The funding of certain further medical training courses has been significantly expanded in recent years. In 2015, the minimum number of training positions in general medicine to be funded increased from 5,000 to 7,500. In 2019, the further training of specialists in primary care was further improved by increasing the number of positions to be funded nationwide from 1,000 to up to 2,000. In addition, funding for further training in paediatrics and adolescent medicine was explicitly stipulated. It was explicitly stipulated that at least 250 paediatricians and adolescent doctors are to be funded. Trainees in outpatient care should initially receive the same remuneration as assistant doctors in hospitals.
Improving psychotherapeutic care
In order to strengthen psychotherapeutic care, the G-BA made the regulations on the range of therapies significantly more flexible in its Psychotherapy Guideline of 2017. This relates in particular to the establishment of psychotherapeutic consultation hours as low-threshold access, the promotion of group therapies and the simplification of the application and review process. In addition, the appointment service centres of the associations of SHI-accredited physicians were obliged to arrange appointments for an initial consultation within the framework of such psychotherapeutic consultation hours and for the promptly required treatments resulting from the clarification.
In addition, the powers of psychotherapists to prescribe certain services have been extended more and more over time. For example, they can prescribe services for psychotherapeutic rehabilitation, ambulance transport, hospital treatment, sociotherapy, psychiatric home care and occupational therapy. In addition, psychotherapists can now also offer video consultations. In 2019, the G-BA also decided to significantly increase the licensing options for psychotherapists. In this way, more needs-based care will be achieved.
Improving midwifery care
Ensuring nationwide provision of midwifery care, including the free choice of place of birth, is an important concern for the Federal Ministry of Health. In order to achieve this goal, the conditions for practising midwifery must be improved. For example, the GKV-Versorgungsstärkungsgesetz (GKV-VSG) of 2015 restricted the right of recourse of health and long-term care insurance funds against freelance midwives. This contributes to a reduced use of liability insurance and thus to a long-term stabilisation of insurance premiums and ensures a nationwide provision of midwifery care. Freelance midwives who provide obstetric care services and meet certain quality requirements are entitled to a guarantee supplement, which relieves them of the financial burden of insurance premiums.
With the Prevention Act (PrävG), which came into force in 2015, the period during which insured persons can be cared for by a midwife in the puerperium was extended by four weeks to now twelve weeks. If ordered by a doctor, care can also be provided for longer.
The comprehensive provision of midwifery care is an important prerequisite for the free choice of place of birth.
To support families looking for a freelance midwife, the GKV-Spitzenverband provides an electronic search directory on its website due to a legal obligation. With the help of access to a comprehensive database, it is possible to search for midwives who work in the vicinity of the insured person.