Minister: Half of Hospitals Face Problem - Germany's hospital reform sparks backlash over staffing rules and bureaucracy

The German government's hospital reform is facing growing criticism as key figures demand changes before its final review. The Bundesrat will examine the proposed amendments on March 27, but concerns over staffing rules and bureaucracy threaten to derail the plans. Lower Saxony's health minister has already called for urgent revisions to avoid severe consequences for hospitals.

At the heart of the reform are performance tiers, designed to set uniform standards for equipment, specialist staff, and other essential criteria. Hospitals failing to meet these benchmarks—particularly in high-care units—risk losing their performance-level classification and funding. This could block them from offering certain treatments and billing statutory health insurers.

In Lower Saxony, half of all hospitals may struggle with the new minimum staffing thresholds for nursing personnel. Health Minister Andreas Philippi, an SPD politician, has labelled the potential ruling as 'more than disproportionate.' He even referenced the diagnostic code F70 for mild intellectual disability to highlight what he sees as flawed logic in the thresholds. Philippi has already written to Federal Health Minister Nina Warken, pushing for immediate adjustments. The Lower Saxony Hospital Association has added its voice to the criticism. Its chairman, Rainer Rempe, warned that excessive bureaucracy could sink the reform entirely. He argued that cutting red tape would not only improve care quality but also boost staff satisfaction—a view echoed by the NKG, which represents hospital managers. Without significant changes, the association insists, the reform's goals will remain out of reach.

The Bundesrat's upcoming review on March 27 will decide whether the reform moves forward in its current form. Hospitals in Lower Saxony—and potentially across Germany—face funding cuts and service restrictions if staffing rules stay unchanged. The pressure is now on federal policymakers to address these concerns before the final vote.