Linke on health and care

The Left wants older people to be able to live in their own home and familiar neighborhood for as long as possible. To that end, local care and support services are to be built up, including public home care, starting in poorer neighborhoods.

Old people should be able to live at home for a long time. For this, help should be available nearby. The city should build up its own home care service. There should be new forms of housing for older people. The city should put up 1,000 new benches.

The platform names affordable housing forms such as shared apartments for seniors, multigenerational houses, and age- and disability-friendly homes. Preventive home visits, care advice at home, shopping help, and relief for family caregivers are to be added. To counter loneliness, care centers, neighborhood centers, meeting places, and mobility services are to be linked and volunteer work funded. Infrastructure includes lighting, public toilets, accessibility, free local transit, and 1,000 new benches by 2025.

The Left wants to push at the federal level for a wage-replacement benefit for family caregivers equivalent to Elterngeld (parental allowance). It is meant to cushion financial hardship during the care period and contribute to a fairer distribution of care work.

Many people care for relatives at home. They often earn less then. The Left wants a caregiver allowance like the parental allowance. It replaces part of the wage. People should get it for 12 or 24 months.

The basic caregiver allowance is to be paid for 12 months and the plus version for 24 months. The benefit is to be calculated as a percentage of previous wages. This is meant to give family caregivers time for close, good care. At best, the party also expects a fairer sharing of care work.

The Left wants to give priority to nonprofit providers in elder care and, in the long run, transfer homes owned by financial investors to public hands. In its view, the profit motive leads to worse care and overburdened staff.

Many nursing homes belong to big companies and investors. The Left thinks this is wrong. Nursing homes should belong to the city or to nonprofit groups. The office that inspects the homes should get twice as many staff.

According to the platform, about 40 percent of homes in Bremen belong to corporations that give their investors returns that are sometimes in double digits. The housing and care inspectorate is to get twice as many staff for better oversight. Where corporate facilities earn above-average profits, the party wants to intervene with regulation. To secure skilled staff, the training of semi-skilled workers together with the employment agency and a recruitment campaign for nursing are to continue.

The Left wants to turn long-term care insurance at the federal level into full-coverage insurance so that people in nursing homes no longer have to use up their savings. A generally binding collective pay scale is to apply to all care workers.

Care in a nursing home is very expensive. Many people have to spend their savings on it. The Left wants care insurance to pay all costs. All care workers should be paid by a collective agreement.

According to the platform, anyone with a pension below 2,500 euros who needs residential care ends up on basic income support. As a result, welfare offices have to step in more and more often. Compliance with the new duty to pay collective rates at care services and in homes is to be monitored. A generally binding pay scale is to apply at least in Bremen and Bremerhaven if it cannot be achieved nationwide.

The Left wants to create neighborhood health and care centers under public ownership, starting in districts hit hardest by poverty. Doctors, nurses, social workers, midwives and counselors are to work there under one roof. According to the program, the goal is to reduce health inequality between poor and wealthy districts.

Poor districts often have too few doctors. The Left wants to build new health centers there. The centers should belong to the city. Doctors, nurses, midwives and counselors work together there.

The centers are to be set up in the north, east, south and west of Bremen and later extended step by step to all districts. Besides treatment, they are to record what promotes or burdens health in the district. Self-help, counseling and places to connect are planned for family caregivers, parents and older people. Experience from projects such as "LIGA" in Gröpelingen is to be taken into account, accompanied by scientific evaluation. The neighborhood health workers are to be expanded and secured permanently beyond 2023.

The Left wants to set up and expand midwife centers in the districts and create more university places for midwives. Through the Bundesrat (the chamber of the states), it seeks a nationwide solution for midwives' liability insurance. The program sees care at risk because of low pay and high insurance costs.

Many pregnant women cannot find a midwife. The Left wants more midwife centers in the districts. There should be more university places for midwives. The costly insurance for midwives should get new nationwide rules.

Attending midwives, who allow one-to-one care during birth, are to be brought back. The party wants to extend the midwife-led delivery room at the Bremerhaven-Reinkenheide hospital to other hospitals in order to promote natural births and lower the C-section rate. The results of the round table on natural birth are to become binding for maternity hospitals. Family midwives and early support for families in difficult situations are to be expanded. Because vocational school training is ending, the program calls for considerably more university places.

The Left wants to fund research on illnesses that mainly affect women. According to the program, medicine long treated the male body as the norm, which created knowledge gaps. An information drive is meant to raise awareness among medical staff and the public.

Medicine studied mostly men for a long time. So less is known about women's illnesses. The Left wants to fund more research on this. It also wants to inform doctors and the public better.

