this:

“Out-of-court arbitration procedures are often not yet satisfactory for those involved. They have to be standardized and designed to be patient-friendly, e.g. to reduce time-consuming and costly journeys to the courts. This may also include adjustments to the health professions legislation in the federal states. Patient representatives should have more effective participation rights in all expert commissions and arbitration boards. "

Participation of patient representatives in the expert commissions and arbitration boards, which are offered by the medical associations as voluntary services, has so far only existed in Rhineland-Palatinate. There the arbitration committees of the chambers of health professions are made up of two members of the chamber (in our case doctors) and two - incidentally, voting - affected representatives (i.e. patients) in addition to the legal chairman. The largest arbitration board for ten federal states in Hanover has also appointed a “patient representative”. However, unlike in Rhineland-Palatinate, he is not entitled to vote and is not elected by the organizations appointed for patient participation in accordance with Section 140f SGB V, but by the shareholders of the arbitration board, the state medical associations of the nine northern German federal states and the Saarland, at their own discretion ( So, so to speak, “according to the manor of the manor”).

It remains to be seen whether this GMK document will have any effect. When it comes to concrete decisions, other factors are decisive than non-binding decisions. For example the financial priorities. For us, however, the document is a good basis for arguments in support of our very similar demands.