Minister of State Petra Köpping presented the report on the status of the implementation of the "20-Point Program - Medical Care 2030" in the cabinet today. The program was approved by the cabinet on June 19, 2019. The implementation of the program is agreed in the current coalition agreement.
Health Minister Petra Köpping explains: “I am very pleased that the program has been largely implemented. Because in order for good medical care to be possible in Saxony in the future, we urgently need young specialists, especially in general medicine. We have a special need for skilled workers here. We all know that general practitioner care in rural areas in particular is strained in many places. We have therefore already implemented a large number of measures to recruit doctors. Of course, we will subject all of the measures in the 20-point plan to an up-to-dateness check and, if necessary, make adjustments with a view to expected developments.«
Science Minister Sebastian Gemkow: »Ensuring medical care in rural areas is literally a joint task. A large number of stakeholders have contributed to the measures that have been initiated in recent years. This also includes the medical faculties in Leipzig and Dresden, which have created important prerequisites in medical training in order to improve the supply situation with doctors in rural areas in the future.«
The implementation of the program is well advanced, including the following implementation successes:
University places and scholarships
For example, 90 additional study places in human medicine have been created at Saxon universities and there has been a country doctor quota in Saxony since 2022. It makes it possible to study medicine outside of the numerus clausus regime if the participants commit themselves, after completing specialist training, preferably in the field of general medicine, to a period of ten years in an area in the Free State that is underserved by general practitioners or threatened by undersupply practice.
The “MEDiC” model course of the TU Dresden/Dresden Medical Faculty at the Chemnitz site in cooperation with the Chemnitz Clinic has been established. The third year has now started their studies. The "MiLaMed" project of the medical faculty of the University of Leipzig was implemented. Both MEDiC and MiLaMed will be continued with state funds after the first project phase has been financed.
In addition, further study places were created outside of Saxony. The program of the Association of Statutory Health Insurance Physicians in Saxony (KVS) »Study in Europe – Future in Saxony« has been expanded. The KVS and the health insurance companies pay tuition fees for 20 medical study places in Hungary at the University of Pécs per year. Since 2020, Saxony has been financing up to 20 additional medical study places per year. For this, the students undertake, after completing specialist training in Saxony outside the cities of Leipzig, Markkleeberg, Dresden and Radebeul, e.g. B. to work as a general practitioner for at least five years.
The general practitioner grant for medical students in Saxony also attracts future specialists, especially in general medicine, to rural areas. Both junior programs together currently have around 350 program participants, 24 of whom have already started their specialist work and around 85 participants support medical care as doctors in training.
initial and continuing education
Both medical faculties have increased their efforts to attract more teaching practices in rural areas. As a result, a total of 122 additional academic teaching practices outside the metropolitan areas of Dresden, Chemnitz and Leipzig have been integrated into the training of medical students. Both faculties want to upgrade the previously dependent departments for general medicine to independent institutes. This significantly strengthens the external perception of general medicine as an independent specialty. The financing of the "Leipzig Competence Path General Medicine" (LeiKA) is also secured in the future.
In addition, the further training of doctors will be strengthened. There are currently 17 regional further education associations in general medicine in Saxony. Since 2018, a total of 36 additional training positions have been funded for the implementation of sections of medical training. The number of specialist certifications in general medicine has already increased.
The "Doctors for Saxony" network as a platform for bundling the players in the healthcare system supports the recruitment of young people with a variety of measures, including image campaigns, to make the many support offers for future doctors in Saxony better known.
For the promotion of the digital upgrading of hospitals, 10 million euros per year are also budgeted in the current double budget. The funds will be given to the planned hospitals in the Free State as part of the hospital flat-rate funding. In this respect, the subsidy according to Part B of the eHealthSax guideline was transferred to the hospital flat-rate subsidy.
In addition, a total of 2017 projects totaling 27 million euros have been funded in accordance with part A of the eHealthSax directive since 22. This includes measures that improve the processes in the healthcare system, facilitate access to care or enable the formation of networks. There is a lot of potential for digitization in rural areas in particular, especially in connection with the transfer of services from doctors to non-medical staff (»delegation«).
One of the challenges of the coming years is to meet the need for specialists in general medicine and in certain selected specialist areas in Saxony in the long term. In rural areas in particular, but also in the city of Chemnitz, it is becoming increasingly difficult to fill contract doctor positions again and to provide care as needed. The general practitioner care situation is especially tense in rural areas. The State Committee of Doctors and Health Insurance Funds in Saxony has identified undersupply for 5 of 48 planning areas (Frankenberg-Hainichen, Reichenbach, Torgau, Weißwasser, Werdau) and for 27 planning areas there is a risk of undersupply in general practitioner care.
As of April 1, 2023, there were 452,5 vacant general practitioner positions throughout Saxony (i.e. these positions can be filled until oversupply is determined in the respective planning area. This is usually the case when the target level of care - number of inhabitants per doctor - for the respective physician group > 110 percent). A total of 2.597 general practitioners are currently working (total of the physicians relevant to the need).
In addition to general practitioner care, the State Committee of Doctors and Health Insurance Funds has identified an undersupply for dermatologists in one planning area and an impending undersupply for paediatricians, neurologists, urologists, dermatologists and ophthalmologists in at least one planning area and the associated need for young doctors.
Ensuring outpatient medical care is closely linked to the doctor as a resource. The age structure of the doctors in Saxony and the expected retirements in the next few years will reinforce this development. The average age of general practitioners is 54 years.
The need for doctors is not only increasing due to the demographic change in the population, but also due to the increase in professional downtime (e.g. due to increased use of parental leave) and the fact that the number of doctors who work part-time or are employed are active has increased.
The Ministry of Social Affairs has commissioned a new projection of the supply and doctor requirements for 2035. Based on the update of an expert opinion from 2016 by the Central Institute for Statutory Health Insurance Physicians in Germany on the need for contract doctors and doctors in Saxony in 2035, it is intended to depict the supply landscape in the Free State of Saxony. Subject areas such as the trend towards more outpatient care, telemedical service provision and work-sharing processes are included. The results of the projection and the self-government’s responses to the implementation status are used to review the measures in the “20-Point Program – Medical Care 2030” and, if necessary, to adjust their alignment with a view to 2035.
With the adoption of the “20-point program – medical care 2030” in June 2019, the state government followed on from the 31 proposed measures adopted by the cabinet on January 2012, 20 (medical care in rural areas/interdepartmental measures to ensure a needs-based medical care in rural areas in the Free State of Saxony, Decision No. 05/0509) and had developed it further.
The implementation report can be found here: https://www.gesunde.sachsen.de/download/SMS_Bericht-20-Punkte-Programm-Medizinische-Versorgung-2023_Stand-Mai-2023.pdf
Source: Press release from the Saxon State Ministry for Social Affairs and Social Cohesion from 06.06.2023