Ljubljana - The public health insurance fund has called on stakeholders in the healthcare system to eliminate what sees to be unacceptably long waiting times. These have not been shortened by means of more funds, so solutions should be sought in better organisation of work, sorting out waiting lists and measuring the number of effective hours worked.

The assembly of the Health Insurance Institute (ZZZS) made the call on Tuesday as it was acquainted with the statistics showing that expenditure for healthcare services increased by 47% from 2013 to 2021, while the number of medical teams in family medicine and at children's and school clinics was up by 12%.

A new feature that is gaining traction is remote consultations, with their number standing at almost 2.1 million last year, compared to none in 2013.

However, more funds has not resulted in shortened waiting times, so the ZZZS assembly calls for better organisation of work and measuring data on the number of the effective hours worked.

The number of employees and the quantity of earmarked funds have increased, while the norms at the primary level have been reduced, and waiting times drastically protracted, said Nevenka Lekše, a representative of pensioners in the assembly.

She finds it unacceptable that doctors have only two hours for appointments over the phone a day, and believes the management of individual public institutions is also faulty.

Doctors are allowed to provide health services at private providers in their free time, while the capacities in public institutions remain unused, she noted.

ZZZS director general Tatjana Mlakar said that the implementation of programmes at the secondary level was not satisfactory.

There are significant differences in the performance of individual providers, so a solution for waiting times is in organisational approaches, not financial ones, said Mlakar, who would like to see a better use of equipment, staff and space.

She would also sort out waiting lists, as the relevant national call for applications has shown that the published waiting lists are unrealistic and that a large number of people are unjustifiably on the list.

"We found that almost 40% of those who are waiting for surgery had actually already had one," said Mlakar, adding that another measure could be streamlining and reducing red tape in information support in the healthcare system.

The ZZZS assembly has thus called on the government to draft a proposal for a single information system and include this in the national digitalisation programme.

Also proposed are changes to the public sector wage system act that would provide incentives by increasing the variable part of the wage for more productive and high-quality healthcare workers.

The ZZZS assembly would also like to see changes that would empower managements and introduce elements of corporate governance in the form of incentives for positive business results and accountability for negative results.

They would more consistently separate public healthcare from private healthcare to enable more efficient use of staff, space and equipment in public institutions. This would also solve the issue of doctors performing both public and private practice.

The ZZZS assembly supports inclusion of private providers with a concession in the public healthcare system in a way that both would be able to operate under the same conditions for rewards in terms of productivity, quality and efficiency.