The program calls this gap the "gender data gap." Research projects on it are to be funded in the state of Bremen as well. The information drive is meant to make women-specific illnesses and symptoms better known. As a further barrier, the program names the worsening supply of gynecologists and midwives in poorer districts.

The Left wants a law that ensures Bremen has enough facilities for counseling on and performing abortions. According to the program, women often face long waits or have to go to other states.

Women in Bremen often wait a long time for an abortion. Some have to travel to another state. The Left wants to change that with a law. There should be enough clinics and counseling.

Pro familia, where the program says about 85 percent of abortions in Bremen take place, is to keep receiving sufficient state funding. Doctors are to get more training on medication and surgical abortions; the topic is to become part of medical education and specialist training. Medication abortions are to be offered more often and paid for more simply and adequately through a flat fee. Also planned are a legal advice service for doctors at the health authority and a funding program for operating rooms in gynecological practices.

The Left wants to make the anonymous health voucher for people without legal residence status permanent. Language barriers are to be overcome with interpreters whose costs are covered. The program sees the right to health for people with a migration background restricted by hurdles.

Some people live in Bremen without valid papers. They can see a doctor with an anonymous health voucher. The Left wants to keep this for good. Interpreters should also help at the doctor's and be paid for.

Health care staff are to receive ongoing intercultural training. People with traumatic experiences of flight are to have enough easily accessible psychotherapy. Migration is to be taken into account systematically in care, prevention and health promotion.

The Left wants to remove barriers for people with disabilities in doctors' offices, hospitals and other health facilities. Examination equipment, communication and information are to be adapted to their needs. Their self-determination in care and inpatient facilities is to be guaranteed.

People with disabilities often have a hard time at the doctor's. The Left wants to remove obstacles in offices and hospitals. Information should come in plain language. People should be allowed to bring their assistants.

Plain language, understandable patient information and suitable counseling are to become standard. Medical and nursing staff are to get dedicated modules in training and continuing education, led by knowledgeable peer trainers. Personal assistants are to be allowed to come along to examinations, hospital stays, and preventive and rehab facilities, even when not organized through the employer model.

The Left wants to plan outpatient and inpatient care together instead of strictly separating the two. The new hospital plan is to rest on an analysis of needs in Bremen, Bremerhaven and the surrounding area. According to the program, the restructuring must lead neither to job cuts nor to outsourcing.

Doctors' offices and hospitals are planned separately today. The Left wants to plan both together. First, needs should be studied closely. Nobody should lose their job in the restructuring.

In the program's view, separating the sectors leads to lost information, duplicate examinations and poorer treatment. Because many Bremen facilities also serve patients from Lower Saxony, joint planning with the neighboring state would be the ideal. The hospital plan is meant to fix oversupply, undersupply and misdirected care.

The Left wants to abolish hospital financing through flat per-case fees and replace it with funding that covers actual needs. It aims for a hospital system in public ownership without a profit motive. Bremen is to launch a Bundesrat initiative for this.

Hospitals now get a fixed amount per treatment. This is called a per-case fee. The Left wants to abolish it. Hospitals should get as much money as they need. They should belong to the state and make no profit.

In the program's view, per-case fees allow profits at private hospitals while municipal hospitals bear the losses. It says cost pressure worsens working conditions and quality of care, and unprofitable fields such as pediatrics or gynecology are cut back. As a next step, standby payments are to come as basic funding, especially for emergency rooms, obstetrics and pediatrics. The system can only be changed at the federal level.

The Left wants to keep state funding for hospital investment permanently at today's level, which the program says has doubled since 2019. The city is also to take over loans of the municipal hospital group GeNo for its partial replacement building.

Hospitals need money for buildings and equipment. The state gives twice as much today as in 2019. The Left wants to keep it that way for good. The city should also take over debts of the municipal hospitals.

According to the program, the doubling has so far been achieved only with temporary funds. Individual grants, which paid for the new pediatric building in Reinkenheide, for example, are to keep being used in a targeted way. The special program for hospitals and public health from the Bremen Fund is to continue in the regular budget. For GeNo, the city is also to take over the part of the operating loan that carries old deficits. The party rejects paying off the 100 million euro registered bond out of GeNo's current revenue.

The Left wants to concentrate emergency care in a few central, well-equipped emergency rooms at specialized hospitals. For cases that are not life-threatening, there are also to be evenly distributed outpatient sites. This is meant to use scarce staff better and relieve emergency rooms.

Bremen has eight emergency rooms. The Left wants a few large and very good ones. For milder cases, there should be emergency practices nearby. That gives staff more time for the seriously ill.

