Grüne on health and care

The Greens want older people to be able to live at home for as long as possible and to be protected from poverty. To that end they call for more low-barrier, affordable housing with neighborhood-based care and infrastructure that suits all generations.

Old people should be able to stay in their homes for a long time. The Greens want more homes without barriers. The homes should be affordable. Care should be available nearby. The Greens also want to do something about loneliness.

The infrastructure the program has in mind includes medical and nursing care close to home, barrier-free public transit, shops for daily needs and meeting places. To lower the risk of nursing-home care, loneliness is to be prevented, for example through neighborhood initiatives and multigenerational housing projects. Easily accessible care services and household services are also to be strengthened. Older people are to receive graduated help with daily life and care according to their needs.

The Greens want to ensure a dignified end of life for everyone, especially for the most seriously ill. To that end, palliative care is to be expanded, particularly outpatient care and care for children and young people.

Many people want to die at home. The Greens want to make that possible. Palliative care eases pain for very sick people. This help should be available more often, also at home and for children.

The program notes that many people wish to spend their final days with loved ones in familiar surroundings. In reality, it says, many die alone or in nursing homes and hospitals. The expansion is therefore to focus on outpatient palliative care and children's hospices.

The Greens want to strengthen the public health service structurally so it can fully deliver prevention and health education. A state prevention foundation is to pool funds, and local health counseling is to be supported.

Public health offices should get stronger. They should do more to keep people healthy. A new state foundation should collect the money for prevention. Towns should offer more health advice.

Plans include targeted health monitoring and municipal health and care conferences. Health professions such as community health nurses and school nurses are to carry more weight in the public health service, and health education is to be anchored more firmly in schools. A master's program in public health is to be set up at the state's major university locations. Health kiosks and heat action plans are to be funded, and money under the federal Prevention Act is to go to municipalities in a more targeted way, especially for children, young people and seniors. On sexually transmitted infections, the Greens rely on education, better testing, easily accessible treatment and support for the Aidshilfe organizations.

The Greens want to digitalize health care more extensively, arguing that Germany has fallen behind in this area. Patient data should be available securely and in line with privacy law, and medical confidentiality should apply to digital data as well.

The Greens want more digital tools in health care. Public health offices should work more digitally. Patient data should be safe. Doctors must keep digital data secret too.

Processes in the public health service are to be reviewed and digitalized where it makes sense, including as part of implementing the Onlinezugangsgesetz (Online Access Act). The platform names robotics, telemedicine, the electronic patient record and ambient assisted living systems as areas to make use of. An infrastructure is to be funded that makes patient data reliably available as needed. Medical confidentiality and patient privacy are to remain protected for digital health data.

The Greens want hospital planning to be guided by quality of treatment and to divide the state into at least eight care regions with tiered services. The aim is basic care across the state and specialized centers in large hospitals.

The Greens want to plan hospitals in a new way. The state should have at least eight regions. Each region has smaller and larger hospitals. The quality of treatment should matter in planning.

Each region is to have at least one specialized-care hospital in addition to basic and standard-care hospitals. Maximum-care hospitals and university hospitals are to round out the offering. The goal is an overall plan that looks at outpatient and inpatient care together. Regional integrated health centers are to be included in hospital planning and funded. In the spa regions, rehabilitation clinics are to be taken into account and developed further.

The Greens want on-call medical services, emergency rooms and ambulance services to work together more closely so that people with acute illness get the right help at any time. Integrated emergency centers are to be set up at hospitals.

The Greens want better help in emergencies. On-call doctors, emergency rooms and ambulances should work together better. Hospitals should get emergency centers. Ambulances should get equipment for remote treatment.

The emergency centers are to offer outpatient or inpatient treatment as needed. Pilot projects such as community paramedics and mobile first responders are to be rolled out statewide. Transport services, especially in rural areas, are to take people to on-call practices or hospitals when no ambulance is needed. Ambulances are to carry telemedicine equipment as standard, and remote emergency physicians are to supplement care in parts of the state.

The Greens want to tackle the shortage of skilled workers in health care with more training, easier recognition of foreign qualifications and better working conditions. Among other things, at least 200 new places to study medicine are to be created and tuition fees dropped for several professions.

Health care lacks many skilled workers. The Greens want at least 200 new places to study medicine. Some training programs should no longer cost school fees. Skilled workers from abroad should find it easier to work and stay.

Foreign qualifications are to be recognized quickly, backed by training and language programs, and foreign skilled workers are to get a permanent right to stay. To draw doctors to rural areas, the Greens rely on attractive working hours, teamwork and university ties, and physician assistants are to take tasks off doctors. State-run schools for therapy, nursing and assistant professions are to be expanded, school fees dropped for fields such as nursing assistance and special-needs care, and all health professions are to get training pay. State funding is to be tied to pay under collective agreements. Daycare at hospitals, flexible hours and health promotion are meant to keep staff in the job and win back those who left.

