"Medical care for children is not secured either as an outpatient or as an inpatient"

The head of a children's clinic in Bonn has just called the practice, reports pediatrician Axel Gerschlauer: "We are full and can only take patients in emergencies," he said. The system of inpatient and outpatient child care is collapsing, nothing works anymore.”

Gerschlauer doesn't know exactly how to proceed. He treats more than 1,500 children and young people every quarter. Again and again he had to turn away parents with newborn children, says the Bonn doctor. "I can only take in a few in addition to the siblings and the war refugees."

He works around 50 hours a week and he is still convinced that he has chosen the best job in the world. Even if the general conditions have never been as bad as before.

The availability of paediatricians is a major problem throughout Germany. The demand for appointments is higher than the supply - and it continues to increase. There are too few pediatricians working in Germany, as well as too few practice employees. At the same time there are demanding and insecure parents, a high need for advice, an increased number of early detection examinations, more anxiety disorders, depression and developmental delays than three years ago.

In mid-October, the Berlin paediatricians had already appealed to the health senator, demanding more support and warning that they were "at the end of their strength".

"We're already up to our necks in water," confirms pediatrician Gerschlauer in a call for help to the Association of School Principals in North Rhine-Westphalia. "The medical care of children and young people is not guaranteed either as an outpatient or as an inpatient." The letter is an attempt to reduce the workload in the pediatrician's practice.

In it he informs the school directors that certificates will no longer be issued in the event of illness. School management or day-care providers often require the issuance of various certificates, which are usually based on their own house rules; For example, the presentation of a certificate in the event of an illness that lasts longer than three days, a health certificate after a flu infection or the certificate that the child is healthy when it first visits a daycare center.

“Most doctors feel that their medical work is being misused when unnecessary practice appointments are requested from schools for certificates and at the same time children who are really ill are sometimes no longer receiving care due to the lack of doctors,” writes Gerschlauer in a form. This is now being distributed to parents and young people in several practices in North Rhine-Westphalia and sent to school management. "We expressly call on school management to change the relevant regulations so that certificates can be omitted."

Read the appeal of the pediatrician practices in the original here

At the beginning of autumn, a draft for the reform of the Infection Protection Act had provided for a certificate to be compulsory in schools. Children with cold symptoms should therefore stay away from class until a doctor has ruled out a corona infection. After an infection, a medical certificate should also be submitted. After protests from paediatricians, the passage was removed from the legal reform.

The Infection Protection Act, which has been in force since the beginning of October, only provides for a health certificate for very few diseases such as salmonella; there is only a medical obligation to report illnesses such as rabies or a severe vaccination reaction. But under no circumstances with a normal flu infection. "This applies: It lasts seven days without a doctor's consultation and a week with a doctor's appointment," says Gerschlauer. A conventional virus infection does not make sense to treat except with the three Ns: Nurofen, nasal drops, Netflix. "So you have to do what is good for you at the moment, take painkillers if necessary - and wait and see."

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