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"Three-year old boy, deaf, crippled and completely idiotic. The nursing costs amounting to 8 Marks a day", exhibition of the Reichsausschuss für Volksgesundheit (Reich Committee for National Health), March 1914
The public was continuously presented with figures on the costs for nursing and taking care of sick and disabled persons. Schools in their maths lessons even provided students with comparisons between the income of "hereditarily healthy" families and the money spent in nursing institutions.
The austerity programmes with reference to the nursing sector already started before 1933 when the worldwide depression began to spread. In 1932 the hospital allowances underwent a first cut. After 1933 and especially with the outbreak of World War II, the life conditions of the inmates of institutions deteriorated dramatically, sometimes even leading to death by starvation.
Landesverwaltungsrat Bernotat talking about austerity measures in mental hospitals, on occasion of the meeting of officials in charge for mental hospitals, on 24th September 1937 in Munich
In a speech of 1937, Landesrat Fritz Bernotat, since 1937 Referee for the Nassau district agency and in 1940 primarily responsible for the establishment of Hadamar as T-4 institution, spoke openly in favor of the principles concerning Nazi welfare policy: the costs for the "hereditarily diseased" identified by him as "asocial" individuals, should be kept as low as possible, whereas more money should be given to "healthy persons". Liberalism as well as Christian charity were considered to the main opponents of Nazi racial policy,, with both - philosophies emphasizing the role of the individual.
Works regulations for the Kalmenhof mental hospital at Idstein i.Ts. (1933)
Efficiency audit and organizational inspection of the Merxhausen mental hospital near Kassel, 2nd September 1937
Serving as an example, the Merxhausen mental hospital in 1937 underwent an "efficiency" audit by the "Wirtschaftsberatung Deutscher Gemeinden". According to the audit, the institution that was taking care of approximately 900 female patients at the time should accept another 200 sick people in order to be even more "efficient". By transferring female patients from clerical institutions (Bethel near Bielefeld, Hephata near Treysa) as well as from the institution Merzig in the Saar district in the course of war preparations against France, the number of inmates in Merxhausen was raised up to 1.172 in the year 1939. As a consequence of life in such cramped and poor housing and nursing conditions, the death rate in Merxhausen rose from 6.5% (1937/38) up to 23% (1940/41) and finally to 30.6% in the years 1944/45.
Merxhausen mental hospital, 1928
The Merxhausen mental hospital was established by landgraves as a foundation for poor and sick women in the year 1533. Since 1880, Merxhausen, in its function as a Prussian Mental home and Nursing institution of the Kassel district agency, had experienced an enormous extension. Since 1935, forced sterilization of female patients was practiced in the institution on application of the Merxhausen director Theodor Malcus (1881 -1967).
Transfer of sick people into state-operated institutions of Hesse, 9th March 1929
In the republic of Hesse with its seat of government in Darmstadt, the department III (internal administration) of the state government was responsible for the administration of the institutions. The Nazi austerity policy was in tine with what had been done in previous years in the province of Hesse-Nassau, and including the transfer of foster-children of clerical and private institutions to the state-operated institutions. It was this policy that prepared the concentration of inmates of institutions in order to provide for a relatively smooth "selection" within the scope of the "euthanasia programme".