The West German health and social services: A comparison with their British equivalents

Abstract

An analysis has been made of the German local government, health and social services, with particular reference to West Berlin. A comparative study of these with those of Great Britain show many points of similarity but also reveal several fundamental differences. These are:— o (i) Federal, Land and Local Government .—The Land , like the American State, is the sovereign power in the federal system. Its local government units are based on regional groupings which incorporate both town and country and control almost all public utilities and services which are situated within their own area. (ii) Health Services .—( a ) By their almost complete devolution of authority from the Land to the local unit of authority, the latter's health department has the opportunity of offering a much more comprehensive co-ordination of all social, health and welfare agencies at community level. ( b ) Insurance medical practice is still a part of the general insurance scheme. Great Britain would have had a comparable scheme if, in 1948, the National Health Insurance's range of medical care had been extended to cover dependents and all forms of institutional treatment. (iii) Social Insurance .—( a ) The insurance schemes run by public corporations, are actuarial in that they are self-supporting and, within an upper and a lower limit, the more a man earns the greater his contributions and his eventual benefits. As these schemes are entirely independent of the Land finances, the individual contributions are much higher than those in Great Britain. ( b ) These insurance schemes show, incidentally, that the Germans have accepted the principle of equal pay for equal work. In the salaried groups the pay is weighted for both marriage and children. (iv) Labour Department .—( a ) Unemployment benefits include a rent assessment and so are relatively higher than those in Britain. There is, however, a tighter means test employed for those on assistance. ( b ) The German trade unions have advanced beyond joint consultation in industry to an active share in industrial policy decisions.