Last order of business: hospitals snub

Typically, Heiniger: Shortly before his departure from the government, he submits to a law which has the potential to change the Zurich hospital landscape, he wrote, but without the involvement of the people Concerned. The hospitals are snubbed.

That would not have been necessary. Heiniger leaves without the strong traces in the healthcare sector. His masterpiece, the hospital planning, he has created in his early days as a Zurich's health Director. The free Democrat was followed in 2007 on the green-liberal Verena Diener. They had been led, as now, Heiniger, also for twelve years, the Directorate of Health and went down in history as a politician, the castle of nine hospitals and still be re-elected. What had begun in servants, continued to Heiniger: He trimmed the hospitals on cost-effectiveness. Its collective decisions were strictly or athletic, as he, the marathon runner would say.

The constant pressure on the hospitals to work efficiently, had the vapors in a cost-effect, of the Canton Of Zurich hospital tariff was national to Leittarif. And although there are in the Canton of Zurich a very large medical treatment offer, the Premiums here are comparatively moderate.

Heiniger has never been happy from the outside, the three talk. This has intensified with the time.

in 2012, there was a break in the Swiss health care: The hospitals have received since then from the state and the health insurance your costs, not just reimbursed, but are paid per case. The new incentives, by now, every hospital wants to treat a lot of inpatient patients in order to achieve profits, which in turn will allow investment in modern equipment.

At the time of the transition, the Zurich cantonal Council issued a new list of hospitals, which was based on a fundamentally new system. This was the work of a group of experts from the Directorate of Health, which had Heiniger employed. They divided the medical facilities at the hospitals in different performance groups. For example, "basic package of surgery and Internal medicine", "heart" or "gynecology". This allowed to shape the hospital list, differentiate and link the performance contracts with targets.

What used Heiniger diligently. He committed all the list of hospitals to provide a certain number of training places in nursing, the shortage of skilled labour. He had a Minimum number of cases for complex operations, in order to prevent the opportunity of intervention. While the efforts to achieve a concentration of highly specialised medicine by means of minimum numbers is the case, the country began to slow, Heiniger such in the Canton of Zurich in several areas of expertise. So he took on a pioneering role.

range: Thomas Heiniger has belonged to 12 years in the government enough

Also to the First, he with the requirement that the hospitals perform more than a dozen procedures on an outpatient basis, which the Canton saves many millions of francs. Because of the hospital treatments, it pays 55 percent of the outpatient nothing. The Federal government has now adopted similar regulations. And most Swiss-German cantons have adopted the nomenclature of the Zurich hospital planning.

to set a good example and something to put it: did Thomas Heiniger in his twelve years in office, more often. Two more, the Swiss health care system-defining examples are the Medical Board and the electronic patient dossier. The Medical Board is an expert group that examines selected treatments for their effectiveness and thereafter, recommendations for the application or non-application. The idea stemmed from Verena Diener, Heiniger has been implemented. Also for the electronic patient dossier he has made and, finally, the cantonal Parliament approved start-up funding. Now a platform in the building is connected to several other cantons.

He had taken "responsibility for the System," and that he had strengthened the Position of the Canton of Zurich, says Thomas Heiniger, looking back. He is very proud of that. When he started, he fought against the other cantons, the zürich University hospital transplant was allowed to keep the heart. He managed that; with the Progress of Zurich's interests, he threw back the national coordination efforts.

The "Regulation" of the Directorate

The University hospital is shown perhaps the biggest difference between servant and Heiniger. While its predecessor, the flagship of the Canton of neglected, let Heiniger him a lot of support. He made sure that the Unispital may build yourself, what is the planned total renewal is an advantage. At his request, the government special funds approved in the amount of tens of millions of francs for the promotion of cutting-edge medicine.

The smaller hospitals are angry that the University hospital benefits from Heinigers centralisation policy, while they are increasingly weakened. Against the recent guidelines of the Directorate of Health, the regional hospitals are drawn even before the court. Without success: starting this year, Minimum number of cases for the surgeon and for common operations like hip replacement apply.

Now the hospitals has Heiniger completely outraged. The hospital Association criticized the new hospital law as unnecessary and untenable. A "Regulation" of the Directorate is manifested in it. The law would allow the government strong intervention in the public hospital market. He could put the hospitals an upper limit for the number of treatments and the Exceed sanction. The law provides for fines of up to a Million.

It is a paradox that, of all things, the FDP-politician draws Heiniger now, in order to allow large equipment back to grant.

Such a paragraph from the pen of a free-minded astonishment. Heiniger she defended The state in need of intervention options to counter the Oversupply. The intensified competition has led in recent years to such as left-wing politicians from the beginning, criticized, recognizes health Director. It'll be part of the surgery is unnecessary, he says. It is for this Situation to blame. He started in 2012, the private Hirslanden clinic on the hospital list, he has the arms race among hospitals inspired.

It is a paradox that, of all things, the FDP-politician draws Heiniger now, in order to allow large equipment back to grant; it would be a reversion to servant times. The bill breathes the spirit of the administrative bureaucracy.

time for change

Heiniger went in his zeal for Regulation. It is the corrective to the official point of view was missing him. In the last years, the employees who were to have an open mind leave, the Directorate of Health. Heiniger has never been happy from the outside, and this attitude has increased with time. His relationship with the member of the Parliament and, in particular, to the Supervisory Commission for social security and health is anxious. People that have to do with him, to criticize his arrogance. Even the Doctors, who were enthusiastic in the beginning, because Heiniger allowed for the dispensing of Drugs in the whole of the Canton, resulting in increasing isolation.

It is time for a change – even if it is not the or the New, maybe better. The Directorate of Health is a challenging Department. And it must be a lot of Know-how. At the same time with the head of the long-time General Secretary, the gray Eminence of the Directorate.

And Thomas Heiniger? The former lawyer who is now 61, also wants to make in the future, "socially useful work". Therefore, he says the Red cross and Spitex Association, when they asked him for the Bureau.

(Tages-Anzeiger)

Created: 28.04.2019, 22:33 PM