Health minister says action at primary level urgent

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Ljubljana – An emergency law on healthcare that the government adopted this week will be fast-tracked through parliament, possibly as early as next week. Its goal is to calm down the situation in primary care and provide a realistic picture about the capacity of the healthcare system as a whole, Health Minister Danijel Bešič Loredan told the STA.

The emergency law will provide additional funding for services, establish a clearer picture of waiting times through a new department and better data, and provide financial incentives for primary-care doctors and their nurses.

The key solution is the payment of all health services performed, services currently being limited by how much the public health insurer is willing to pay in a year. “If work is performed, it will be paid,” the minister says.

Roughly EUR 200 million is currently budgeted, but the figure can rise to up to EUR 350 million depending on incentives for doctors. “It is very difficult to gauge what will happen,” Bešič Loredan says.

General practitioners have reacted coolly to the financial incentives arguing that they are already overstretched. But Bešič Loredan says that there are other provisions that will help with that, including reduction of red tape and more support staff.

One major thing the government has set out to achieve is to get a realistic picture about waiting times; data is currently unreliable, many providers do not keep their figures up to date, and they use different IT systems.

“Our wish is to fully digitise the system in two years. This will also make it more transparent,” said Bešič Loredan, who expects a more realistic picture about waiting times to start emerging in September.

Bešič Loredan says waiting times are already realistically shorter than what current data show, but in some segments they are significantly too long.

“If a patient has to wait half a year or more for prostate or kidney cancer surgery because there are no urologists, we will have been super successful if we cut this to a month – and even this month is too long for the patient.”

Beyond that, the emergency law will provide a snapshot of the healthcare system and the limits thereof in preparation for a more systemic reform. “Based on that we’ll see where we’re actually at so that it is then easier to decide in which direction we will systemically change the system,” according to him.

He thinks reform of the system is feasible until 2025 “if everything goes smoothly.” While the direction has not been set yet, Finland’s reform is a role model.

As for other challenges the ministry faces, Bešič Loredan said the existing pay system is one of the main problems in the sector. The emergency law does not deal with that. “We expect a structural reform of the pay system,” he said.

Doctors have long sought to leave the single pay system that covers the entire public sector, but Bešič Loredan said that “they will not be allowed” to do so. “We can however probably fin solutions that will cover the entire health system.”

Despite popular reports about staff shortages and nurses and doctors either emigrating or leaving the profession, figures show there is enough staff, at least in the nursing segment.

“If that is the case, we just cannot allow ourselves not to create conditions conducive to keeping nurses in the system,” he says.