The purely custodial function of the asylums was underlined by decrees issued in 1931 and 1932 [before the nazis came to power] which affirmed the exclusive right of the police to commit people to asylums in the interests of public safety. Expenditure cuts were recorded from virtually every region. In Brandenburg all budgetary headings excepting drugs were cut by 20 percent; in Upper Silesia, clothing costs per patient were reduced from 60 RMs per year to 45 RMs; daily food costs per patient sank from 0.75 RMs to 0.55 RMs. In Saxony, essential building maintenance work was cut by 10%, clothing bills by 8%, equipment by 10% and food by 4%. In Pomerania, patients received ersatz coffee, margarine and a bit of bread for breaking fast; patients needing salvarsan or other drugs had to pay for them. In Westphalia the authorities cut all non-essential outgoings by up to 20%, including expenditure on heat, light, power and water. Everywhere, posts were frozen or a certain proportion of office staff made redundant.
[...]
Like Friedlander, Bratz did not quarrel with economies at a time of national emergency. He pedantically detailed how money could be saved, under various cost headings. Schizophrenics could be given a second wool blanket as the heating was turned down; thermometers in every ward would counteract any complaints about the cold with irrefutable proof of the adequacy of the temperature. Power bills could be cut by using low-wattage light bulbs; or, more simply, the patients could have an extra hour in bed on dark winter mornings. If one washed down the walls it would only be necessary to whitewash the ceilings occasionally. Uneaten food could return to the kitchen for further consideration rather than being consigned to the swillbins. Patients could wear their own clothes rather than a uniform. The cost of drugs was to be shown clearly in the books doctors used to order them from the pharmacists. Patients could replace staff in the kitchens or washhouse, and (not withstanding problems of confidentiality) as clerks or secretaries in the administration.
[...]Bratz recommended what was essentially a two-tier system. The hospitals which first admitted patients were to be centres of research and places where modern therapies were designed to achieve as rapid a rate of discharge as possible. Those who did not respond to therapy were to be spun off, in the interests of economy, into a sort of nether world where they received merely basic attention.
[...]Some would benefit from mental progress, others (whose very presence cast a long shadow over its pretensions) were to be excluded from its orbit. This was to create the psychiatric equivalent of the dividing line between a hospital and a hospice, and the conceptual framework which at the very least sought to diminish the number of "incurable" patients. Interestingly enough, psychiatrists who advocated such a division of the patient body made explicit connections between having to assign patients to the categories "curable" or "incurable" and the decisions doctors made in the case of patients who were terminally ill or experiencing extreme suffering:
"Who will be bold enough, even in cases where schizophrenic dementia has only been manifested for a few years, to pronounce the final spiritual death sentence and order transfer to an asylum for the incurable? That would truly be a difficult and portentous decision for both the patient himself and his family, like the controversial tribunals in the case of the destruction of life unworthy of life".
Colleagues of Friedlander's began to argue that caring for chronic or geriatric patients was "a luxury Germany could not afford". A financially constrained nation was in the process of "caring itself to death".
