Minister: Half of Hospitals Face Problem - Lower Saxony warns Germany's hospital reforms risk closing local clinics

Lower Saxony's government has raised concerns over Germany's planned hospital reforms. Health Minister Andreas Philippi acknowledges the changes as a chance for improvement but insists on urgent adjustments. Without revisions, he warns, the new rules could threaten many hospitals in the region.

The reform introduces performance tiers, setting strict standards for equipment, specialist staff and treatment criteria. Hospitals must meet these to bill statutory health insurers. A key issue is the proposed minimum staffing thresholds for nursing personnel—particularly in intensive care units.

In Lower Saxony, half of all hospitals could be impacted by the new staffing requirements. Failing to meet thresholds in high-care units may lower a hospital's performance classification and cut its funding. The Lower Saxony Hospital Association has also criticised the plans, arguing that excessive bureaucracy could undermine the entire reform. Minister Philippi has directly contacted Federal Health Minister Nina Warken to push for changes. The Bundesrat will review the reform amendments on March 27. Meanwhile, the INPULS tool for assessing intensive care staffing remains unapproved as of February 2026, with further testing still needed.

The reform's success now hinges on upcoming revisions. Without adjustments, many hospitals in Lower Saxony risk losing funding or facing downgrades. The Bundesrat's decision later this month will determine whether the concerns lead to concrete changes in the policy.