According to the program, the eight emergency rooms are unevenly distributed, some are close together, and they are not adequately equipped. Emergency practices or portals attached to hospitals are to treat infections and wounds, for example, outside office hours. Cutting duplicate structures and unnecessary transports is meant to free up staff. At the federal level, the party wants to push for health insurers to pay adequately for emergency care, which currently runs deficits.

The Left proposes a workload compensation scheme for nurses in the municipal hospital group GeNo that amounts to a 35-hour week without loss of pay. This is meant to make the profession more attractive. Alongside it, the party calls for a hiring drive and more training.

Nurses in hospitals have a very heavy workload. The Left wants to cut their working hours. They should work 35 hours a week. Pay should stay the same. More nurses should also be hired and trained.

The party does not want to wait for binding nationwide staffing rules (PPR 2.0). It expects other hospitals in Bremen and nearby Lower Saxony to follow suit because of the empty labor market. The hiring drive is meant to keep work from becoming more intense with shorter weekly hours. GeNo's nursing training is to be expanded and brought together at the central site.

The Left wants to plan doctors' practice seats by district rather than for the city as a whole. Planning is to take into account factors such as poverty, unemployment and care needs. The program cites a lack of general practitioners and specialists in poorer districts.

Poor districts lack doctors. Today, planning covers the whole city at once. The Left wants to plan for each district separately. Poor districts should get more practices.

So far, the association of statutory health insurance physicians plans Bremen and Bremerhaven as one area each. Until a reorganization, the party proposes a procedure like Berlin's: practice seats that become vacant in well-served districts are gradually moved to less well-served ones. Districts with high poverty rates are to get extra seats for general practitioners and pediatricians. At the federal level, the Left wants states to get more powers and the self-governing bodies to be bound to public care goals.

The Left wants Bremen to push at the federal level to remove the legal basis for practices run by private investors. The party is mainly opposed to private equity firms in outpatient care. In the state, a transparency register is to disclose ownership.

Some doctors' practices belong to financial firms. The Left does not want that. The federal government should ban such practices. In Bremen, a register should show who owns practices and care facilities.

The program justifies the demand by saying health is not a commodity. The state transparency register is to record above all the owners of medical and nursing facilities. The rules on investor-run practices have to be changed at the federal level.

The Left wants psychiatric care without coercion and violence and more outpatient care so that fewer hospital stays are needed. This includes a crisis service that can be reached around the clock and also visits people. The state law PsychKG is to be reviewed to see how protection from forced treatment can be strengthened.

The Left wants psychiatric care without coercion and violence. People with mental health problems should get more help outside the hospital. A crisis service should be reachable day and night. There should be enough therapy places.

Outpatient pilot projects are to continue permanently, as is help with returning to everyday life after longer hospital stays. The program calls for enough outpatient psychotherapy available promptly. It considers a binding reduction of beds in inpatient psychiatry necessary, without quality declining there. In closed and forensic wards, enough specialist staff are to make treatment without coercion possible. Peer recovery workers are to be secured for the long term and work programs for those affected expanded.

The Left wants to further expand the public health service (ÖGD) and gear it toward health promotion and prevention. Federal money from the pact for the public health service is to be used for this. A health plan for Bremen is meant to coordinate existing prevention programs better.

The public health service includes the local health offices. The Left wants to expand it further. It should help people stay healthy. There should be more staff for this. A plan should link all services better.

Prevention is to reach people more in their neighborhoods, with outreach and participatory approaches. New topics such as "climate and health" are to get more weight in the public health service. Besides doctors, social workers and public health scientists are to be hired. Prevention and nursing specialists are each to serve as fixed contacts for a set number of residents. To attract staff, the program names collective agreements, permanent contracts and further training.

The Left wants to relieve family caregivers through more professional care and local counseling. Municipal health and care centers and the “Pflege im Quartier” (care in the neighborhood) concept are meant to make care work more of a public task.

Many people care for their relatives themselves. Most of them are women. The Left wants to help them. There should be more care services close to home. The city should also be planned better for families.

Planned measures include preventive home visits for seniors across the board, more services at care support centers and additional short-term care places in both cities. The health and care centers are to combine medical care, self-help, counseling and networking. Care support centers should also give labor-law advice to people working in household services. For urban planning, the platform names wider sidewalks, short routes to daycare, public toilets and a cityscape without sexist advertising.

The Left supports legalizing cannabis and selling it in a controlled way with strong youth protection, and wants further decriminalization in Bremen. Addiction is to be met with help, education and prevention rather than repression.

