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Alpine clinics run out of puff

(hoehenklinik-davos.ch)

Sanatoriums in Davos, famous for treating lung patients with a dose of fresh alpine air, are undergoing a crisis, with three being forced to shut down.

swissinfo paid a visit to the village in canton Graubünden to find out whether the closures signal the end of the alpine resort as a centre for health and well-being.

Davos, which lies high in the mountains at an altitude of 1,500 metres, has been a magnet for lung and rehabilitation patients for over a century.

In its heyday – the 1920s and 1930s – doctors would send their patients from all over Europe to Davos’ two-dozen clinics to recover from tuberculosis (TB).

German author Thomas Mann even based his novel, The Magic Mountain, an ironic tale of TB patients in Davos, on the German-run Valbella Clinic.

But having survived a post-war cut in clinic numbers, due to the discovery of antibiotics as a cure for TB, the village is now facing a fresh crisis.

In a space of a few months, the number of Swiss and foreign sanatoriums has fallen from seven to just four.

The Valbella clinic, along with another German clinic, closed its doors at the end of November last year.

The Swiss Thurgauer Schaffhauser clinic is to shut at end of March 2005.

Heavy heart

“We closed the clinic with a heavy heart,” said Herbert Bühl, president of the Thurgauer Schaffhauser clinic’s foundation.

“We really tried to save the clinic for three years, but we had to decide whether to keep it going with a big deficit and head into financial disaster, or whether to close now and give the staff a good social plan,” he told swissinfo.

Other clinics in Davos are also feeling the pinch. The Dutch Asthma Centre has just merged with the German Hochgerbirgsklinik Davos-Wolfgang for financial reasons and the Alpine Children’s Hospital – one of only two such clinics in Switzerland – has received a temporary financial lifeline from Davos and canton Graubünden.

Only the modern and impressive-looking Zürcher Höhenklinik Davos, which is fully funded by the canton of Zurich and has undergone considerable investment, can be said to have a healthy outlook.

“We now have a 91 per cent occupancy rate and our change of strategy in the 1990s to specialised rehabilitation functions very well, so we are in good shape today,” said director Thomas Kehl.

According to Andrea Meisser, the local Davos councillor in charge of health, the crisis facing many clinics can be attributed to developments in both the German and Swiss health systems.

High costs

“It’s the high [health] costs and the politicians who want to cut them which has led to fewer patients whose stays in Davos are paid for by health insurers,” Meisser told swissinfo.

“And in the case of the Thurgauer Schaffhauser clinic, it’s the two cantons that won’t pay anymore,” he added.

Another aspect of the problem is the trend towards rehabilitation at home or abroad, which is cheaper for insurers than sending patients to clinics in Davos.

This has led to some clinics struggling to fill their beds. Since May last year the Thurgauer Schaffhauser clinic has only had a 50 per cent occupancy rate – a factor which contributed to its decision to close.

For Davos, the loss of the clinics is a blow not only to the economy, but also for its residents, with around 300 positions cut.

A walk around Davos reveals posters advertising meetings calling for action to save jobs. Health work in Davos is scarce, as positions in other sanatoriums are already filled.

Meisser says that one of Davos’ biggest challenges will be to help these people find jobs. But he expects the village’s economy, which will be hit by a loss of revenue and taxes, to pick up again after a year.

Optimistic

And he remains optimistic about the future of Davos as a health centre.

“This is a crisis, but it’s not a crisis for the entire Davos health industry – it’s more of an opportunity to change the structures, to prepare the future,” he told swissinfo.

This would entail a reorientation towards more modern conceptions of health and well-being, as well as the surviving clinics concentrating on their core competencies in lung, allergy and asthma treatments.

In addition to seeking potential investors for the empty clinics, the 13,000-resident town – which this week hosts the annual World Economic Forum summit and is a popular ski and tourism centre – has set up a working group for health issues.

But for all three men, the glory days of The Magic Mountain are definitely over.

“It was a wonderful time, but it’s history,” Kehl told swissinfo. “The market doesn’t wait and you have to go with the times or else you will literally go with the time.”

swissinfo, Isobel Leybold-Johnson in Davos

In 1950, there were 24 sanatoriums in Davos.
In 2005, this number will fall to four, plus the Davos hospital.
300 people are to lose their jobs.
Davos has 13,000 residents, with 1,000 people employed in healthcare.
It has been reported that the future of two alpine clinics in Crans-Montana in canton Valais are uncertain.

The Magic Mountain (1924) tells the tale of Hans Castrop who visits his cousin in a Davos sanatorium.

He becomes fascinated by the world he finds there and stays for seven years. He only leaves after the outbreak of the First World War.

Mann’s novel was inspired by a trip to Davos in 1912 to visit his wife, Katya, who was ill with bronchitis.

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SWI swissinfo.ch - a branch of Swiss Broadcasting Corporation SRG SSR