Estonia's largest hospital closes doors

  • 2000-11-23
TALLINN (ETA) – The largest Estonian medical institution, Mustamae Hospital, has been forced to close its wards for the time being as the resources allotted by the state health insurance fund for treatment of patients were exhausted. Patients who need emergency aid will be treated all the same, Estonian dailies reported Nov. 20.

The hospital is forced to reduce the number of beds for stationary patients and send employees on a seven-day paid vacation.

The hospital's board decided to cut down on expenses and get rid of 107 beds on Nov. 1. Today the hospital can host 516 stationary patients, but this number will be reduced by 96 next Nov. 28.

The hospital allegedly would need 33 million kroons ($1.8 million) more for the third quarter of this year.

Workers of 16 stationary divisions at the hospital will get their salary during the forced holiday, Ralf Allikvee, Mustamae Hospital's chief doctor, told the Estonian daily Ohtuleht on Nov. 17. The divisions will be closed down.

The hospital sees the paid vacation as a norm. "Our employees deserve it," said Allikvee. He said emergency aid will nevertheless be provided despite the financial difficulties.

The urology and gynecology section is the first to be closed for one month.

As of Nov. 17, there were 420 stationary patients in hospital. Maris Jesse, health insurance fund director, said that she read about the closing of wards in the papers and is therefore unable to comment on the case as the hospital has not informed the fund yet.

Minister of Social Affairs Eiki Nestor told the Postimees daily the shortage of money is the result of the poor hospital management. "The hospital has been unable to plan its activities so that it could work rhythmically till the end of the year," the minister noted. He also said that the hospital doesn't have to report to the ministry when it wants to send its doctors and nurses on a paid leave.

Chairman of the Riigikogu social commission Toomas Vilosius said that the wards to be closed down at the Mustamae Hospital have been superfluous for a long time. "It's impossible to keep so many hospital beds with the present health insurance volume," Vilosius noted.

Allikvee criticized the practice where doctors have to make financial decisions. In his opinion, it is the job of the sick fund.

Allikvee also said that treatment and funds should be concentrated in hospitals which provide high-quality treatment and which have modern equipment, while sick funds should analyze medical services.

Tallinn Central Hospital has stopped registering patients for the current year and is registering them for next year. The waiting list is longest in the Central Hospital's eye clinic, where patients are being registered for next June.

Andres Maesalu, the hospital's chief doctor, said the volume of emergency treatment has grown to 48 percent from 36 percent last year, and the hospital doesn't have enough funds to pay for it. According to Maesalu, the Central Hospital this year received 10 percent less funds than last year, while all costs have gone up.

Indrek Oro, chief doctor at the oncology center, said that in oncology, patients can't be divided into ordinary and emergency patients. "We have only emergency patients," he noted.

However, even in the oncology center, the waiting lists are about a week or two long.

Oro, who is also chairman of the health insurance council, said that the difficult financial situation of hospitals is caused by the higher cost of medical services which have stayed at the same level for the past three years, yet hospital fixed expenses and the sums to be paid for medicaments as well as for sick leave have gone up.

He said that the problem could be solved through the introduction of a private health insurance plan, a better price-shaping policy and the reform of medical establishments.