Clinic closures in Germany continue despite pandemic

With coronavirus deaths averaging around 1,000 per day and many hospitals on the verge of collapse, the downsizing of the German health care system continues unabated. More and more clinics are working at full capacity, medical and nursing staff are exhausted and increasingly subject to infection from the virus. In some cases, the virus is spreading out of the clinics across entire regions with a number of such cases reported last weekend.

In Herne, North Rhine-Westphalia an outbreak occurred at St. Anna Hospital. Officials confirmed that 40 members of staff have tested positive so far. Due to the high number of infections, tracing of the transmission chains is no longer possible. The hospital has suspended operations except for emergencies and births and all scheduled surgeries were postponed.

At the Sana clinics in Lübeck, Schleswig-Holstein 79 staff had tested positive for the virus by Saturday. Two COVID wards care for 41 patients and two of the patients are undergoing intensive care.

At the Red Cross Hospital in Bremen, a freeze on admission and discharges has been imposed following a COVID-19 outbreak. Thirteen patients and 24 employees tested positive for the virus, according to a spokeswoman for the hospital.

At Helios Klinikum in Nienburg, Lower Saxony, 40 employees and patients have tested positive so far. “Fifty to 60 percent of the infections are currently taking place at Helios and in the nursing homes,” district spokesman Cord Steinbrecher told NDR.

At the Deister-Süntel Clinic in Bad Münder, 21 of the 140 staff and 13 patients recently tested positive for COVID-19. The increased infection numbers in the district are due in part to the outbreak at the clinic, an authority spokeswoman in Hamelin said.

The situation could worsen dramatically with virus mutations detected with increasing frequency. According to recent research, these mutations are significantly more contagious than the original variant.

Last Friday, for example, the Humboldt Clinic in Berlin-Reinickendorf was placed under quarantine by order of the health department to prevent the spread of the mutant stain B.1.1.7. By Saturday, routine tests in the internal medicine and cardiology wards confirmed 14 cases among patients and six staff. The Berlin-Reinickendorf health department expects more cases of infection as further tests are conducted.

According to a report in the Tagesspiegel newspaper, members of the hospital staff are also likely to have been infected. Reinickendorf public health officer Patrick Larscheid said the outbreak at the hospital “has reached a scale we can hardly survey at the moment.”

According to the news magazine Focus, the first case at the Humboldt Clinic was officially confirmed on January 14. An admission freeze was imposed last Friday with no emergency cases to be admitted until further notice. Employees continue to work despite the risk of spreading the disease, operating on a “shuttle quarantine” system between home and clinic.

The pandemic, which has now been raging for a year, urgently requires an expansion of health care, but the exact opposite is taking place. Last year, 21 clinics across Germany were closed down. In dozens of other hospitals, unprofitable departments were shut down and in some regions comprehensive obstetric care is no longer guaranteed. Another 30 clinics are due to close, or are threatened with closure.

Experts assume that there could be many more closures, as smaller hospitals in particular are losing revenue as a result of the pandemic. At the end of last year, the DKI’s “Krankenhaus Barometer 2020” reported that the economic situation for German hospitals was dramatic. Almost every second hospital (44 percent) was indebted in 2019 and less than a third of hospitals expect positive figures for 2020.

This destructive policy of placing profits above health and life is not new. In 1991 there were more than 2,400 hospitals throughout Germany now down to around 1,400 in 2020. Even in the current crisis leading economic representatives persist in calling for the further dismantling of the country’s health care system to maintain the flow of profits to a narrow elite.

In 2019, a study by the Bertelsmann Foundation called for a reduction in the number of clinics to 600. This proposal received support from all political parties, led by the federal Health Minister Jens Spahn (Christian Democratic Union) and health expert Karl Lauterbach (Social Democratic Party). Last fall, when the pandemic once again spread rapidly, the Bertelsmann Foundation, together with the Barmer Institute for Health Research and the Robert Bosch Foundation, saw an opportunity to use the crisis to press ahead with the plans to close those clinics which were in financial difficulties.

It also became clear that business and political leaders were not just keen to close clinics. They plan to completely “reorganise” the hospital landscape, as they titled their project. In addition to closing hospitals, they are seeking to push ahead with their privatisation.

According to the “Transaction Monitor Healthcare,” drawn up by management consultants PricewaterhouseCoopers (PwC) in 2019 and the first quarter of 2020, about half of all clinics sold went to financial investors who are interested solely in increasing profits. They often convert the clinics into medical care or rehabilitation clinics, which generate more profit than inpatient treatment in hospitals.

To date, around 40 percent of German clinics are in private hands. This represents more than a doubling of this figure over the past 30 years. In Germany, Asklepios clinics are now among the largest private operators, alongside Helios and Sana. In its interim report for this year, the company states that 2020 was “one of the most successful years in the history of Asklepios.”

Politicians of all stripes continue to urge privatisation in the hospital sector, even during the pandemic. In the district of Oberspreewald-Lausitz in Brandenburg, the district council decided to sell a majority stake in Klinikum Niederlausitz to Sana-Kliniken, despite criticism and protests from staff. Here, too, the clinic had slipped into the red in recent years—a fact which is now being used to justify privatisation.

The privatisation and closure of clinics and their transformation into pandemic hotspots are the result of a policy that places profits above lives. The federal and state governments are not prepared to provide adequate health care facilities and personnel for the broad masses of the population.

All hitherto privatisations and cuts in the health sector, the consequences of which are now becoming apparent, must be reversed. Clinics and other health care facilities must be transferred into public ownership and democratically controlled by the workforce.