August 10, 2022 – On August 5, Index’s journalist Vladimir Matijanić, aged fifty-one, tragically passed away due to the negligence of the Croatian health system. With several autoimmune diseases, he tested positive for covid-19 on August 2. Both he and his girlfriend spent days trying to convince the hospital staff to take them seriously. The emergency services only ever looked at him once, refusing to take him into the hospital even when he was extremely ill. Matijanić's colleagues at Index recounted the key mistakes of the system.

For context, TCN first reported the news here, followed by the reaction of the Croatian Health Ministry who ordered an inspection into the medical assistance to the reporter. Understandably, the way the hospital staff treated the dying journalist did not go down well in Croatia, causing public outrage.

At Index, his premature death prompted many of his colleagues to examine the extent to which the poor reaction of the Croatian healthcare system was responsible for this tragic outcome.

It is simply unacceptable that Matijanić, a man with so many serious underlying diseases, which brought him at particular risk for a severe form of covid-19, despite persistent inquiries and even a trip to the hospital, did not manage, over several days, to receive thorough and adequate examination and/or hospitalisation and to receive medicine intended for the prevention of severe forms of disease meant precisely for people of his health profile, which Minister Vili Beroš stated that “we have verified it exists” in stocks in the health system.

“We called ten times and begged them to admit Vlado to the hospital. They refused”

Questions arise as to how much and in what ways the health care system is responsible for Matijanić's death. In cooperation with several medical experts, Index took to list the key mistakes in order.

Firstly, the main culprit for Matijanić's death, just like for the death of many other patients with covid-19 and other diseases, was a poorly managed health care system, where a part of the doctors and medical staff are its victims, along with regular citizens who need help.

The system did not properly advise Matijanić about vaccination

Matijanić claimed that doctors advised him not to get vaccinated because he had several autoimmune diseases, primarily Sjogren's syndrome and suspected sarcoidosis, as well as dermatopolymyositis, hypergammaglobulinemia and airway abnormalities, including interstitial lung disease, a condition for which sarcoidosis and Sjogren's disease are among the most common causes.

The advice is contrary to scientific conclusions, as studies have shown that people with autoimmune diseases tolerate vaccines well. For example, the Sjogren's Syndrome News page cites the recommendations of the American agency for disease control and prevention, the CDC, according to which most patients with this diagnosis are recommended not only to get vaccinated but also to get booster vaccines.

At the same time, studies have shown that people with autoimmune diseases are a risk group for several reasons, among others because they can get infected more easily, they often have lung diseases, they usually take immunosuppressive drugs, and their reaction to covid-19 can be exaggerated and misdirected, commonly referred to as a cytokine storm.

The fact is that the vaccine against covid-19 in patients with autoimmune diseases, especially in people with dermatopolymyositis, could cause more pronounced side effects, but according to the conducted studies, the risk of side effects is still much lower than from not vaccinating. The doctors who knew about his underlying diseases should have monitored his condition and, in accordance with the development of knowledge and recommendations, should have updated him with them and recommended vaccination with additional monitoring measures. People with such underlying illnesses require more than "routine procedures".

The fact that there are few of them in the population emphasizes, even more, the need for more detailed and expert care. Finally, even if someone in the system had recognised that his condition was such that vaccination was not recommended for him, they should have officially and in writing informed Matijanić about this and then followed it with special attention and updated the recommendations in accordance with the new findings and changes in Matijanić's condition.

On the contrary, it turned out that Matijanić, who went to nursing vocational school and was not an anti-vaxxer, was simply not adequately "guided" by the system in this regard.

Matijanić should have been kept in the hospital with his diagnoses

Matijanić's partner Andrea Topić says that she took him to the Emergency Infectious Disease Department on August 2 thinking that he would be kept there. It is questionable why they didn't do that when they knew about all the diseases he had, but they just let him go home. Topić believes that it is possible that Matijanić's covid-19 developed even before August 2 as his home antigen test already showed he was positive that morning, and a few days earlier he complained to the immunologist about weakness and malaise.

A person with Matijanić's diagnoses should have been admitted to the hospital if he was confirmed to have covid-19 and if he had symptoms such as elevated temperature, weakness, malaise, wheezing, and cough. On the contrary, in patients suffering from interstitial lung disease, these symptoms – no matter what caused them directly (e.g., a common cold) - are a sign that an acute deterioration (exacerbation) has occurred, and this is always an indication for detailed hospital treatment and, typically, hospitalisation.

The fact that he did not feel any better even when his temperature dropped can only be an argument in favour of the fact that something was not right.

The doctor should have taken his case much more seriously

As was reported by Index, recordings of Matijanić's calls to medical professionals show that none of them took his situation seriously enough.

