Although to the official birth of the new healthcare map there are still at least a few months remaining, the mystery surrounding the contents of the draft documents, have caused panic among hospital managers. Most at risk of hospital bed cuts in the country feel the heads of private and communal healthcare institutions. The former are generally recognized by the state as uninvited guests, while the latter barely cover the medical standards even now and their possible hiking will automatically throw them out of the game. So, the two parties have formed a common front to defend their territory.
On the other side of the fence is Health Minister Dr. Tanya Andreeva. She has the terribly difficult task to sort out the wheat from the chaff because out of about 400 hospitals, clinics, hospices and medical centres, 377 have contracts with the health fund for this year. Whether this number is small or huge is for the experts to say, but it is a fact that the World Bank has repeatedly pointed out that the large number of hospitals in the country and their fragmentation is one of the main reasons for ineffective healthcare services and waste of resources in Bulgaria. In this respect, apparently the die is cast, but resistance will be fierce. Healthcare law is so permeable that allows it to be attacked from all sides.
The National Healthcare Map is a tool for the closure of hospitals and creates preconditions for the government, represented by the Ministry of Healthcare, to intervene rudely into the market of healthcare services, said the chairman of the National Association of Private Hospitals Dr. Yavor Drenski. According to him, the healthcare map will suspend the entrepreneurship in the sector, which should not be allowed, as private hospitals take care of around 300,000 patients a year.
Dr. Metodi Yankov added that if the map is preserved in its current form envisaged by this new project, it will cause huge waiting lists of patients. Many private and small community hospitals will not be able to enter into a contract with the health fund and will be closed, said Yankov .
The Association, together with the Centre for the Protection of Rights in Healthcare, the Bulgarian Association for the Protection of Patients and the Association of Municipal Hospitals vowed that they would send the new medical standards to court. According to the agreement, they are designed to restrict the access of patients to certain hospitals due to which about 20 municipal hospitals have been closed.
Representative of patients Stojcho Katzarov indicated that standards are a major cause of deficit in the budget of the healthcare fund and generate debt to hospitals because they contain only quantitative criteria and had no relationship to the quality of health services. Katzarov believes that all the 39 medical standards are illegal, but will attack at court only the one for surgery, so that the health system does not collapse.
Minister Andreeva assured dissatisfied that the health map will not threaten with mechanisms by which some hospitals depending on their property will be able to sign contracts with the fund, and others – not. She said that in the methodology of the document many criteria will be set, and among them are the number and age of the population, disability, morbidity, complexity of healthcare services and others who are developed to primarily protect patients. If hospitals feel at risk because they do not meet the criteria, they have enough time to fix the problems. All of us feel anxiety, and this is normal because this is the first time the healthcare map will be binding, as everywhere else in the world, said the healthcare minister. So far, it is clear that there will be no reduction of hospital beds in regions with poor healthcare coverage, and hospitals in inaccessible and remote areas will not be closed.
Representatives of the Medical Association set the emphasis on personnel and equipment. According to the leader of the medics, Dr. Tsvetan Raichinov, the map needs an accurate assessment of the coverage of medical personnel and their competence, the available equipment and features of individual hospitals. To unify these parameters, it is necessary to set a minimum number of medical specialties by type for the particular population groups to be served, he added. Mr. Raichinov believes the scheme could only work if emergency care perfectly fulfills its role. On their turn, regional medical councils should help through issuing opinions whether an area can open new individual practices or clinics.
The BANKER
