FDP on health and care

The FDP wants to make prevention and prophylaxis a focus of its health policy. It relies on incentives and rejects bans. According to the platform, this should raise quality of life and keep health care costs in check.

The FDP wants to do more for prevention. Prevention means doing things so you do not get sick. The FDP wants to offer incentives for this. It does not want bans.

The platform counts healthy eating, exercise, vaccinations and checkups as prevention. The FDP expects this area to become more important. It justifies the focus with a liberal policy that puts the individual at the center. Prevention is to be made attractive through incentives, not bans.

The FDP wants to secure family doctor care across the state and offer young physicians more flexible ways of working. Self-employed practice is to remain, while rural areas should offer more salaried and part-time positions. The background is that many family doctors will soon retire.

Many family doctors will retire soon. The FDP wants to win young doctors for rural areas. They should also be able to work as employees or part time. Doctors should still be allowed to run their own practice.

The platform calls the mostly self-employed family doctors the backbone of care and wants to strengthen their role as first point of contact and guide for patients. Because the new generation of doctors partly has different expectations, group practices, branch practices and municipal health centers are to supplement the solo practice. Telemedicine is to support their work. Municipalities should be able to help even though the Kassenärztliche Vereinigung (association of statutory health insurance physicians) decides on licenses.

The FDP wants municipal health centers modeled on the one in Büsum to secure medical care in rural areas more often. Municipalities are to help set them up, and the state is to support them with funding. The legal requirements for founding such centers should be as lean as possible.

Rural areas should get more health centers. The town helps to set them up. Büsum already has such a center. The state should support the towns.

The municipality is to provide administrative help when a center is founded and, where needed, suitable buildings. Ideally a care center is attached, offering home care, day care, family relief and short-term care. The state is to push at the federal level for secure payment of such models. In addition, physician networks should open up to cooperation with nursing care, outpatient palliative care and midwives.

The FDP wants doctors to be able to hand more tasks to assistants, for example on home visits. This is to be combined with telemedicine and counter the thinning out of care in rural areas. Towns without a family doctor are to get fixed contact points.

Assistants should take more work off doctors. For example, they make home visits. The doctor then talks to the patient by video. Towns without a family doctor should get a fixed contact point.

The platform names non-physician practice assistants (NäPAs) and physician assistants, who take on supporting tasks. On home visits they are to measure and transmit data so the doctor can hold the consultation remotely. Contact points in small towns are to follow the model of the nurses on the Hallig islands. Digitalization is also meant to strengthen specialist care in rural areas, such as ophthalmology and dermatology.

The FDP wants to relaunch the state's Versorgungssicherungsfonds (care security fund). It is to keep funding projects for digitalization, networking, mobility and future-proof local care. This is how the state is to contribute to outpatient care.

The state has a fund for medical care. A fund is a pot of money. The FDP wants to fill this fund again. It should pay for new local projects.

The platform rates the previous fund as a success. New projects are to be funded in four fields: digitalization, networking, mobility and local care services. The money is also to be open to self-employed midwives so they can network with one another and with other professions and areas of care.

The FDP wants to strengthen outpatient palliative care and link it more closely with hospices. The expansion of hospice places already under way is to be completed in the coming years.

Very sick people need help at home. The FDP wants to strengthen this help. It should work better with hospices. A hospice cares for dying people. There should be enough places.

The platform considers services that visit patients at home indispensable in certain situations, above all in palliative medicine. The FDP wants to expand these services and promote cooperation with hospices. It says the number of hospice places has already risen markedly, and this expansion is to be brought to a close.

The FDP wants to draw up a hospital infrastructure master plan and invest more money in clinics. The plan is to combine good accessibility with high-quality medicine. Investment funding is to be secured by law for the long term together with the municipalities.

The FDP wants a big plan for hospitals. The state should put more money into clinics. Clinics should be easy to reach and offer good medicine. Citizens and experts should have a say.

Money is to go both to sites where services are concentrated and specialized and to basic and standard care close to home. The master plan is to take greater account of cooperation between these hospitals and the university medical center, the state's only maximum-care provider, and coordinate services. Because structural changes and new sites are possible, the platform expects higher costs than simply reinvesting in what exists. The master plan is to include a dialogue forum where citizens and experts can contribute.

The FDP wants to push at the federal level for a fundamental reform of hospital payment. Hospitals providing basic and standard care are to receive base funding for equipment and standby costs. This is meant to reduce the economic pressure and misguided incentives of per-case flat rates.

Hospitals today get money per treatment. That is often not enough. The FDP wants fixed base funding for local hospitals. They should have fewer money worries. The federal government must change laws for this.

According to the platform, per-case flat rates (DRGs) often fail to cover costs and ignore standby costs, meaning the expense of simply keeping services available. Hospitals reacted by offering more profitable and fewer unprofitable services, which led to unsuitable regional structures. The FDP therefore wants changes in federal law. In addition, midwife-led delivery rooms are to be allowed at hospitals with pediatrics in order to secure obstetric care.

The FDP wants to allow walk-in practices at hospitals around the clock so that emergencies get the right outpatient or inpatient treatment. In rescue services, telemedicine, uniform quality standards and needs-based air rescue are to keep the time until first treatment short.

Help should come fast in an emergency. Hospitals should have practices that are always open. An emergency doctor should also be able to help by video. Islands should have enough rescue helicopters.

The FDP wants to keep pushing at the federal level for the around-the-clock practices at hospitals. For rescue services, the platform names the tele-emergency doctor and additional care models. Statewide quality indicators are to be set together with the providers. In air rescue, islands and the Hallig islets are to get special attention, dispatch centers are to work together better, and common standards are to be set. One focus is sepsis: fast detection and coordinated procedures are meant to lower the figure of about 75,000 deaths a year in Germany cited in the platform.

