HPI

Všeobecná zdravotná poisťovňa (General Health Insurance Company) could get more money from new way of risk-adjusted redistribution of insurance contributions between health insurance companies for the first time in October this year. This should by brought by the amendment to the Act on health insurance submitted to the Parliament by Richard Raši. Risk adjustment should be calculated by the Healthcare Surveillance Authority.

Although Všeobecná zdravotná poisťovňa – VšZP (General Health Insurance Company) offered additional sources to some hospitals. In last year, however, VšZP spent on hospitals 8% less than the year before. While in 2010 the VšZP's costs on inpatient health care reached more than € 815 million, last year it was only € 752 million. The biggest health insurance company decreased its expenses also on pharmaceuticals in 2011, aproximately by the same rate. Otherwise, costs on outpatient care and medical devices increased, in both cases by about 4%.

Healthcare specialists announced possible protests and strikes, if only salaries of hospital doctors and nurses will be increased. According to the president of Slovak Medical Union of Specialists, Andrej Janco, the raise of salaries of doctors and nurses is taking place at the expense of all others in the system. Union represents about 600 private clinics. President of the Union admits that the financial resources to cover wage increasing of all healthcare professionals are missing. But he also states that increasing of wages of doctors and nurses without increasing of salaries of other healthcare professionals will cause commotion. 

For non-registered human pharmaceutical prescription should be newly responsible the prescribing doctor. For therapeutic use of pharmaceuticals the informed consent of the patient should also be required. This results from the amendment to the act on pharmaceuticals and medical devices. The aim of this measure is especially the adoption of European legislation. Legislative frame tightens the supervision over the human pharmaceuticals, market surveillance and sanctions for non-compliance with the relevant assessment.

Minister of Health Zuzana Zvolenská continued this week in the personal changes in the state-run organizations. Changes thus took place on further directors´ posts in hospitals. New head of the MoH noticed the main hygienist and directors of hospitals in Bratislava, Banská Bystrica, Žilina, Prešov and Košice and directors of some emergency services. Zvolenská according to the spokeswoman of the Ministry prefers the experts with practice and she installed in the managerial posts people, who were addicted to this issue long-termly and are seen as experts in their field.

Debt in healthcare system has decreased last year almost by € 131.2 million thanks to the bail-out of the state-owned hospitals. At the end of last year the debt was € 154.01 million. This results from the report on the development of debts in the health sector. Hospitals in the scope of self-governmental units have the biggest problem with indebtedness and they owe the most to the suppliers of pharmaceuticals and medical devices.

According to the head of the Association of Hospitals in Slovakia, Marián Petko, from June there will be a threat of dismissals of nurses and cancellation of departments in hospitals. Costs of small hospitals on wages are already now in amount of 85% of their total costs. After further raise of salaries of doctors in July hospitals will have to use all their resources on salaries. Petko urged nurses for a compromise, for example that the wages would increase gradually. 

Hospitals, which did not increase the salaries of nurses in accordance with applicable legislation, are afraid of the sanctions. One of the threats is a Labour Inspectorate, which may impose penalty for violation of labour law. Problems, however, might be also caused by insurance companies. Control of the fulfilment of personnel norms falls within the competency of health insurance companies. These may, after finding of the failings, access to different measures, for example also to the termination of their contractual relationship.

Private outpatient doctors are asking for the same adjustment of minimum wages as it is in the case of doctors in hospitals. According to the president of the Association of Private Doctors, Ladislav Pázstor, they are asking for the basic salary in amount of € 1 600. He  assumes that, in terms of their members, outpatient sector would need € 118 million per year, as together with higher salary of nurse the costs on the outpatient clinic would be € 2 900 monthly. Association has allegedly also prepared its own plan of protests.

Management of hospital in Poprad signed a new contract with health insurance company Dôvera. Hospital will thus provide the Dôvera policyholders not only with acute care, but also with the planned operations. After publishing in central register of contracts the contract will enter into force on Saturday, April 14th. According to the director of hospital the new contract conditions constitutes the compromise between insurance company and hospital.