The Greens want nurses' responsibility to be reflected in pay and working conditions. They rely on wider collective bargaining coverage, less temp work, far more training places and more independent authority for qualified nurses.

The Greens want to improve nursing jobs. Nurses should get better pay. There should be more training places. Well-trained nurses should be allowed to decide more on their own.

Training alliances are to bring in smaller hospitals, care and rehab facilities and private nursing schools, and part-time training is to become easier. Nursing academies modeled on the one at Hannover Medical School are to offer further training, for example for nursing managers. A pilot project is to train community health nurses and deploy them in primary care; to that end the Greens want to push at the federal level for a reform of the rules governing health professions. Medical tasks are to be transferred to qualified nurses, which the platform says reduces hospital admissions from nursing homes. Nursing is to have a stronger voice in health care decision-making bodies.

The Greens want care around childbirth to be available close to home and more staff in maternity care. Maternity care is to count as basic care, so that the nearest service can be reached within 30 minutes at most.

The Greens want better help with childbirth. No woman should drive more than 30 minutes to a maternity ward. There should be more midwives. Midwives should get better pay.

More midwives are to be trained at universities, and one-to-one care during birth is to be put into practice. Midwife-led delivery rooms and freelance midwives working in hospitals are to be strengthened, and birth centers supported with investment grants. The Greens advocate better pay and a solution for midwives' liability insurance. Vaginal births are to be better paid in order to reduce incentives for what the platform considers unnecessary cesarean sections.

The Greens want abortion to be part of standard medical care and available everywhere in the state. They also advocate that abortion should no longer be a criminal offense.

The Greens say the pregnant person alone decides about an abortion. Abortions should be available everywhere in the state. There should be enough doctors and hospitals for this. Abortion should no longer be a crime.

State hospital planning is to make sure that hospitals with a gynecology department offer abortions, regardless of the owner or the views of the head physicians. The topic is to get more weight in medical school, and continuing education for doctors is to be expanded. Family planning and counseling centers are to be funded securely, and voluntary counseling expanded. Training and studies are also to raise awareness of violence during childbirth. The Greens welcome the repeal of Section 219a of the Criminal Code.

The Greens want to implement the recommendations of the Landespsychiatrieplan (state psychiatry plan) so that people in a mental health crisis get help faster. Outpatient crisis support is to grow, waiting times are to shrink and involuntary commitments are to become less frequent.

The Greens want to help people with mental illness better. There should be more fast help in a crisis. The wait for treatment should be shorter. Fewer people should be sent to a clinic against their will.

Inpatient treatment is to be supplemented by hospital-level treatment delivered in the patient's usual surroundings. More specialists are to be trained, and psychiatric research and teaching at universities strengthened. In child and adolescent psychiatry, prevention and early detection are to improve and more treatment places are to be created. Care for mentally ill refugees is to get more attention, and self-help services are to be funded.

The Greens want everyone in Lower Saxony to receive medical care, including people without health insurance or residence papers. To that end, an anonymous health voucher is to be available across the state. The platform justifies this with avoidable severe illness and with lost revenue for practices and hospitals.

Some people have no health insurance. The Greens want them to be able to see a doctor too. They plan an anonymous health voucher. Anonymous means nobody learns the person's name. This way nobody has to fear being deported.

The anonymous health voucher is to build on an earlier pilot project and apply statewide to people without insurance, whatever their residence status. Street clinics and medical counseling for migrants are to get lasting funding and stable staffing. Counseling is meant to help those affected, where possible, move into legal residence and regular care. At the federal level, the Greens want to end the duty of welfare offices to report data on cost coverage to the immigration authority. For refugees, the platform also mentions a health card for all and covering the cost of interpreting.

The Greens want to expand home-based and day-care nursing services near where people live and to ease the burden on family caregivers. The platform notes that the number of people needing care is expected to roughly double by 2050 while too few people enter nursing professions.

More and more people need care. The Greens want more care services close to home. There should be more places for day care and short-term care. This should ease the load on family members. Care workers should get better working conditions.

The plan includes more places for short-term, day and night care and support for alternatives such as shared housing for people needing care. In the party's view, neighborhood care workers could relieve relatives and spot overload early. Geriatric centers are to get more treatment capacity. Digital tools, assistance systems and neighborly help should let people live in their own homes as long as possible. To counter staff shortages, the platform relies on preventing the need for care, better working conditions, training and strong representation for the nursing professions.

The Greens want to make it easier for civil servants to join statutory health insurance, following the so-called Hamburg model. The platform sees this as a step toward treating them the same as salaried public employees.

Civil servants usually have private health insurance. The Greens want to make public health insurance easier for them. Hamburg is the model. Civil servants and regular employees should be treated more alike.

Under the Hamburg model, the public employer contributes to statutory health insurance premiums instead of only subsidizing private coverage. The platform describes the measure as an important step toward equal treatment of both groups of staff in the administration. It is part of the aim of making the administration a more attractive employer.