Help for hospitals: where are the 7,305 intensive care beds?

More than half a billion euros in tax money has flowed to the clinics so that they can create additional intensive care beds. It is unclear where several thousand beds have gone.

The Federal Ministry of Health (BMG) is currently researching where the new intensive care beds that should be built in the wake of the corona pandemic have gone. In an internal letter to the federal states, which is available exclusively to the ARD political magazine Kontraste, BMG State Secretary Thomas Steffen noted significant deviations. 7,305 intensive care beds were missing, "which, in purely mathematical terms, would have to be available due to the funds paid out," writes State Secretary Steffen.

Health Minister Jens Spahn demanded that the hospitals expand intensive capacities right at the beginning of the pandemic. For this he promised 50,000 euros in funding per bed. Hospitals have to report to the so-called "DIVI Intensive Care Register" how many free and occupied intensive care beds they have: there are currently around 32,500 intensive care beds there. Due to the millions of tax paid out, however, it would have to be over 39,700 beds – around 7,300 more beds.

So far no information from the ministries

Is this simply a reporting error, has the hospitals simply not complied with the obligation to enter into the DIVI intensive care register, or have older intensive care beds been taken out of service and illegally replaced with new ones? When asked by Kontraste, the Federal Ministry of Health did not respond by the editorial deadline.

The Ministry of Health in North Rhine-Westphalia said on a contrast request that the discrepancy was still being checked. In its letter, the BMG actually asked the federal states to clarify the deviation in intensive care beds by July 10.

"We are talking about a discrepancy of 7,000 beds, that is an unexplained funding amount of 360 million euros. That is a strong piece," says Reinhard Brucker, head of the large company health insurance fund VIACTIV. He criticizes the fact that the clinics have not yet had to give an account of the funds paid out.

The intensive care physician and initiator of the DIVI intensive care register, Prof. Uwe Janssens, was also extremely astonished when asked: "This enormous discrepancy must be cleared up," he told Kontraste.

Billions poured out with the watering can

In addition to creating new intensive care beds, hospitals must also keep beds free for corona patients. The clinics are financially compensated for every empty bed: As of today, the federal government has paid 6.6 billion euros in tax money.

At the beginning, head of the cash register, Brucker, found the flat rate of 560 euros per day sensible because it had to be done quickly. But that until the end of June – despite the absence of corona patients – billions were poured out with the watering can, Brucker considers a mistake.

Were there deadweight effects?

The Helios Hospital Bochum-Linden also benefits from the hospital rescue package. Even before the outbreak of the Corona crisis, the Helios Group announced the closure of part of the clinic. Then came Corona. Helios stated that it would temporarily suspend the closure: At the request of the city of Bochum, 40 internal beds will be kept ready for the pandemic until the end of September, including with human resources, Helios announced on request.

To contrasts, however, employees report anonymously that other patients are hardly treated there. Thus empty beds would be guaranteed, and the corona flat rate of 560 euros per day will flow until the end of September – not a bad deal.

Lack of controls

The payment of these lump sums should only be controlled "downstream", said Federal Health Minister Spahn when asked by Kontraste. "Downstream" means: Only after the funds have been paid out does the Federal Ministry of Health find out how much money which hospital has received. Effective control looks different: "Every little self-employed person has to prove what he needed the 9,000 euros for, and for such billions of euros it means: We just do the accounting," criticizes the head of the treasury, Brucker.

In order to reduce possible false incentives, Spahn introduced a new rule on July 1st: there is now between 3 euros per day for each free bed. But that also harbors new injustices: because the maximum rate of 760 euros is paid – in addition to university clinics – also all orthopedic clinics – including hospitals with a high proportion of "material costs". But if there is no operation and the beds are empty, there are no costs for expensive implants, so why do these clinics get the maximum rate?

Another absurdity: The Nuremberg city clinic, which has cared for 80 percent of corona patients in the region, will have to get by on 560 euros per day in the future. The federal government urgently needs to improve the reorganization of the lump sums as well, says Treasurer Reinhard Brucker.

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