The Left thinks the ban on cannabis has failed. Cannabis should be legal and sold under control. People who use drugs should not be treated like criminals. People with addiction should get help.

Reporting every case of cannabis possession to the driver's license office is to end. In prison, higher thresholds are to replace the current zero-tolerance practice, under which even 0.1 grams triggers an investigation. The practice of dropping cases involving small amounts of other drugs such as ecstasy for personal use is to be written into a guideline. For Bremen's main train station, the party calls for a tolerant, outreach-based and supportive approach with consumption and rest rooms.

The Left wants to expand substitution programs for people addicted to drugs and set up a diamorphine clinic for the most severely addicted. Bremen should also get a drug-checking service to reduce risks from contaminated substances.

The Left wants more help for people addicted to drugs. They should be able to get substitute drugs from a doctor. There should be a special clinic for people with severe addiction. It gives them pure diamorphine, which is medical heroin. People should also be able to have their drugs tested.

Existing methadone programs are to continue according to need and in several languages. In addition, the party plans a clinic that dispenses pure diamorphine to the most severely addicted. The platform also sees this as one way to respond to rising crack use, which often happens alongside methadone. Decentralized services for short-term detox and supported housing, with close support from social workers, are also planned. Drug support services overall are to grow, especially outreach in other languages. A drug-checking service is meant to lower the risks of use.

The Left wants to develop pilot projects for the controlled dispensing of crack. It also calls for tolerance zones and permanent rest and consumption rooms instead of merely pushing the drug scene away from the main station.

Many people use the drug crack near Bremen's main station. The Left wants to test handing out crack in a controlled way. There should be fixed rooms where people can rest and use drugs. The party does not want to just push people away from the station.

According to the platform, crack use around the station has risen sharply and those affected are harder for drug support services to reach. Pilot projects for controlled dispensing are therefore to be developed. The party also calls for tolerance zones and permanent rooms for staying and using; it considers the mobile consumption room on Friedrich-Rauers-Straße important. In the Left's view, displacement without alternative spaces only moves the scene and makes help harder to reach.

The Left wants to keep the municipal hospital group Gesundheit Nord (GeNo) financially secure. Its restructuring should neither worsen care nor burden staff; the federal government should reorganize hospital financing.

Gesundheit Nord runs city hospitals in Bremen. The Left wants it to get enough money. Care for patients should not get worse. Nurses should earn more.

According to the platform, building renovation and a new medical strategy are on the agenda. Municipal hospitals should no longer be restructured on business criteria alone. Pandemic costs should be fully compensated, and Bremen cannot carry hospital investments by itself. The party considers the flat-rate per-case payment system (DRGs) unsuitable. Nurses and other hospital staff should be paid better.

The Left wants to make meals in daycare centers and schools free and shift public canteens to regional, seasonal, and organic food. In the party's view, healthy eating should not depend on income.

The Left wants free meals in daycare centers and schools. The food should be healthy and come from the region. There should be less meat. The city should have drinking fountains everywhere.

Daycare centers, schools, university cafeterias, hospitals, and canteens are to follow the Planetary Health Diet in the long run, which means fewer animal products. Daycare centers and schools are to get enough state money for this. At the federal level, the party backs a zero percent value-added tax on healthy and sustainably produced staple foods. School and daycare gardens, home economics classes, and urban gardening projects are to be supported. Drinking fountains are to be available citywide, and restaurants and shops are to get help installing tap water dispensers.

The Left wants to turn the Bremen-Nord hospital into one offering the full range of medical care and keep its care for premature babies. Access to pediatricians and specialists is also to improve.

The Left wants to expand the hospital in Bremen-Nord. It should offer all important treatments. The unit for premature babies should stay. There should be more children's doctors and specialists.

The party opposes withdrawing Level II care for premature infants. It calls for more midwives with better working conditions as well as interpreters. The Kassenärztliche Vereinigung (the association that allocates doctors' practices) is to be organized into smaller regions. In the program's view, a separate association for Bremen-Nord would allow care based on actual need.

The Left wants to preserve and expand the public Reinkenheide hospital in Bremerhaven. To counter a looming shortage of doctors, it calls for a framework plan based on actual need.

Bremerhaven has one public hospital. The Left wants to keep and expand it. Bremerhaven will soon lack doctors. The Left wants a plan to fix that.

The program notes that the city's two other hospitals have belonged to the private AMEOS group since 2014. Planning is to be based on real local need rather than the allocation formula of the association of statutory health insurance physicians. All patients are to get adequate care regardless of how they are insured. Introducing polyclinics is to be examined.