BERLIN (dpa-AFX) - The proposals of the government commission on hospital reform violate the legislative competence of the federal states enshrined in the constitution, according to a study. "The Basic Law does not provide for a legislative competence of the federal government, neither for the hospital system in general nor for hospital planning in particular," says the 144-page legal opinion, which will be presented in Berlin on Thursday. Author of the study is Ferdinand Wollenschläger, holder of the chair for public right, European right and public economic right at the University of Augsburg.

The study was commissioned by the three Union-led health ministries in Bavaria, North Rhine-Westphalia and Schleswig-Holstein. It was to examine the constitutionality of the expert proposals submitted by the 17-member government commission on hospital reform.

According to the report, the states must retain considerable independent scope for hospital management even after the reform. In short, the federal government is not allowed to make any regulations that influence the hospital structure of a federal state.

The concept of the expert commission presented in December is the basis on which the legislative plans are to be oriented. However, some other emphases have already become clear in federal and state consultations. In essence, the remuneration system with flat rates for treatment cases is to be changed in order to relieve clinics of economic pressure. In order not to be dependent on more and more cases, they are to receive a larger share simply for providing services. The plan also calls for the hospital network to be divided into three levels of care and financed accordingly - from basic care close to home, to a second level with additional services, to maximum care providers such as university hospitals.

Critics of the reform plans fear that emergency care and regular inpatient care cannot be maintained in many hospitals as a result. Bavaria already presented a study in February, according to which every eighth hospital in the Free State is at risk. Local authorities have also repeatedly warned of a collapse in hospital care./had/DP/zb