SPD on health and care

The SPD wants lunches in daycare centers and schools to meet the standards of the German Nutrition Society and to be free for children from low-income families. School health nurses are also to be introduced at schools.

Children should get healthy lunches at daycare and school. For children from poor families, lunch should be free. Schools should also have health nurses. They look after children and school staff.

Free lunches are to come first at locations facing particular challenges. These daycare centers and schools would be able to choose this as a focus within their educational concept. School health nursing is to be introduced step by step and offer health care and health promotion directly at school. The service is aimed at children, young people and school staff.

The SPD wants to keep all hospital sites in North Rhine-Westphalia and end closures. Some hospitals may be given a different care mandate. The platform argues that sick people need a hospital nearby.

The SPD does not want to close any hospital in the state. All sites should stay. Some hospitals may get different tasks. Sick people should have a hospital close to home.

In the SPD's view, sites should not be judged by population density and age structure alone. The party also describes hospitals as employers and as an economic factor. State hospital planning is to make sure that basic pediatric surgery for children and small children is available close to home.

The SPD wants to overcome the separation between outpatient and inpatient care and between statutory health insurance and long-term care insurance. Doctors' practices and hospitals are to work together more closely. According to the platform, this brings more efficiency without extra pressure on staff.

Today doctors' offices and hospitals are strictly separate. The SPD wants them to work together more closely. Health centers should help with this. Towns and cities should have more say.

In the SPD's view, today's separation has bureaucratic rather than medical reasons. As organizational forms, it wants to make particular use of medical care centers (MVZ) and integrated cross-sector health centers (ISGZ). In planning talks with investors and operators, municipalities or their holding companies are to be more closely involved.

The SPD wants to reform hospital funding in two steps and build up stocks for medical emergencies. Local public health offices are to get more staff, money and digital equipment. Savings are not to come from staff, quality or sites but from cutting red tape.

The SPD wants to change how hospitals get their money. The state should store supplies for emergencies, such as masks and tests. Public health offices should get more staff and money. Unneeded rules should go.

First, the financial conditions within the current system are to be changed quickly, while a new payment system is developed with the federal government in parallel. As a lesson from the COVID-19 pandemic, the SPD plans secure supply chains and coordinated stockpiling, for example of protective gear, test kits and disinfectant. The platform considers the storage costs justified. Regulation the party sees as unnecessary is to be identified and removed systematically; the platform cites as an example that pharmacists were long not allowed to vaccinate. The SPD says it is willing to invest more in health and in return expects less pressure on staff.

The SPD wants to regulate how much profit private hospital operators, hospital companies and hospital groups may take out of their facilities. If operators pull out as a result, hospitals could return to municipal ownership. The party wants the money to benefit local health care.

Some hospitals belong to private companies. The SPD wants rules on how much profit these companies may take out. The money should stay in health care. If companies give up, towns and cities should be able to take over the hospitals.

The platform justifies the regulation by saying that savings from less red tape would otherwise be pulled out of the system by private operators. According to the SPD, making money with health care remains allowed, but the health system must not be worn down for personal gain. The party says it is prepared to have municipalities run hospitals again if necessary.

The SPD wants to bring more family doctors to rural areas and to urban neighborhoods with few privately insured patients. It plans financial incentives and additional medical school places. The platform points to an expected drop in the number of family doctors by 2030.

Rural areas do not have enough family doctors. Poorer city neighborhoods also lack them. The SPD wants to bring more doctors there. It wants to offer money for studies and for new practices. It also wants more places to study medicine.

The incentives named are scholarships for students, loans for setting up practices, and more places in medical programs. According to the platform, planning figures from the associations of statutory health insurance physicians show about 1,165 fewer family doctors by 2030 than today. The family doctor is to remain the first point of contact in the health system. The SPD also wants to find new ways to recruit specialists, especially pediatricians. Rehabilitation clinics are to be supported in the state's future health planning.

The SPD wants nurses, therapists, and doctors to learn together more during training and university studies. Nursing and therapy professions are to get educational paths up to a doctorate. More university places are planned for midwives.

Nurses, therapists, and doctors should learn together during their training. People who work in nursing should be able to study further. This should go all the way to a doctorate. There should be more study places for midwives.

According to the platform, these professional groups usually meet only on the job, even though care is teamwork. The SPD attributes the shortage of nursing and therapy staff partly to a lack of career prospects. It therefore wants to create conditions that open a path from vocational training to a doctorate. This includes funding university-level research in nursing and therapy. Midwife support for births is to be secured across the whole state.

The SPD wants statewide, barrier-free dental care and supports owner-run local pharmacies. Gaps in care for mental, neurological, and orthopedic conditions are to be closed. The platform argues that prevention costs less than expensive treatment later.

There should be dentists everywhere in the state. New practices should be easy to enter for everyone. Pharmacies should also be nearby everywhere. The SPD says prevention is cheaper than costly treatment later.

