ZAGREB, 12 June 2022 - The measures proposed by Health Minister Vili Beroš to reform the health system have been welcomed by the heads of two Zagreb hospitals, who say that introducing a model of payment to hospitals based on efficiency would be a major change in the operation of hospitals, burdened by debts.
The announced reform measures, such as the establishment of excellence centres, hospital accreditation and payments based on efficiency would change the operation of hospitals which are given billions of kuna from the budget every year to settle their debts, the head of Zagreb's Sisters of Charity Hospital, Davor Vagić, said at a panel on the hospital system, held as part of the MedMed 2022 conference in Grožnjan on Saturday and organised by reporters covering the health system and health-related topics.
Croatia has 62 hospitals, including hospital centres, clinical and general hospitals and special and private hospitals.
Medical workers attending the panel were agreed that the number of hospitals should not be reduced but that they should be repurposed and accredited and excellence centres established, noting that changes should be made to the model of payment to hospitals.
Hospitals operate with a programmed loss and despite budget rescue aid in the amount of HRK 6.3 billion in 2021 and HRK 3.5 billion in 2022, their due debt currently amounts to HRK 2.5 billion, warned Dražen Jurković, director of the Association of Health Sector Employers.
Hospital directors attending the panel expressed support to the proposed changes to the model of payment to hospitals, their computerisation and monitoring treatment outcomes.
Vagić said that if the reform was launched by the end of the year, its results would be visible only after three years and that the situation could be better in five years' time.
The head of Zagreb's KB Dubrava hospital, Ivica Lukšić, said that each new health administration annulled decisions taken by the previous one, which was the reason why the reform, called for by almost every government, had never been implemented.
Lukšić said that with the existing limits, hospitals could not operate in the black, which was why better organisation and a single system of procurement were necessary.
A representative of the association of family doctors, Vikica Krolo, welcomed the proposed reform measures related to primary health care, such as the merging of community medical centres, which in the future should also offer specialist examinations.
Vagić noted that specialists working in hospitals would have to be motivated to work in community medical centres and that they could not be assigned to work there by decree.
He said that he would always advocate the right to work in the private sector for hospital doctors who regularly meet their obligations in the public sector but that he agreed with the minister's position that order should be made in that regard.
Commenting on announced changes restricting the work of public sector doctors in the private sector, Croatian Medical Chamber head Krešimir Luetić said that the chamber considered as satisfactory the existing rules, under which a public hospital doctor wishing to take on a second job in the private sector has to regularly and professionally perform their duties under their employment contract, continue their own professional development, respect work organisation and does not have a criminal, misdemeanor or disciplinary decision issued against them.
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