Estonian doctors, nurses warn against creation of monopoly hospital

TALLINN – The Estonian Medical Association and the Estonian Nurses Union have addressed Prime Minister Kristen Michal and Minister of Social Affairs Karmen Joller, expressing their concern that the merger of hospitals in Tallinn could result in the creation of a hospital with a monopolistic position, where ensuring good working conditions and fair remuneration might become difficult.

"The creation of a unified hospital in Tallinn is a major change that will significantly impact our healthcare system and Estonian society as a whole. Such a step deserves the involvement of the healthcare community and public discussion, as well as consideration of possible alternatives. Reducing healthcare costs and improving the quality of care are certainly worthy goals, but we also see potential risks. The merger of hospitals entails inevitable expenses that should be assessed before any decision is made,” the professional associations say in their appeal published on Tuesday.

The associations say they consider it important to ensure good working and salary conditions for medical professionals, but in their view, this becomes difficult with a single large employer that is essentially in a monopolistic position in the capital city.

"Healthcare professionals will have fewer options, and the only alternatives for changing jobs may be private clinics or going abroad. One extremely large hospital would disrupt the balance of healthcare service provision across Estonia and thereby deepen the already large regional disparities. If a new hospital building is constructed in the future, consolidating a large part of the current clinics, security risks must also be taken into account," the associations emphasized.

The Estonian Medical Association and the Estonian Nurses Union believe that the establishment of a unified hospital in Tallinn should not be decided in haste, and propose to initiate discussions involving the entire healthcare sector and representatives of patients.