"It just doesn't work that way" - Holetschek criticizes Lauterbach

As Chairman of the Conference of Health Ministers (GMK), Bavaria's Health Minister Klaus Holetschek (CSU, 58 years old) gained fame throughout Germany during the pandemic. The former ombudsman presents himself as a “doer” who likes to get things done quickly; his greatest opponent: unnecessary bureaucracy. For 2023, he has set himself the goal of credibly improving the care situation and getting more exercise in his private life. He gave up smoking twelve years ago. WELT met him in Munich for an interview.

WORLD: The hospitals in Bavaria are full again. Not an easy time, is it?

Klaus Holetschek: The situation, especially in the children's hospitals and with the resident doctors, is still tense. In Bavaria we are not badly positioned with 3000 adult intensive care beds plus a good 400 pediatric intensive care beds, but there is simply a lack of staff in all places.

WORLD: Medicines are also currently in short supply – how do you want to take countermeasures?

Holetschek: Over the holidays, we asked the paediatricians to only state the active ingredient on prescriptions so that the pharmacies can then produce their own fever juices, for example. In order to reduce dependence on countries like China in the long term, I advocate a clever stockpiling system. And one should also investigate whether, in extreme cases, the Bundeswehr could manufacture and supply drugs. We need to see medicines as part of the critical infrastructure. It used to be said that Germany was the pharmacy of the world. But then we drove innovation and important production out of our country with bureaucracy.

WORLD: The pandemic is slowly coming to an end. Bavaria was the first federal state to abolish the obligation to wear masks in public transport. Federal Minister of Health Karl Lauterbach and many of your state health minister colleagues want to continue to do so - with reference to other respiratory diseases. Don't they understand the Infection Protection Act correctly?

Holetschek: To be clear: I still recommend wearing a mask. But if I interpret the Infection Protection Act correctly, then a mask requirement is linked to the fact that the health system is overloaded - due to the corona virus. Ergo: Because of the flu and RSV, I can't make a mask compulsory unless I change the law or make an opening clause. Neither has happened so far.

WORLD: How do you feel about the mask requirement in long-distance transport?

Holetschek: Definitely pick it up and turn it into a recommendation. After the mask requirement in air traffic was abolished, the nationwide rules are no longer consistent anyway.

WORLD: Chancellor Olaf Scholz is opposed.

Holetschek: I am surprised that the chancellor is sticking with Lauterbach and not with his Minister of Justice, who should know the legal situation best and has called for the obligation to be abolished.

WORLD: Your tone has become sharper when it comes to Lauterbach. Most recently, you accused him of "teaching" his country colleagues.

Holetschek: It's not exactly clever when some things are passed through Twitter, press conferences or other channels before they reach us. I have the feeling that he doesn't treat the countries as equals, but maybe they are just one of many lobby groups for him. Then he should deal with the federal structure of our state - because it just doesn't work that way.

WORLD: At the turn of the year, the institution-related vaccination obligation ends. What to do with nurses who lost their jobs as a result?

Holetschek: First of all, it's a good thing that it's being phased out. I asked for that very early on.

WORLD: But you campaigned for compulsory vaccination to be introduced at all.

Holetschek: I advocated a general obligation to vaccinate and saw the facility-related obligation to vaccinate as the first preliminary step. At a certain point, however, it was noticed that there was no general obligation to vaccinate, and so we said that we could no longer carry out the facility-related one - that endangers the security of supply. All nurses who were already employed were allowed to continue working with us. Those who didn't want to be vaccinated couldn't be reinstated at certain institutions, yes - but we can't change that now afterwards.

WORLD: How do you get more doctors and nurses?

Holetschek: The working conditions must become more attractive - then we can also push back temporary work. We need reliable duty rosters, tax-free allowances and returnee programs. For me, this goes as far as state-subsidized housing and preferential treatment of childcare options. We can't get any further with small-small.

WORLD: Topic Corona. As part of the GMK, you spoke out in favor of a commission of inquiry on the subject of "Child health in times of a pandemic" at federal level. Wouldn't such a review body also be something for Bavaria?

Holetschek: We now had a committee of inquiry in Bavaria that dealt with a sub-topic of the pandemic and, in my view, came to the conclusion that the state government acted correctly in essence - for example in the procurement of masks.

WORLD: It was more about personal misconduct. I meant an all-encompassing assessment of the measures in Bavaria.

Holetschek: I don't think we need such a commission. Within the government, we have always reflected on the measures we have taken and draw lessons from them for the future. And you mustn't forget: Our measures have been subject to permanent judicial review. Of a total of 1,851 cases in which my ministry was involved, we only lost in 42, and 221 are still ongoing.

WORLD: From my own experience, I can say that Bavaria intervened particularly severely in the freedoms of its citizens. New rules were announced almost every week, and Parliament was only symbolically involved. Didn't the whole thing already have authoritarian traits?

