Health care reforms criticized

RIGA - Current government health care reforms are a step toward fee-for-service health care, said President Valdis Zatlers after his meeting with Prime Minister Valdis Dombrovskis (Unity) on Dec. 29, reports news agency LETA. Zatlers, himself the former head of the Riga Traumatology and Orthopedics Hospital, admitted that he might be biased when discussing this issue, because he has spent all his life working in health care.

It must be taken into account that it is often young people who suffer injuries that may affect their entire lives, said Zatlers, adding that a traumatologist is not a plumber who can just collect his tools and head for the next apartment.
The health care reforms should have been discussed with professionals, and several serious problems have already been caused by not taking into account their opinions. The reforms which will be carried out in the next half year should be carried out over a period of at least two years, says Zatlers.

Dombrovskis said that reforms must be evaluated and corrected if necessary.
The priority of financing of first-aid stations will change this year; there will be less funding for first aid stations that treat less than 3,500 patients per year, and their working time schedules will also be changed, according to amendments approved by the government.

Eleven main multi-profile hospitals will be prioritized for receiving funding this year, while another 11 may cease providing emergency medical services, according to the government’s accepted amendments in the financing priority changes and the organization of health care services.

Liepaja Regional Hospital, Daugavpils Regional Hospital, Children’s Clinical University Hospital, Pauls Stradins Clinical University Hospital, Riga Eastern Clinical University Hospital, Jelgava City Hospital, Jekabpils District Central Hospital, Rezekne Hospital, North Kurzeme Regional Hospital, Vidzeme Hospital and the National Rehabilitation Center ‘Vaivari’ will be prioritized in receiving health care funding, also including providing emergency medical services.
Thus, the priority will be given to the multi-profile hospitals that provide treatment to the most patients, while the 11 so-called local multi-profile hospitals, where the number of patients is smaller, will receive less funding, Health Ministry spokesman Oskars Sneiders said.

Additionally, the hospitalization plan by the Emergency Medical Service will be specified, and will provide information to which hospital the patient will be brought, according to his place of residence and illness.
From July 1, 2011, emergency medical services may only be provided in multi-profile hospitals, where at least 7,000 patients will be treated and 400 childbirths registered per year, said Sneiders.

Traumatology and Orthopedic Hospital will no longer offer emergency medical services from July 1.
In covering year-end budget shortfalls, the Health Payment Center has informed hospitals about amendments to last year’s contracts which provide for allocation of an additional 11.6 million lats (16.5 million euros) for hospitals to cover their debts, reported the Health Ministry’s Communication Department.

In order to rationally use funding and equally support all 22 hospitals in Latvia that provide twenty-four-hour emergency medical services, as well as those hospitals that that have smaller debts or no debts at all, 70 percent of the additional funding will be divided proportionally according to the amount of funds stated in the contracts with the hospitals, and only 30 percent of the additional funding will be divided proportionally to hospitals’ debts as of Dec. 1, 2010.
Additional funding has also been also granted to the State Hospital of Traumatology and Orthopedics and to National Rehabilitation Center ‘Vaivari.’

The Cabinet of Ministers on Nov. 25, and Saeima on Dec. 9 last year approved allocation of additional funding to several ministries, including 11.6 million lats to the Health Ministry in order to ensure the functioning of hospitals.
Coverage of hospitals’ debts at end-year has been practiced before, as many medical establishments are unable to operate within the budgets approved for them.