A Shortage of Hospital Beds and Underfunding in Pediatrics: The Case of Meningococcal B Vaccination and RSV Immunoprophylaxis
Dear Parents, Teenagers, and Children,
Please support us in our work in pediatric and adolescent medicine. We would like to draw your attention to some issues in pediatrics:
A. Berlin is a growing city; unfortunately, the number of pediatric hospital beds has been steadily declining for the past twenty years, as illustrated by the attached *Tagesspiegel* article from July 2, 2024:
In some cases, we have been forced time and again for years to refer children from our practice to the children’s hospitals in Nauen or Ludwigslust because there are no available beds for children and adolescents in Berlin. The situation is even more difficult in child and adolescent psychiatry. This cannot and should not be the case. The children’s hospitals need better funding, more staff, and more beds at the Pediatrics.
B. We very much welcome the introduction of new intramuscular vaccines against meningococcal B and passive immunization against RSV. Unfortunately, health insurance companies and the Ministry of Health are attempting to fail to recognize our work in a manner commensurate with the effort involved in terms of labor, staff, and space.
1 - Meningococcal B Vaccination: Statutory health insurance providers and the Ministry of Health offer us, as medical practices, 4–9 euros for the essential meningococcal B vaccination of an infant or toddler, whereas, by comparison, your veterinarian charges you 30–70 euros for vaccinating your pet, in accordance with the fee schedule for veterinarians. We demand equal recognition for the work performed on your child and corresponding compensation. For this reason, pediatric and adolescent medicine practices have entered into a dispute with the health insurance companies. As a result, you are currently receiving an invoice from all pediatricians for the meningococcal B vaccination that is equivalent to the invoice for private patients, since there is still no billing code in the EBM for the meningococcal B vaccination covered by health insurance. This invoice is based on the Schedule of Fees for Physicians (GOÄ), which has not been updated for 30 years.
If you are having problems getting reimbursement from your health insurance provider, please read the following:
Please note that while your health insurance company bills us directly for all other vaccinations, we still receive only 7–20 euros for administering the vaccination to your child. Unfortunately, this does not cover our costs. As a result, pediatric practices are forced to vaccinate more and more children in less and less time. We feel this is disrespectful to you, your children, and our staff.
2 - RSV Immunization: We are not to be reimbursed at all for the counseling, labor (including storage and administrative costs), and other expenses associated with intramuscular RSV immunization using an RSV antibody, whereas the technically identical administration of COVID antibodies to at-risk groups during the pandemic—using the same intramuscular route—was reimbursed with a three-digit euro amount, and pharmacists receive approximately 19 euros solely for the storage and administration of the RSV antibody:
It is no coincidence that most pediatric practices are forced to provide assembly-line care—often with outdated equipment—in small, rather dim ground-floor offices. The funding allocated to pediatricians puts us at a significant disadvantage compared to our colleagues in fields such as dentistry, ophthalmology, and dermatology.
We are calling for more hospital beds for children and adolescents in Berlin and fair compensation for our work, so that we can continue to provide high-quality medical care for our young patients in our beautiful facilities equipped with state-of-the-art technology. SUPPORT US!
Your practice team