Spitex wants more money: dispute about childcare costs escalates

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Giana (1) has had three surgeries in her short life. The girl has a windpipe that is too soft and an esophagus that is too narrow. She had to be ventilated and artificially fed. Still, she was able to go home quickly. The Kinderspitex helped with this: an employee is there two to four hours a day and takes care of the girl, writes the “Spitex Magazin”.

About 2,600 seriously ill children like Giana are cared for by Spitex. Disability insurance (IV) pays for children with congenital defects – however, this rate does not cover all costs. The Spitex has long discussed the compensation with the IV. Now it’s time for a bang: the Spitex associations will cancel the IV collective labor agreement at the end of this year.

Dispute over 30 francs

From Spitex’s point of view, the nurses receive too little money. «The current rate is CHF 114.96 per hour. However, we would need 145 francs,” says Marianne Pfister, co-director of the umbrella organization Spitex Switzerland. 30 francs are therefore uncovered. So far, the cantons and municipalities have adopted this difference. However, the latter are not obliged to do so, as the infusion must cover the full costs, says Pfister. The association warns: If the Spitex for children no longer existed, “Switzerland would have a major problem with the safety of care for seriously ill and dying children”.

At its core, it involves a data dispute. The Spitex must provide the drip with data showing the costs of care. Spitex had the data collected by an independent audit firm. The IV accepted the method and scope — but not the results, Pfister says.

The responsible Federal Social Insurance Service (BSV) takes the position that the data is not transparent enough and is not sufficient to explain the huge cost differences between the different Spitex organizations.

Federal agency is angry

But even if talks continue, the mood is likely to be dire. Because the BSV accuses the Spitex of fake news. Because in the press release, Spitex writes that the federal agency even wants to lower the rate to 107 francs.

That is not true, the agency said. “The IV is not intended to reduce the applicable rate, but to maintain it.” The Federal Bureau finds unusually clear words. One was “strange” about the various false claims. It is therefore also wrong that the infusion is obliged to cover the full costs.

When asked, Pfister rowed back. The BSV only “indicated” that the rate should have been reduced based on their data. But anyway: “The current rate is too low. It’s not enough to keep it. The children’s Spitex needs more money.”

Children and parents should not suffer from collective bargaining disputes

Pfister emphasizes that Spitex does not want to put the dispute on the children’s shoulders. Instead, the audience must be formed early on. “We have been talking about the database for a year and not about the rates. Now there has to be a solution.”

But what will happen to the children if there is no solution in January 2024? The BSV writes that the financing is complete and there is no deterioration for the children. Even after termination, the collective labor agreement remains valid for one year.

If no contract is concluded, the office staff can extend the contract for another year or even set a rate later. For Pfister, that’s only half the story. “The decisive factor is whether the cantons and municipalities want to continue to pay the difference. Otherwise, the Spitex children’s organizations will no longer be able to finance their work.”

What do the cantons think? The Conference of Health Directors (GDK) is covered. “The GDK will insist that a new contract with cost-covering rates can be concluded as soon as possible.” Regionally different rates are also conceivable.

Source:Blick