[Limits of optimizing resource allocation by debiting the public health service]

Based on the Dornier consulting opinion on the public health service system of Berlin, the limits of optimising the resource allocation process are discussed with respect to austerity budgets. The discussion focuses firstly on problems of finding a consensus of opinion about public tasks and purposes in the German settings of pluralistic impact on health policy, and secondly on methodical, functional and practical limits. Methodical arguments are supported by a comparison of personal density with regard to the twelve largest cities of Western Germany, and supplemented by a factor analysis of sociodemographic characteristics in order to quantify the need of social work in an urban context. Functional and practical limits are demonstrated with respect to the realisation of the principle of subsidiary and concerning the practice of wholesale cut-downs of public health services budget.