Together with people directly affected and representatives from the areas of the health service, care provision and care research, the Ethics Council focused public attention on the current debate over deficits in hospital services for people with disabilities, and explored possible solutions by looking at existing, well-functioning models.
In her opening remarks, the commissioner for people with disabilities from the Bavarian State Government, Irmgard Badura, expressed her thanks to the German Ethics Council for taking the initiative in publicizing this topic. She pointed out that there is insufficient provision within the present health system for people with disabilities. Ms Badura called for legislation at federal level with a view to improving the treatment of people with disabilities in hospitals. She expressed her hope that the Bioethics Forum would help to stimulate steps towards finally ending this unequal treatment.
The public debate and studies on the deficits in health provision for people with disabilities have brought more and more aspects to light in recent years, and especially since the fee-per-case system was reorganized in 2002: Not infrequently, medical decisions are taken without consultation with those affected; the care staff often cannot take the special physical and emotional needs of the patients into account; patients are discharged from hospital care too quickly. Communication with deaf people and people with mental disabilities is seriously impaired.
Legislation on care assistance in hospitals that was passed in 2009 has failed to solve the problem, because it benefits only those people who are eligible to receive cash benefits from care insurance and can use these funds to employ outpatient care staff at home. Recipients of non-cash outpatient care support and people who are already resident in care homes are not eligible for additional assistance in hospital.
Those who spoke during the evening were uniformly of the opinion that, as various examples of successful practice have shown, there is more to the issue than increasing the funds available to hospitals and improving hospital structures so that they are better suited to the needs of those with disabilities. They agreed that it is equally important to provide medical, care and therapeutic staff, by means of better basic and advanced training, with the necessary technical and communicative competences. This includes, especially, developing an attitude in which communication on equal terms becomes normal.
The central recommendations that arose during the evening include sufficient staffing, the provision of coordinated patient advice, an appropriate combination between standard and specialized care as part of a holistic approach, better networking of the entire medical care framework for people with disabilities, as well as documentation of the extra effort that needs to be put into the medical treatment of people with disabilities. The recommendation was also made to ensure that there is a commissioner for people with disabilities in every hospital.
The agreement reached in the coalition negotiations between the parties now forming the present government (CDU, CSU and SPD) to promote medical centres for adults with disabilities was seen as representing an important and positive step in the right direction, and one that should be pursued further.
There was also a consensus that broad public discussion of the issue, such as was launched by the Ethics Council in Munich that evening, would lead to greater awareness amongst those involved in the health system and form the basis for concrete improvements in the future.