In the SPD's view, people skip checkups when practices become fewer and distances longer. New dental practices are to be barrier-free. The platform describes pharmacies as a first point of contact in many regions; they should be able to fulfill their supply mandate statewide and without barriers. The party wants to fill missing outpatient and inpatient services for mental, neurological, and orthopedic conditions.

The SPD wants to fund health guides with state money and set up barrier-free "health kiosks" in urban areas. These neighborhood contact points are to offer easy-access information on prevention, illness, and care. People without health insurance should also get help there.

The SPD wants to use health guides. These are people who advise on health questions. Big cities should get health kiosks. Everyone can get advice and help there. This includes people without health insurance.

The guides would also advise patients and relatives on home, inpatient, and social care; health insurers may take part. For the kiosks, the SPD wants to expand existing AOK projects statewide and recruit staff with varied language skills and cultural backgrounds. The kiosks would also inform about cancer screening, nutrition, and sports, and can be attached to existing advice services. The party also commits to the Pact for the Public Health Service, with more staff and better digital equipment. Prevention programs are planned in family centers at schools.

The SPD wants to create more outpatient therapy places and hospital places, including in child and adolescent psychiatry. Counseling and therapy should be easy to access and available at short notice. The party says mental illness, suicide, and loneliness must not remain taboo.

Many people wait a long time for therapy. The SPD wants to create more therapy places. This also applies to children and teenagers. Help should be quick and easy to get. Schools should offer more psychological support.

The platform calls for education and prevention, especially for young people. Waiting months for an appointment with a psychotherapist should end. School psychology services are to be expanded so children and teenagers can work through lockdown experiences. The SPD wants to strengthen community psychiatric networks and help build them statewide to secure local support before hospital admission. Self-determination and avoiding coercion are to be respected.

The SPD wants to ease the burden on family caregivers, including through comprehensive advice in care competence centers and more places for short-term, day, and night care. Time spent caring should count toward pensions, and caregiving should be compatible with work and family. The platform notes that three quarters of people needing care in the state are looked after at home by relatives.

Many people care for relatives at home. The SPD wants to help them. There should be centers with good advice. There should be more places for day care and short-term care. Time spent caring should count toward the pension.

For full-time workers who care for relatives, the platform gives the example of dropping the contribution surcharge for childless people. In care support centers, trained guides would develop personal support plans; residential care should be available close to home. A state program would fund short-term, day, and night care places. The SPD also wants to expand care hotels and widen an AWO Westliches Westfalen pilot project offering health retreats for family caregivers. An easy-to-reach support service is planned for children and teenagers who care for their parents.

Following the example of Rhineland-Palatinate, the SPD wants to deploy specially trained professionals as "Gemeindeschwestern" (community nurses) who advise people at home. It also wants to promote alternative housing such as shared care apartments and digital aids. The goal is for people to live independently for as long as possible.

The SPD wants community nurses. These are trained workers who visit older people at home and advise them. There should be more shared homes for people who need care. Digital tools should also help in daily life.

The advice is to cover housekeeping, health, housing, mobility, and social contacts, and to connect people with offers such as senior meetups or exercise classes. Where such offers are missing, the professionals should help start them. Shared housing for seniors and people needing care should also be open to younger people with disabilities or care needs; the SPD cites the growing number of people needing care without family nearby. Funding is planned for digital aids, user training, home retrofits, and digitizing care services. In nursing homes, technology should allow consultations with doctors without transport.

The SPD wants to reduce the strain in care professions with shorter, reliable working hours, fair pay, and better career prospects. Programs are to win back care workers who have left the field. The party rejects a nursing chamber with compulsory membership against the will of employees.

Many care workers leave their job early. The SPD wants to make the work easier. Working hours should be shorter and reliable. Pay should be fair. Nobody should be forced to join a nursing chamber.

According to the platform, many drop out of care training or leave the profession after six years on average. Requalification programs are meant to ease the return to work. Care workers are to get permanent seats on crisis teams at the local and state level, and the SPD announces regular exchanges with them. For foreign caregivers working in home care, it wants a legal framework with clear working and rest times; it welcomes a Federal Labor Court ruling on their pay.

The SPD wants public funding for care facilities so that the investment costs charged to nursing home residents go down. At the federal level, it also pushes for a cap on residents' out-of-pocket contributions.

A place in a nursing home costs a lot. Residents also pay for buildings and equipment. The SPD wants the state to give homes money for this. Residents would then pay less. The share residents pay themselves should also get a limit.

The platform describes investment costs as a large and growing item charged on top of residents' own contributions in residential care. Public funding for the facilities is meant to reduce it. The SPD wants to advance a cap on out-of-pocket contributions at the federal level.

The SPD wants to accompany the federal government's planned cannabis legalization with a statewide prevention and youth protection program. Addiction counseling for people at risk and their relatives is also to be secured.

The federal government wants to allow cannabis. The SPD wants a program across the whole state to go with it. The program should warn about addiction and protect young people. Addiction counseling should stay secure. Families and children matter most here.

The prevention and youth protection program is to apply across the whole state. Counseling is aimed at people at risk of addiction and their relatives and is to be safeguarded. The platform gives particular weight to help for families and children.