Holetschek: No. Of course, a lot could have been done better in terms of communication. But in a disaster, where something happens all the time that you cannot be prepared for, the state must be able to act quickly to protect people. There were no corona vaccines and no medicines. When I phoned hospitals or retirement homes, the desperation on the phone was palpable.

We have always struggled to find the right way, listened to countless experts, often had to readjust the regulations. There were new developments and different needs to consider. It wasn't easy. But in an emergency situation you will never be able to discuss every point to the end. Far too often people complain that politicians don't dare to make difficult decisions.

WORLD: All of this could now be dealt with publicly in Parliament.

Holetschek: Do you think that we were not transparent in Parliament? We really had government statements, urgent requests or questions from MPs all the time in the state parliament sessions. And look at the press releases from other parties such as the SPD or the Greens - they supported many of our measures.

WORLD: The opposition could also question itself self-critically. Last winter, unvaccinated people were almost completely excluded from social life, were no longer allowed to visit bars and events, and were no longer allowed to pursue their hobbies. It even hit students. Do you regret it afterwards?

Holetschek: There was a nationwide consensus among the prime ministers and experts that vaccination is the most important tool for avoiding serious illnesses. Because of Delta, the healthcare system was at risk of being overwhelmed, and we had to protect the vulnerable groups in particular. The consideration was and is that vaccinated people have a higher protection against becoming seriously ill themselves than unvaccinated people.

WORLD: You also justified 2G by saying that the vaccination would protect against the virus being passed on.

Holetschek: Yes, at that time the prevailing opinion was that vaccination also protects others. Under the dominance of the omicron variant, one has really seen that infections can no longer be ruled out, even in vaccinated people. I know you say you knew that before.

WORLD: A lot of trust in politics has also been lost due to the distorted incidence of the unvaccinated and the vaccinated, especially in Bavaria.

Holetschek: From my point of view, everything has been said about that.

WORLD: The measures have temporarily brought the cultural and leisure sector to a complete standstill - in Bavaria of all places, which according to the constitution is a cultural state. Was it too easy to label certain areas as not systemically important and underestimated their importance for society?

Holetschek: In order to stop the spread of the virus, we had to close everything that was not absolutely vital. Today I would say that culture is also food - that is certainly one of the lessons of the pandemic.

WORLD: Young people in particular were mentally stressed by the measures. Despite this, it is still very difficult to find a therapy place. What are you doing to improve the situation?

Holetschek: We have created new study places for psychotherapy. I also believe that in the future we will no longer need so many inpatient therapy places, but rather a network of low-threshold offers such as outpatient clinics. The first contact can be switched to digital. Overall, we simply have to acknowledge that these clinical pictures are actually increasing compared to before.

WORLD: At the beginning of the pandemic I was 19, now I'm 22. It should actually be the best time in life. Instead, young people had to cut back a lot during Corona. Do you have an idea how we could be compensated for this in terms of intergenerational justice?

Holetschek: Other generations also had to accept shocks that were terrible. Nobody deliberately initiated the pandemic. It was an irretrievable time that had to be overcome and from which we must learn for the future. Is there any reasonable compensation for this?

WORLD: Other countries are giving away vouchers for cinema tickets, books and concerts.

Holetschek: We also did something like that for club sports. But if you tell me you've lost two years of your life and I give you a voucher like this, you wouldn't feel that you were being taken seriously. Many young people also understood the measures and adhered to them out of responsibility towards their older family members. I see that with great appreciation.

WORLD: A topic that concerns young people, but also you, are the traffic light plans for cannabis legalization. They try everything to prevent this project. At the same time, drinking alcohol is celebrated in Bavaria like no other federal state. Is not that a contradiction?

Holetschek: I think we have a very credible drug policy in Bavaria that has developed over many years. We do a lot of prevention work and support those affected and their doctors. Of course we also have problems with alcohol and tobacco. But that's exactly why you don't have to open a new barrel with cannabis now. It would have been nice if Lauterbach had taken a look at one or the other country during his visit to America, where you can now see that the number of diseases has increased and that the black market has by no means been eradicated.

WORLD: Bavaria is notorious for punishing cannabis users severely. Is it still proportionate for people to lose their jobs or have a criminal record just for passing around a joint?

Holetschek: The public prosecutor's offices have a certain amount of discretion, which they are already making use of. But it would be a dangerous trivialization to say that cannabis is a stimulant like any other. Doctors warn that it contributes, among other things, to the development of psychoses in young people. It is also often taken in combination with other addictive substances – with high-risk effects that are difficult to assess. And now we are supposed to allow cannabis to be bought on every corner without assessing the consequences for road traffic, for example? To me, that shows that this prestige traffic light project is more about ideology than health protection.

WORLD: But what you describe also applies to alcohol.

Holetschek: You won't be able to ban it that easily. In every state there are certain things that are historically just there.