Latvia to revamp health care

  • 2006-11-22
  • By Elizabeth Celms
RIGA - Over the past two years, thousands of medics have abandoned Latvia for higher wages in Western Europe, leaving the nation's heath-care system in a desperate situation. Faced with this growing crisis, the Health Ministry has decided to take action, giving Latvia's doctors a reason to stay.

On Nov. 15, the ministry proposed a revolutionary 2007-2009 work strategy, which promises to nearly triple doctors' wages by 2010, reduce the number of hospitals in Latvia by half, and introduce a statewide 24-hour emergency network.
"One of the primary goals is to keep Latvian medics working in the country, which will enhance the nation's medical system as a whole," the ministry's public health director, Daina Murmane-Umbrasko, told The Baltic Times.
Although the new strategy can't replace the thousands of Latvian medics already abroad, it should at least discourage doctors from leaving in the first place.

"[Raising wages] is one of the most effective ways to motivate people," Murmane-Umbrasko was quoted by the Latvian daily Diena as saying on Nov. 16.
Indeed, the ministry's proposal to nearly triple medics' monthly wages by 2010 is an ambitious one. But according to medical union statistics, if salaries are not increased, the country could lose a total of 1,500 doctors and 2,000 nurses by next year.
Under the new strategy, Latvia's most experienced doctors will earn 600 lats (861 euros) per month, while lower-level medics will earn 500 lats per month.
Yet many in the medical field are skeptical of the plan.
Maris Mezeckis, a resident doctor at Latvia's Oncology Center, said he doubts the government can afford such a drastic wage increase.

"These are just promises," he said. "I don't believe they'll really be able to increase our wages by three times. Is there enough money in the budget?"
Asked if he thinks the proposed strategy will solve Latvia's medical labor shortage, Mezeckis expressed more doubt.
"Doctors will continue to leave anyway. Even if the [ministry] does increase wages to 600 lats [per month], salaries are still much higher in Western Europe 's some 3,000 to 40,000 lats per month," the resident doctor said. "Increasing wages will help the situation, but it won't solve the problem completely."
For years now, there has been an increasing need to optimize Latvia's disjointed network of hospitals and medical centers. Therefore, the Health Ministry is planning to completely reorganize the nation's health-care structure, starting with the number of hospitals.

Under the 2007-2009 proposal, the government will downsize Latvia's 100 hospitals to 50, creating a tighter, more efficient medical system.
The state will establish 11 comprehensive medical centers, each with its own specialized team of doctors and modern facilities, in addition to 20 regional hospitals.
According to Murmane-Umbrasko, fewer hospitals means better personal care.
With more doctors working at each facility, patients will be treated and discharged sooner, she said, which allows for a smoother operating system on the whole. Health Ministry officials estimate that the average time spent by a patient in hospital care will drop by 10 percent.

Asked what he thought about this strategy, Mezeckis turned optimistic.
"This is the right way to develop our health-care system," he said. "It's necessary to decrease the number of hospitals so each has a higher capacity. This is how it is in Western Europe, and how it should be in Latvia."
The Health Ministry also plans to introduce a single, nationwide emergency helpline to replace the current system, which often requires several phone calls for local assistance.

"If the ministry's plan goes ahead, this will be its most necessary development," Mezeckis said, adding that many people in Latvia's rural districts struggle to get immediate emergency care.
In addition to connecting every hospital under one, 24-hour emergency line, the new system will combine Latvia's catastrophe and trauma centers, which currently operate as two separate structures.

The statewide introduction of a Web-based medical system is perhaps the Health Ministry's most ambitious plan.
Project E-health Latvia, the 2007-2009 proposal's gem, aims to provide health care information to every resident via the Internet. People with online access will be able to register for a doctor's appointment or request special care in any medical area without leaving their home. The Web site will also offer comprehensive health care information.
The ministry hopes that with a better, more accessible medical system, every Latvian will be able to visit the doctor at least once a year, which will prevent more serious medical problems in the future.

"In the end, this will cost the state much less than hospitalizing patients," Murmane-Umbrasko said.
Indeed, the proposal has yet to be approved. But according to Health Ministry officials, the nation's health care situation is at the point where such a strategy is crucial.