Following intensive investigations in the one-month first phase of the merger control proceeding, the Bundeskartellamt has cleared the takeover by Helios Kliniken GmbH of Malteser Rhein-Ruhr gGmbH. The two hospital operators are in competition with each other in the provision of acute in-patient hospital services in Duisburg and Krefeld.

Andreas Mundt, President of the Bundeskartellamt: “To some extent the two hospital operators have a strong joint market position in this region. Especially in the Krefeld area the merger will lead to considerable market share additions. We have thus carefully examined the merger, but were able to clear the project already at this stage after comprehensive investigations. Patients will have sufficient alternatives to choose from and there will be no significant impediment to effective competition.”

Helios Kliniken GmbH is the largest operator of private hospitals in Germany and a subsidiary of the internationally active Fresenius healthcare group. Helios operates 86 hospitals in Germany, including two each in Duisburg and Krefeld. Malteser Rhein Ruhr operates the St. Anna and St. Johannes Stift hospitals in Duisburg and the St. Josef hospital in Krefeld-Uerdingen.

The Bundeskartellamt evaluated the complete case data of all hospitals in the re-gion as part of its investigation. The data were provided upon request by the insti-tute for the hospital remuneration system (Institut für das Entgeltsystem im Krankenhaus, InEK). Competition concerns expressed by third parties could not be con-firmed by the investigations.

Background – Merger control in the hospital sector:

Irrespective of their operators, hospitals are independently active as entrepreneurs and compete with one another. Due to strict legal provisions there is almost no price competition in this sector. It is therefore the main objective of merger control to maintain competition in the quality of healthcare for patients. It is crucial to ensure that patients have sufficient local options to choose from.

In spite of the growing concentration in the hospital sector only very few mergers had to be prohibited by the Bundeskartellamt in recent years. Of the altogether 329 transactions notified between 2003 and September 2020 only seven were prohibited. Eight merger projects were not notified after they had been critically assessed following an informal advance enquiry.