[Experiences of the German public health service with the implementation of a new infections disease control act--results of focus group discussions].

The new infectious disease control act (IDCA) enacted in 2001 has resulted in far-reaching structural and organisational changes in German public health service (PHS) especially in respect of the surveillance of notifiable diseases. We conducted focus group discussions with 54 employees of the PHS from 14 German states (Länder) in order to investigate how implementation has been received and what could be improved further. Four focus group discussions each based on an identical agenda were performed with 13 or 14 participants. The contributions were taken down during the discussions and later entered into a data base and encoded. Encoding was summarised in 9 subject headings. It became clear that the implementation of the IDCA was mostly well accepted and the support by state departments and the Robert Koch-Institute, the Federal Public Health institution, was well received. However, especially introduction of a mandatory instruction of food handlers caused some initial difficulties. Concerning the list of notifiable diseases some diseases had been omitted whereas some were considered dispensable. Overall the insufficient staffing of local health departments was criticised. A major portion of the identified problems has in the meanwhile been solved; for others, solutions are under way. Some of the problems, however, would only be solvable by modification of the IDCA. Overall the focus group discussions were a useful tool to adapt the design of the surveillance system to the needs of local health departments.