Last year The Healthcare Surveillance Authority (HCSA) received 1,647 complaints where patients or their families complained about the medical procedure. Compared YoY it is about more than 600. Nearly 500 complaints were related to the ambiguity of death. According to the HCSA, every second complaint was baseless. Most criticized doctors were surgeons, general practitioners and gynecologists. Most complaints were of hospital. HCSA fine procedures of doctors by 127 penalties for 188 thousand Euros. The complaints were related to improper performance of the delivery of the baby, inappropriate medication or underestimating the patient's condition. Doctors say that such sanctions are often subjective. They clamour for uniform procedures that accurately define processes during interventions.
Receipts from cash registers may have to be issued by the doctors either. Ministry of Finance hopes that this step can bring more money to the state budget. Currently, cash register in outpatient clinics has not to be used, although patients there pay in cash and the doctors should pay taxes of this cash. Doctors do not like this proposal. If this measure enters into force, doctors announced increasing of fees. Doctors now collect cash money from patients for acts that health insurance company does not pay them. Electronic cash register is not used, so patient just has a ticket of receipt. To check actual income of physicians is therefore not possible.
Slovak Medical Chamber proposed that an expensive nurse in the clinic could be replaced by cheaper medical assistant. Assistant has a high school, so has lower salary as a nurse with the university. Doctors, who are also owners of clinics, would like to choose who to employ. Today's legislation does not allow it. According to the legislation, in the office has to be a nurse. Slovak Medical Chamber lobbies for changes in Decree, which would allow general practitioner to choose who would like to employ in the office. According to Slovak Medical Chamber, instead of nurses could be in the office medical assistant, assistant or physician after graduation.
At Slovakia are pre-operative assessments made about quarter million times per year. This examination should be easier for patients from now. The Ministry of Health plans to enable its performing from March by general practitioners, both for children and adults. So patients will no longer have to visit the internist. Currently, without visiting internist is impossible to be hospitalized. As explained by the main expert of Ministry of Health, for general practitioner is it possibility and not an obligation. Condition for providing this assessment is for example to have the ECG, which is not mandatory equipment for GP´s, however, many of general practitioners have it.
Contracting the physicians – specialist by the state-owned General health insurance company (VšZP) should be changed the next year. The biggest health insurance company will prolong their contracts until the end of 2014; however, the price terms will be in force only until March. According to the director of health insurance company Marcel Forai there is no plan of cancelling the current contracts with physicians yet. There will be just new settings for the criteria for contracting new physicians and new rules for ordering the health care. The goal is a fairer remuneration of specialists on the basis of more transparent criteria. The state insurance company wants to contract the physicians according to the amount of working hours and not according to number of physicians. As Forai pointed out, e.g. in the Bratislava region the VšZP has contracted 27 endocrinologists; however, from the point of view of working hours it is only 23 physicians.
State-owned General Health Insurance Company (VśZP) will in the coming months examine how many of the physicians – specialists are available for the patients. And not only from the point of view of geographical availability but also capacity availability. The result should be that specialists will get conditions which they have to fulfil in order to obtain a contract with the insurance company. General Health Insurance Company will focus on the physicians who run their private outpatients’ department only on part time. At first sight is the network of specialized outpatients’ departments oversized, however, in reality patients many times cannot get an appointment with the physician when they need it. Therefore the director of General Health Insurance Company has stated that they will not contract the number of physicians but the scope of opening hours.
Hospital physicians’ salaries will absolutely rise. President Ivan Gasparovič signed an amendment to the Health Insurance Act. According to it, a doctor with specialization will from January 2013 earn 2.3 times the average wage, doctor without specialization about 1.25 times the average wage. Overall, increasing will cost more than 30 million per year. Hospital, however, do not have needed sources and most of them are in indebted. Ministry of Health rejects additional subsidization. The same amendment also introduces a new product in the reimbursement of health care abroad - patients no longer need approval from their insurance company before planned outpatient procedure.
Inpatient doctors would see the third stage of increasing their salaries. Members of Parliament have approved an amendment to the Health Insurance Act. Change in legislation regulates the third stage of raising salaries of doctors, which is divided on the years 2014 and 2015. Increased salaries for doctors will require 19.3 million euros next year. A year later, this amount will rise to more than 36.6 million euros. A doctor with specialization should in the next year earn a total of at least 20.261 euros, and then from 2015 at least 22.715 euros per year. His colleague without specialization should earn next year salary not below 12.060 per year.
Government approved the proposal that guarantees next stage of increasing the salaries of doctors. The proposal of amendment to the Act on Health Insurance, which modify the salaries, is based on an agreement between the Minister of Health and Medical Trade Unions association. Salaries of doctors will rise two times. Necessary funds for increasing of salaries must find hospitals by themselves, whereas for this purpose are not allocated any special resources. Small and medium-sized hospitals associated under the Association of Hospitals of Slovakia (AHS) do not have money for further increasing the salaries. AHS therefore wants to initiate negotiations with insurance companies to raise funds for small and medium-sized hospitals. Since January 2014, salaries should increase on 1.25-fold of the average national wage for the doctors without attestation and 2.1-fold for the doctors with attestation.