German hospital group terminates nurse after criticism of situation in ICUs

As new infections reach record levels in Germany, the number of people requiring hospitalization for COVID-19 is growing. In the midst of the pandemic, the privatized hospitals are putting staff and patients under enormous stress in order to grind out greater profits. Reports of the terrible conditions in intensive care units (ICUs) are being brutally suppressed.

Romana Knezevic, a nurse at the Asklepios Klinik St. Georg in Hamburg, experienced this firsthand. After she spoke to the Hamburg Journal on December 17 about the disastrous conditions in the hospital’s ICUs, the hospital group terminated her for alleged misrepresentation.

In the interview, the Asklepios Clinic employee and works council member described how treatment and end-of-life care for patients suffered under the shortage of personnel. For example, in the ICUs at St. George’s, staffing ratios are often one to five, although a ratio of one to two or one to one is normally envisaged. There are also too few cleaning staff, she said, so their work has to be done by nurses, leaving less time for patient care. Knezevic also spoke of patients dying alone in their rooms, without consolation and company.

The nurse made it clear that the situation had already been strained before the pandemic. With the many additional cases, some of them severe, it has moved beyond the pale.

The Asklepios Clinic defended the termination and denied all accusations. “It is unacceptable that employees knowingly spread false information to the media for ideologically and politically motivated reasons or present exceptional situations as the regular case,” a company spokesman said.

However, there is no reason to doubt the nurse’s statements. The allegations made by the company management serve solely to set a precedent and intimidate any employee who would dare to call out the catastrophic conditions.

The Hamburg Hospital Movement (Hamburger Krankenhausbewegung) had already spoken out publicly to inform the public about systematic overwork and chaotic conditions at several hospitals in Hamburg. Another intensive care nurse from St. Georg had already told the Hamburger Morgenpost that at times she had to care for three to four patients at the same time, although a care ratio of one to two was stipulated. “We can’t do it,” she said, “and it’s life-threatening for the patients.”

“The stress level has gone up immeasurably,” complains a nurse at another clinic. There was not enough or inappropriate protective equipment for staff. An intensive care nurse at AK Wandsbek reported that masks and gloves are not available in all sizes. “People are acting as if the second wave came as a complete surprise,” the nurse said.

After the article was published in the Hamburg Journal, around 30 employees of the clinic protested in front of the hospital against the conditions. Interviews with Hamburg Journal on December 21 substantiate Knezevic’s contentions. Nurse Meike Saerbeck explained that their station has “too few personnel in every shift” and must care for up to five intensive care patients. Another nurse confirmed that adequate end-of-life care can no longer be provided.

The conditions at the Asklepios Clinic are not surprising. Even before the pandemic, there were numerous reports of abuses at the company’s clinics. Two years ago, doctors at the clinic declared that safe patient care was “no longer an unqualified certainty,” as quoted in Der Spiegel .

The news magazine reported that doctors spent months warning management about the serious staffing shortages. “In endangerment notices, the physicians sound the alarm and describe disastrous conditions in the hospital group, which is known for its profit drive. Emails, notices and duty rosters presented to Der Spiegel document how Asklepios spreads physician personnel painfully thin and risks patient well-being in the process. Numerous court rulings show that the group even had to pay high regulatory fines because of duty rosters rejected by the works council.”

Alsklepios is one of the leading private hospital groups in Germany. It operates 160 facilities and employs around 49,000 people. By its own account, the group operates Europe’s largest hospital cluster in Hamburg.

The rise of the company, founded in 1985, is representative of the privatization of the public health care system in Germany and highlights its impact. The group primarily took over public hospitals that were sold by federal states or municipalities, sometimes far below value, in order to improve their finances. In 2004, the city of Hamburg sold off the municipal clinics to the private operator. In the same year, Asklepios took over Rhön-Klinik AG, which increased the group’s market share enormously.

Despite a global pandemic and the collapse of clinics under the daily increase in intensive care patients, the group said in this year’s interim report that 2020 was “among the most successful in Asklepios’ history.” Although the number of patients fell by 11.7 percent between January and June, revenue in the first half of the year rose 3.1 percent year-on-year to around €1.8 billion.

Asklepios and other private hospital groups are rubbing their hands in light of the pandemic, expecting gushing profits. On the other hand, smaller clinics, and municipal clinics in particular, are increasingly running into financial difficulties as a result of the pandemic. Several clinics have already declared that they will not be able to pay salaries in the first half of the year without government aid. As recent decades have shown, this is the pattern after such hospitals are sold off cheaply to private corporations.

The announcement of Knezevic’s dismissal has caused public outrage. Dr. Kai Uwe Helmer said on Twitter: “Nothing positive is to be expected from Asklepios in Hamburg, but when people are dying lonely deaths from Corona and those who point that out and want to change it are attacked, that busts the bottom out of the barrel. This dismissal is a disgrace!!! Solidarity with the workers!!!”

“This is of course how you put pressure on the rest of the workforce—see what happens when you criticize us/working conditions,” another comment read. Another user tweeted, “Such incidents show that private companies and profit motives have no place in health care. Clinics are tasked with patient welfare and belong in public hands!”

Contrasted to the justified anger and indignation among employees, the hypocrisy of politicians and trade unionists is nothing short of outrageous. While representatives of the Verdi union call the dismissal “excessive” and publicly criticize Asklepios, union representatives sit on the supervisory board and are perfectly well informed about the practices and conditions in the company, and fully support them.

When Deniz Celik, health policy spokesman for the Left Party in Hamburg’s parliament, calls the dismissal “filthy,” this cannot hide the fact that his party represents the policies that make this possible. In Berlin, for example, the Left Party, in cooperation with the Social Democratic Party, has rigorously privatized public enterprises for years. The Senate coalition of SPD, Left Party and Greens is responsible for disastrous conditions at clinics in the German capital, which are collapsing under the weight of coronavirus cases. Since the beginning of November, 10 percent of clinic employees in the state of Thuringia, where the Left Party state premier, Bodo Ramelow, has backed the concept of “herd immunity,” have tested positive for COVID-19.