Citizen proposals on hospitals in the Regen district

What will a sustainable hospital provision look like in the Regen district? This question was the focus of the public dialogue “ARBERLANDKliniken 2035”.

From November 2025 to February 2026, 60 randomly selected citizens discussed the challenges facing healthcare with experts, politicians and hospital managers. The result: the participants called for far-reaching changes – and the majority recommended the construction of a central hospital.

The public dialogue is regarded as an exceptional participatory project across Bavaria. Out of more than 3,000 residents who were contacted, 60 people were selected by lottery. The aim was to create as diverse a cross-section of the population as possible. Over the course of five dialogue evenings, those selected engaged intensively with topics such as hospital reform, quality of medical care, emergency care, the shortage of skilled staff and the financial framework.

Healthcare: a complex issue

It became clear just how complex the future of healthcare has become. Experts explained the implications of federal reforms, hospital managers outlined economic constraints, and citizens shared their expectations and experiences. The outcome was not only a comprehensive report on the findings but also a broad consensus.

The most important recommendation concerns the hospital structure in the district. After careful consideration, the majority of the dialogue group members are in favour of establishing a central hospital. Maintaining two fully-fledged hospital sites in their current form, on the other hand, is not regarded as a viable long-term solution.

Recommendations submitted to the district council

From the citizens’ perspective, the key factors were, above all, the quality of medical care, securing specialist staff, and the requirements of the nationwide hospital reform. At the same time, they made it clear that a central location could only be accepted if accessibility, emergency care and local outpatient care remained guaranteed.

In addition to inpatient care, the participants recommended expanding outpatient services and strengthening links with the hospitals. They also identified a need for action regarding digitalisation, the recruitment of specialist staff and reliable funding for the hospitals.

On 9 June 2026, members of the citizens’ dialogue presented their recommendations to the Regen District Council.

From information to participation

For many participants, the format of the dialogue was particularly noteworthy. Instead of presenting pre-determined decisions, the district opted for an open participatory process. Expert presentations, moderated discussions and group work enabled citizens to familiarise themselves with the complex subject matter step by step.

When presenting the results, the spokespersons for the Citizens’ Dialogue emphasised the importance of this approach. They noted that the open discussion of differing viewpoints had played a key role in formulating viable recommendations.

District Administrator Dr Ronny Raith also regards the dialogue as a success. “I am delighted that the public dialogue has helped you to put forward concrete recommendations and that you were satisfied with the discussion platform. This positive feedback confirms to me that we have taken the right approach.” Right at the start of the process, Raith had set out the objective: “We are deliberately involving the public in order to hear different opinions and better understand their needs.”

Recommendations with political weight

The results of the public dialogue are not legally binding. Nevertheless, they are intended to form an important basis for further decisions by the ARBERLANDKliniken Board of Directors and the District Council. The recommendations for action are also addressed to the Free State of Bavaria and the Federal Government, and address issues such as hospital funding, infrastructure and the reduction of red tape.

The public dialogue thus serves as an exemplary demonstration of how public participation can work even when dealing with highly complex health policy issues. Over the course of the process, initial expectations and concerns gave way to a nuanced picture of the challenges. Many participants concluded that changes are necessary to safeguard medical care in the long term.

Translating recommendations into decisions

‘ARBERLANDKliniken 2035’ therefore marks not merely the end of a participatory project. Rather, the political task now begins of translating the jointly developed recommendations into concrete decisions for healthcare provision in the Regen district.

Note: This article was written with the help of AI