Germany's Emergency Care Reform Stalls as Hospitals Face Growing Strain
A proposed reform to Germany's emergency care and rescue services remains stuck in political limbo. The Green Party introduced a draft bill last November, but no progress has been made since. Critics now warn that delays are putting vital changes at risk—changes meant to ease pressure on overburdened emergency departments and improve patient care.
The core of the reform includes a mandatory, nationwide system for initial patient assessments. Under the plan, all patients would first be evaluated to determine whether they need urgent emergency treatment or could be directed to less critical care. Currently, around two-thirds of those visiting emergency departments do not require emergency attention.
The government's proposal also calls for closer cooperation between existing hotlines. The acute care hotline (116 117) and emergency dispatch centres (112) would have to work together to streamline responses. Patients who receive a preliminary assessment—whether by phone, video, or app—would then be prioritised if their condition is equally urgent. Another key measure is the expansion of Integrated Emergency Centers (INZ) in hospitals. These centres would operate 24/7, providing round-the-clock assessments to match patients with the right level of care. The reform further suggests reducing the number of control centres, though this task would fall to individual federal states. Beyond medical care, the system would also guide patients toward mental health, social, or nursing services when needed. Despite these plans, no federal state has yet submitted concrete proposals for implementing the 24-hour INZ centres. The Association of Substitute Health Funds (vdek) has criticised the governing coalition for failing to advance the legislation, leaving the future of the reform uncertain.
The stalled reform aims to cut unnecessary emergency visits and ensure faster, more appropriate care. Without action, overcrowded emergency departments will continue facing avoidable strain. The next steps depend on political agreement and clear implementation plans from the federal states.
