In the serious bus accident in Berlin on Sunday, in which a 15-year-old died, the emergency doctor came nine, but the ambulance only came 20 minutes after the emergency call. Such delays could soon be the order of the day throughout Germany. Because according to experts, our rescue system is on the verge of collapse.
The bus accident in Berlin, in which a 15-year-old girl died at the scene of the accident and a younger girl was seriously injured, casts a dark shadow on emergency care in Germany. According to media reports, the first emergency vehicles were on site nine minutes after the emergency call was received, but the first ambulance only came after 20 minutes. The reason: The rescue service in Berlin has been heavily overloaded for some time, partly because there is a shortage of staff and too many emergency calls that are not based on a real emergency overload the system.
The “Alliance for Rescue Services”, which was founded in Frankfurt in October, also reports that this is not just a problem in Berlin, but nationwide. It is a merger of various organizations such as the Federal Association of Working Groups of Emergency Doctors in Germany, the German Professional Association for Rescue Services, the German Fire Brigade Union, the German Society for Rescue Sciences and the Björn Steiger Foundation.
On Monday, the alliance raised the alarm in Berlin and drew attention to the abuses in this country. Because, as the example of Berlin shows, emergency rescue in Germany is at risk. But why is the rescue service in a rich country like Germany getting more and more into a dangerous imbalance?
“The underlying problem is complex,” explains Ulrich Schreiner from the Björn Steiger Foundation in an interview with FOCUS online. “On the one hand, we have a nationwide staff shortage in the healthcare system and therefore no longer have enough personnel for the assignment,” he explains. On the other hand, the wrong use of the rescue service is still a huge problem in Germany. The threshold for calling an ambulance has dropped significantly – as has the knowledge of when an ambulance is needed at all.
In many cases, an emergency vehicle would be called even though it was not a real emergency. “For example, if a child has a fever and the parents don’t know how to bring it down with calf wraps or fever syrup, they call the emergency services 99 percent of the time,” he explains the problem. The use of the emergency services for minor cases would have increased greatly.
Other European countries such as Denmark are much better at preventing unnecessary calls: “If a dispatcher at the control center notices that an ambulance is not necessary, he forwards the caller to a medical advice service,” explains Schreiner. They can issue prescriptions or, if necessary, even coordinate an appointment with a specialist. “We can’t do all that in Germany – we’re still far behind there,” warns Schreiner.
Such cases often ended up in the hospital and put an unnecessary strain on the system. “The moment 112 is called, the control centers in Germany have to send an ambulance – we don’t have any other alternative,” says Schreiber. The medical emergency service of the National Association of Statutory Health Insurance Physicians on telephone number 116 117 is not as helpful as it could be. “If people are on hold for 20 minutes and realize that nobody will help me, they call 112 again – it’s a vicious circle,” says Schreiner.
Another problem is the fact that the rescue services are a matter for the federal states. The federal states in turn delegated this task to the rural districts and urban districts. “The care that you experience as an emergency patient is different in each district,” criticizes Schreiner.
There are no uniform specifications, depending on the rescue service, other measures are approved or instructed – that’s why you can’t prove a uniform quality, because the operations are regulated differently everywhere.
This also applies to the help period, i.e. the time within which an ambulance must be on site. “This is regulated by law and is different in every federal state – Berlin, for example, where the bus accident happened, has no assistance period at all, in Hesse it is 10 minutes, in Brandenburg 15 minutes,” explains Schreiner.
However, it is difficult to determine how often these are currently being exceeded in the individual federal states due to the tense situation. “There are no public figures on this, you have to query all the districts and urban districts in Germany,” says Schreiner. In Hesse, however, it is known from state parliament documents that the ambulances are only on site within the deadline in less than ninety percent of cases.
However, these values are not comparable, because the assistance period is defined differently everywhere: “In some regions it applies from the receipt of the emergency call in the telephone system, in others from the acceptance of the emergency call, in others only when the ambulance is dispatched.”
That is why Schreiner, together with the alliance, is urgently calling for a nationwide set of rules. This includes, for example, emergency calls that do not turn out to be acutely threatening situations being forwarded to 116 117 and answered there by health advice or a doctor’s home visit. If not every emergency call is automatically followed by hospital treatment, this means a considerable relief for the system, argues Schreiner and his alliance colleagues.
The rescue service should also be made more attractive as a place of work again through modern working time models, training initiatives and appropriate payment. Because of the high workload, many leave this environment after just a few years. “We are currently experiencing an unprecedented professional flight,” said Frank Flake of the German Professional Association of Rescue Services, which also belongs to the alliance.
“If we don’t do anything now, we will crash the rescue system,” warns Ulrich Schreiner. The people in Germany should finally be shaken up and made aware that in an emergency like in Berlin, no ambulance will come in time. The population still feels safe because they are promised that help will be everywhere in Germany in just a few minutes. This promise is now foreseeably a deceptive promise, explains Oliver Hölters, co-initiator of the alliance. Because when it comes to life and death, every minute counts.