“Otherwise you drive the entire system against the wall”: St. Gallen health director Damann is now speaking

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The tremors have started among the employees of the hospitals in St. Gallen. 440 jobs will be lost. Layoffs are inevitable. St. Gallen’s health director, Bruno Damann (66, center), comments.

Blick: Mr. Damann, the hospitals in St. Gallen have been suffering losses for a long time. Why are these layoffs happening now?
Bruno Damann: Such steps are always unpleasant. The board of directors had to respond to the financial difficulties and take these measures to ensure the future financial health of the hospital groups.

The government of St. Gallen also has a seat on the board of directors of the hospital association…
The government only determines the basic parameters and the hospital network then works independently. Anyone who wants freedom must now also take responsibility.

In June, voters helped hospitals with a financial injection of several million francs. Isn’t it cynical to fire people a few months later?
Today’s decision is painful, but it is better to act now or you will drive the entire system against the wall.

The Grabs Hospital can be expanded at a cost of 100 million francs, and scaffolding is also in place at the St. Gallen Cantonal Hospital. Is the canton too dependent on real estate instead of personnel?
No. The buildings were in poor condition. These investments are absolutely necessary. We think skilled workers are better if they can work with modern materials and modern infrastructure.

You recently complained about a shortage of skilled workers, and now you are laying people off. How does this work?
Without knowing the details, I don’t think you would lay off many nursing and medical staff. In my opinion, the majority of clerical and clerical jobs will disappear.

So nothing changes for the medical staff?
It would be useful if the nursing sector also started working more efficiently. Until now, people have worked far too much alone in their own environment. You have to think as a group and use your staff more flexibly.

There are also hospitals that make a profit. In Thurgau, hospitals even yield dividends. What’s going wrong in St. Gallen?
The Canton of Thurgau already implemented the reforms that we need to implement in the 1990s and concentrated on fewer locations. We have to make that right now. Unfortunately, this now means a dry period. In addition, inflation was not reflected in the rate.

Then healthcare costs continue to rise. To combat this, you have argued for fewer health insurers.
We currently have 44 health insurers. They don’t really compete with each other, they just poach good patients from each other. Five to ten different health insurers are sufficient. Then administration and IT will also become cheaper.

Another idea is for the federal government to take over hospital planning.
I don’t agree with this. We might as well do that because we can see where the patient flows are. However, I am in favor of cross-border planning.

Finally, you wanted to make plans together with the cantons of Thurgau, Graubünden and Glarus. But they got out again. Doesn’t this show that such cross-cantonal planning does not work?
The federal government would already have the option to set up planning groups from different cantons, similar to public transport. I hope that we can work with all cantons of Eastern Switzerland to determine hospital locations. But I don’t believe in the fact that it is ‘prescribed’ from Bern. The cantons of St. Gallen, Appenzell Innerrhoden and Ausserrhoden are making a start and will release a common hospital list as early as 2024.

They have already closed hospitals, but now they are cutting back on staff. Is the quality guaranteed in the hospitals of St. Gallen?
Yes. This is our top priority.

Source:Blick