Germany’s healthcare system remains critically unprepared for a large-scale conflict, according to Andreas Gassen, chairman of the Federal Association of Statutory Health Insurance Physicians (KBV). His stark assessment, delivered in an interview with the “Neue Osnabrücker Zeitung”, highlights a concerning lack of preparedness despite the ongoing war in Ukraine and the escalating geopolitical tensions.
Gassen warned that Germany is “not even remotely prepared” for an attack resulting in mass casualties, emphasizing the need for readily available primary care physicians to treat the wounded. Four years after Russia’s initial invasion of Ukraine, a comprehensive federal plan outlining the optimal utilization of all medical resources and addressing critical issues like storage remains absent.
While acknowledging the professional competence of the Bundeswehr’s medical units, Gassen asserted that Germany’s overall healthcare infrastructure and arguably the nation as a whole, is far from “combat-ready”. This vulnerability extends beyond the immediate provision of medical care, focusing particularly on the protection of vital infrastructure.
Gassen highlighted a critical blind spot: the nation’s lack of resilience to hybrid warfare tactics such as disruptions to power and water supplies. He questioned the availability of backup power generators and alternative water sources at medical facilities, beyond hospitals. “We are completely exposed in this regard” he stated, emphasizing the urgent need to address these deficiencies.
The current cohort of general practitioners, Gassen suggested, would be “hardly useful” in a conflict zone, having to maintain routine patient care while simultaneously facing extraordinary circumstances. He proposed the creation of a nationwide register, potentially voluntary, compiling information on medical professionals, their locations and their potential deployment capabilities in an emergency. This register would facilitate the rapid mobilization of personnel in a crisis, especially considering the potential need to recall reserve staff from hospitals, creating further staffing gaps.
The KBV is currently compiling a comprehensive assessment of vulnerabilities, actively collaborating with the Bundeswehr and recently consulting with Ukrainian colleagues for firsthand experience. These consultations underscored the devastating reality of warfare – that Russia is deliberately targeting not only civilian populations and critical infrastructure but also hospitals and medical personnel. Gassen stressed that the Ukrainian experience revealed the critical importance of preparing for the collapse of infrastructure alongside the immediate challenge of treating casualties.
The promise of legislative action made by former Health Minister Karl Lauterbach in March 2024 to improve Germany’s preparedness for military conflict has yet to materialize. There is currently a dearth of information regarding plans from his successor, Nina Warken, raising serious concerns about the government’s commitment to addressing this critical vulnerability. The ongoing situation demands a reassessment of Germany’s national security posture and a rapid implementation of actionable strategies to safeguard the nation’s healthcare infrastructure and personnel.
