Paediatric surgical reality in Germany and visions for the future

Over the past 2 centuries paediatric surgery has developed into a well-reco gnised, independent surgical speciality comparable to plastic surgery or th oracic and vascular surgery. About 550 members of the GAPS (German Associat ion of Paediatric Surgery) annually treat about 2-3% of all 0-15-year-old c hildren of the FRG and operate 32.5% of all children who need a surgical in tervention in paediatric surgical centres. There are 83 paediatric surgical centres in the FRG. Most of them perform more than 2000 operations per yea r. Three newer developments are likely to influence the future of paediatric s urgery in Germany: 1. demographic factors, particularly the massive reducti on of the reproduction rate from factor 1 to 0.59; 2. the new German Nation al Health Care System, called "Strukturreform 2000", which will introduce t he Australian DRG system and a new administrative structure permitting only a restricted care of the patients under tight economic control; and 3. the European regulations of the UEMS/EBPS which the national Landesarztekammer n will be required to adopt.