The FDP wants to create the additional positions in health offices and the health ministry agreed in the ÖGD-Pakt (public health service pact). There should be more leeway in filling them, especially on pay. The state and the health offices are also to work together more closely, for example on IT and disease reporting.

Health offices should get more staff. They should also be allowed to pay better. That makes the jobs attractive for young people. The offices should use shared computer programs.

The FDP bases this on the pandemic experience but also wants to secure tasks such as school entry exams, social psychiatric services, and planning and steering. With job security, working hours and salary, the service is to be an attractive alternative for people starting their careers. Shared IT infrastructure and a more automated reporting system are to relieve the offices and the state reporting center of administrative work. The state and municipal offices are also to discuss whether joint steering through key indicators makes sense.

The FDP wants to expand training and university capacity in health and nursing professions and create a second site for a nursing degree. Skilled workers from abroad should also find it easier to work in the sector. The reason given is the shortage of skilled workers, which demographic change is making worse.

Nursing lacks many skilled workers. The FDP wants to fund more training places. There should be a second place to study nursing. Skilled workers from abroad should be able to come more easily.

The second university site is to be chosen in an open-ended process and improve regional care. New professions such as physician assistant and their degree programs are to be strengthened. The FDP supports opening up dual nursing training through federal law with more appropriate trainee pay. For foreign skilled workers, the federal and state governments are to simplify entry and recognition procedures and offer more language support.

The FDP wants staffing ratios in nursing care to be reviewed and adjusted nationwide. The long-term care insurance funds are to cover the cost of the staff actually deployed and take the importance of care into account in payment negotiations. This is meant to make the profession more attractive and keep workers in it longer.

Care workers should get better working conditions. There should be enough staff. The care insurance funds should pay for the staff in full. Breaks and rest times should really be kept.

Workload and earnings are to be competitive with other sectors, and there should be chances for advancement. The FDP wants to push at the federal level for a suitable framework on payment. Together with employers and the occupational safety authority, ways of recording working hours are to be found that actually secure rest and break times. The platform names further training and supervision as additional tools to make the profession attractive.

After the nursing chamber was dissolved, the FDP wants care workers themselves to decide how their interests should be represented in the future. The next state government should support a broad, democratic process without imposing its own preferences against the majority.

The state's nursing chamber no longer exists. The FDP wants care workers to decide on a new group to speak for them. Many care workers should have a say. The state government should help but not give orders.

The platform points to the vote by care workers that led to the chamber being dissolved. It says the question of effective representation remains open. Employers' associations and unions should also take part in the discussion. An organization backed by a majority of care workers should then be consulted on all state rules that affect how the nursing profession is practiced.

The FDP wants to expand local care advice centers (Pflegestützpunkte) according to need and set up a statewide database of all care services and their occupancy. The state should provide investment funds for places in short-term, day and respite care so that people can return home after a hospital stay.

The FDP wants more advice for people who need care. A database should show all care services in the state. The state should pay for more short-term care places. Short-term care means care for a limited time, for example after a hospital stay.

The need for support from care advice centers is to be reviewed on an ongoing basis. The state should build the database together with the organizations involved. The platform says that places in day, respite and short-term care are lacking, especially in rural areas, and that information is hard to find. A temporary need should not turn into a permanent stay in a nursing home. At the federal level, the FDP wants insurers to cover the operating costs of capacity that is kept free.

The FDP wants to cap the share of care costs that people in need of care pay themselves; long-term care insurance should cover all further necessary costs. To keep contributions stable, a permanent subsidy from federal tax revenue should be added.

Care should stay affordable. The FDP wants a fixed upper limit on what people pay themselves. Care insurance should pay the rest. The federal government should give tax money for this every year.

The platform rejects both higher out-of-pocket shares and continually rising contributions to long-term care insurance. It says care must not become a poverty risk. The federal tax subsidy is described as a third pillar of financing. The FDP notes that other social insurance systems already receive such subsidies.

The FDP wants to use digital technology in care to simplify processes for staff and administration, especially documentation. A state pilot project should test a fully digitalized nursing home. Residents should also get more opportunities for digital communication.

The FDP wants more digital technology in care. This should take work off the staff. Then there is more time for people. One nursing home should work fully digitally as a test. Residents should also be able to talk with family online.

According to the platform, digital technology cannot replace human attention. It should therefore mainly free up time for personal contact with those receiving care. The pilot home would also be equipped with technical aids. The FDP points to the pandemic: digital contact helped residents and relatives but did not replace meeting in person.

The FDP wants to strengthen care oversight at the state level and in the counties and independent cities. People should be able to rely on care standards being met everywhere.

The FDP wants stronger oversight of care. Oversight checks whether homes give good care. The authorities should work together better. This should stop poor care.

The platform names well-resourced oversight of residential care as one building block against poor care. Cooperation between the care oversight bodies, the Medical Service (MD) and the state occupational safety authority should also improve. The goal is effective monitoring in care.

The FDP wants to allow adults to possess and use cannabis and to limit sales to licensed stores. Addiction is to be tackled mainly through more prevention, funded by taxes on gambling, alcohol, tobacco and, in the future, cannabis.

The FDP wants to allow cannabis for adults. Only stores with a license may sell it. The taxes from it should pay for addiction help. Overall, the FDP wants more prevention of addiction.

According to the program, only licensed sales can ensure quality and youth protection and keep contaminated substances out. It argues that the ban criminalizes many people, ties up police resources and, through dealers, eases the path to harder drugs. Tax revenue from cannabis sales is to go first to prevention, addiction treatment and counseling. Revenue from gambling, alcohol and tobacco taxes is also to flow more strongly into addiction counseling, whose services are to be better distributed across regions. The FDP wants to support digital forms of outreach.