From next year, patients in the city of Essen will have to pay part of the cost of travelling by ambulance themselves. This was decided by the city council on 10 December 2025. The background to this is a dispute between local authorities and health insurance companies about so-called „empty journeys“, i.e. journeys where the patient is not taken to hospital. These empty runs account for around a quarter of the total number of ambulance call-outs. As the health insurance companies have recently refused to cover the costs of these empty runs, the cities and districts are threatened with a considerable financial deficit in the future. At the same time, the law on charges forces local authorities to cover the financial requirements of the emergency services. In Essen, patients are therefore now being asked to help close the funding gap for the providers.

However, the city of Essen is not alone in facing this problem: several districts and cities in North Rhine-Westphalia and Brandenburg are currently examining how they can achieve cost recovery. We are eagerly awaiting the hearing of the Berlin-Brandenburg Higher Administrative Court at the end of January 2026, which is expected to clarify the legal situation - at least for Brandenburg. Lawyers Dr Maximilian Dombert and Michael Jessen-Lieberum are representing the district of Teltow-Fläming in these proceedings.