When cheering for the negotiated collective agreement on relief at the six university hospitals, there is almost unanimity. However, there could also be losers in the battle for nursing staff. A clinic manager sees a great need for reform in the healthcare system.
After the painstakingly negotiated relief collective agreement for six university clinics in North Rhine-Westphalia, several experts expect a significantly intensified fight for the rare nursing staff. Not only Essen’s university hospital director, Professor Jochen Werner, praises the agreement reached with the Verdi union. The agreement could serve as a model for hospitals throughout Germany. However, as a consequence of the now necessary increase in staff at the university clinics, he fears cut-throat competition with consequences for the entire German healthcare system, as Werner told the German Press Agency.
University hospitals are already comparatively well staffed. The personnel keys will now get even better. However, the pull will then be even stronger in the university hospitals, said Werner. The losers are all other hospitals in the levels below. In the end, according to Werner, there would no longer be a shortage of nursing staff at university clinics, but rather in the smaller hospitals, in outpatient care or in geriatric care.
His care director Andrea Schmidt-Rumposch has already announced in the WAZ: We will actively recruit employees on all channels in order to build up staff. The agreement will make us even more attractive as an employer. Professor Edgar Schömig also sees the NRW university clinics as pioneers in terms of working conditions in patient care. The head of the Cologne university hospital and negotiator said: Anyone who works in a university hospital can be sure in the future that there are no better general conditions in other hospitals, at least nationally.
For the employees, Verdi had agreed with the university hospitals in Bonn, Aachen, Cologne, Düsseldorf, Essen and Münster after a massive industrial dispute and eleven-week strikes on the key points of the so-called collective agreement relief (TV-E). Formally, the Verdi members still have to agree so that the TV-E can come into force on January 1, 2023. This regulates relief models for the employees. Shift-specific ratios of employees and patients are defined for the nursing staff and sometimes also for other areas of the clinic. If the staff quota is not reached, the employees receive so-called stress points, for which there are then a certain number of days off. 30 additional full-time positions per university hospital have been agreed for service, IT and technology areas as well as outpatient clinics. There are also measures to improve the quality of training.
Katharina Wesenick, Verdi Head of Health in NRW, speaks of a major stage victory. Politicians and the doctors’ union Marburger Bund NRW/Rheinland-Pfalz also commented positively on the result achieved. At the same time, the chairman of the Marburg Association of North Rhine-Westphalia/RLP, Hans-Albert Gehle, called for tariff improvements for his clientele. Politicians should not forget that doctors, who have been chronically overworked for years, urgently need improvements in their working conditions. In the medical field, many positions could not be filled for years. The shortage of doctors is an additional burden for colleagues.
It will be exciting to see how other hospitals, including a number of university hospitals run by churches, position themselves. Dirk Albrecht, managing director of the Catholic hospital operator Contilia, which operates seven hospitals in the Ruhr area, referred to the independent tariff system, the third way.
Professor Christoph Hanefeld, head of the Catholic Clinics Bochum (KKB), assumes that the collective agreement will also affect the university clinics for which he is responsible in Bochum, Herne, Hamm, Bad Oeynhausen, Herford and Minden-Lübbecke. At least there will be approximations, according to Hanefeld in the WAZ with a view to future negotiations. At Bochumer Weg, house tariffs currently apply according to the guidelines of the Caritas Association. According to Hanefeld, there should be no two-class society. That would intensify the cut-throat competition for staff that has been raging for a long time.
Either way, TV-E alone will not solve the nursing misery in Germany, said Werner. To do this, far-reaching and long-overdue reforms in the health care system would finally have to be tackled, nationwide. Because it’s also a nationwide problem. And because this shortage of skilled workers – not only in nursing, but also in other areas – is significantly related to the still too many hospitals in Germany. There we have the crux of the problem.
According to Werner, compared to other countries, there are on average significantly more hospital beds per population in this country, with comparable numbers of nursing staff, but distributed among significantly more hospitals. Added to this is the desolate digitization situation for over 30 years. Werner: If we don’t start planning a nationwide strategy now – and not through the back door, because more and more hospitals are experiencing financial hardship – we won’t make any progress.
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