IntoBalance 07/2008 (english)

Bailout of public hospitals, which should have been changed to join-stock companies, is now suspended. This was the decision of Ministry of Finance. The reason is the stoppage of transformation until the early elections in March. Originally there were € 350 million earmarked for the bailout of hospitals. Debts of 31 public hospitals represent approximately € 500 million. According to MoF spokesman the bailout of hospitals together with transformation into the joint-stock companies should have ensured more effective functioning of hospitals. But as he said, the change of management will not occur without the transformation.

More than 2 000 doctors will not withdraw their notices even after the talks with Prime Minister Iveta Radičová. Prime Minister and doctors discussed about transformation and growth of wages. They agreed that she will speak to experts to try to find such a form of functioning for hospitals, which would ensure rational and effective management of public finances. In the case of wages Prime Minister pointed out, that she must take into account also other workers in the sector, but savings that the new law on pharmaceuticals will bring, could be possibly moved to the salaries of health professionals.

Minister of Health Ivan Uhliarik talked to the doctors from Childrens' Faculty Hospital in Bratislava, they did not arrived to a particular agreement though. Doctors said that minister did not convince most of them to withdraw their notices. Hospital still registers 112 notices, originally there were 121 of them. Minister said that he has also discussed with doctors the additional financing and the approximate amount that the hospital would need for not making the debts. According to doctors, Minister offered € 10 million, but Minister said, they did not talk about the specific sum.

According to daily Pravda from 11/11/2011 our market could miss the wheelchairs, crutches, special medical supplies and hospital instrumentation since next year. According to distributors this might be the consequence of the new pricing measure of the Ministry of Health. After the reduction of margin it will not be allegedly interesting for distributors to deliver the devices to supply points, respectively they will start to deliver products of inferior quality.

If doctors do not withdraw their notices, the availability of health care will be deteriorated. Minister of Health Ivan Uhliarik wants to handle this situation so that after December 1^st several departments of large hospitals will operate in weekend mode. President of Medical trade unions Marián Kollár, however, argues that neither this kind of regime will be possible. For example, gynaecological departments will allegedly not have doctors, because they have, according to Labour code, already met their number of services. Minister of Health and Medical trade unionis are still unable to agree on the wage increases and the transformation of hospitals into joint-stock companies.

Ministry of Health and Všeobecná zdravotná poisťovňa came up with new tactics. They are beginning to offer money to those hospitals, which will ensure, that their doctors will withdraw the notices. Všeobecná zdravotná poisťovňa has offered to add money to dozens of non-state hospitals, although most of notices were registered in large university and faculty hospitals. By signing of the amendments hospitals will be committed to ensure the health care for patients in the full range even after December 1^st. Všeobecná zdravotná poisťovňa believes that this will also help to partially solve the salaries of doctors in hospitals.

According to Minister of Finance Ivan Mikloš the European Union could consider the bailout of hospitals as an unauthorized state aid. Therefore he has decided to reclassify the financial resources assigned for hospitals into a loan. According to him the bailout will de facto not occur, only the creditors will change. Since the loan was provided by state, state will become the creditor. Hospitals will continue to have obligations, but these will be obligations to the state. Minister of Health Ivan Uhliarik, however, insists on the bailout and plans to inform about its necessity on the next session of government.

Hospitals will probably not have to meet the minimum requirements for the material and technical equipment by the end of this year as it is specified in the Decree of the Ministry of Health. According to the Ministry of Health some healthcare providers are actually not able to meet these requirements and so Ministry of Health has decided to give them more time, till the end of 2012. Decree provides, inter alia, the compulsory instrumentation, material and pharmaceutical equipment of the outpatient care and hospitals, but also the number of patients per doctor or nurse in the day or night service.

Slovak Chamber of Pharmacists does not like the new Act on Pharmaceuticals and wants to change it before it comes into force. As the fundamental problem pharmacists consider the legalization of pharmacy networks, introduction of loyalty schemes or the reduction of powers of a professional pharmacists in the exercise of his/her profession. According to the President of Slovak Chamber of Pharmacists introduction of loyalty schemes will support the marketing business activities in the loyalty pharmacies. Representatives of Slovak Chamber of Pharmacists are planning to meet the Parliamentarians and explain them the real consequences of this Act on the pharmaceutical system.

According to daily SME from 12/11/2011 three firms that own health insurance companies and could not make a profit from them, are asking the state for over € 900 million. Act, which prohibited health insurance companies to make a profit, was drafted by the Ministry of Health in the past. This year the Constitutional Court ruled that such prohibition was unconstitutional. Parliamentarians therefore authorized the disbursement. Financial group Penta, which controls the health insurance company Dôvera, is asking the state for the highest amount – € 750 million. Shareholders of defunct Európska zdravotná poisťovňa are requiring more than € 30 million and Austrian shareholder of former health insurance company Apollo is asking for more than € 131 million.