Among other things, the KBC doctor on duty should have reacted urgently when Matijanić told him that he had not been vaccinated and that he had autoimmune diseases. First, he should have asked in more detail about his autoimmune diseases, because patients suffering from them belong to the risk group when it comes to covid-19. The insistence that “Matijanić was not immunocompromised” because he had only started corticosteroid therapy a day before is a result of confusing the terms “immunocompromised” and “immunosuppressed”.

The doctor who knew Matijanić's condition: He was highly immunocompromised

Matijanić’s immune system was certainly long-term compromised in the sense that it reacted unusually, attacking its own tissue, which is a consequence of autoimmune diseases. Therefore, the doctor on duty should have recommended that he come to the hospital so that his condition could be assessed and monitored. Even though Matijanić stated that he was coughing and had a lot of phlegm, the doctor said that it probably would not be serious since it was omicron, regardless of all Matijanić’s conditions, and without having asked about them in more detail. Indeed, omicron causes severe disease in fewer people in the population than some previous variants of the virus. However, due to his characteristics, Matijanić did not fit into the “general population”, but into a specific group of people in whom even a common cold is a potential trigger for life-threatening conditions (e.g., exacerbation of interstitial lung disease).

There is no doubt that in each of his contacts with the health care system, Matijanić had to be admitted or referred for a detailed diagnostic evaluation and appropriate treatment, ideally at the very beginning, but also in every further stage of the disease.

To date, it has been proven certain: 1) that drugs with an antiviral effect intended to prevent the development of a severe form of the disease and intended specifically for people like Matijanić are effective; 2) that anti-inflammatory drugs such as corticosteroids and some others are reasonably effective in those with advanced disease; 3) that supportive treatment - oxygen therapy (including the most dramatic forms such as mechanical ventilation or ECMO device), anticoagulants and possibly antibiotics where there is a basis for this due to bacterial superinfection, are effective and extremely important and that they help reduce mortality.

Overall, if Matijanić had been referred to the hospital at any stage of his condition and treated as recommended by the guidelines, it can be said with high certainty that he would have survived this covid-19 episode.

Problematic administration of corticosteroids

Due to an autoimmune disease, Matijanić took the corticosteroid Decortin, but only for a brief time. The doctor on duty at KBC Split, whom he called, knew about it but did not react, only stating that he could not be immunocompromised since he had been taking it for such a brief time. As already stated, this was wrong – though Matijanić may not have been immunosuppressed since he did not take therapy that reduces the immune response in people with autoimmune diseases, he was immunocompromised due to his underlying diseases.

When the ambulance finally came for the first time, Matijanić's partner Andrea Topić asked the team if it could be Decortin that made him sick, and the answer was no. Moreover, they also gave him an injection with a strong dose of Solumedrol, which is also a corticosteroid.

What is controversial about that? As previously reported by Index, corticosteroids are used in the treatment of covid-19, but mostly only in an advanced stage, around the 7^th day of severe disease, to reduce the excessive reaction of the immune system, the so-called cytokine storm. Since they are immunosuppressants, they reduce the body's reaction to viruses, so if they are given too early, they can increase the multiplication of the virus. Due to the above, they should only be given to patients with covid-19 in a hospital, under constant medical supervision and with oxygen, and not at home.

In other words, the emergency doctor should have taken Matijanić to the hospital after the first visit if she believed that his disease had progressed so much that he needed corticosteroids. Also, she should have been aware of how serious the situation was because, unlike the doctor on duty from KBC, who did not get enough information, she had access to Matijanić's discharge letter.

At the Emergency Infectious Diseases Department, they did not even ask about underlying diseases

When on August 5 Matijanić called the emergency department at the Infectious Diseases Department, the employee on duty did not even ask him about possible underlying diseases, even though he complained of feeling extreme weakness and severe pain in his muscles and joints. The doctor simply recommended ibuprofen for pain.

They did not call him into the hospital even when it was apparent that he was very sick

Furthermore, when on August 5 Matijanić called a medical worker at the emergency department of Infectious Diseases, after his condition significantly worsened, on the recording of the conversation it can be heard that his breathing was laboured. He also pointed out that he had Sjogren's syndrome and the resulting interstitial lung disease, and that he was so weak that he could not even get up to go to the bathroom.

But that medical worker did not take him seriously enough either, and to all this, she advised him to urinate in a bed pan that one of the household members could empty.

His diagnoses and the fact that his breathing was laboured, that he was so weak that he could not get out of bed should have been sufficient reasons for the employee on duty to seriously advise him to go to the hospital in an emergency or to insist that the ambulance take him as soon as possible.

The emergency left him at home despite the diagnoses

When the ambulance finally arrived, the doctor refused to take Matijanić to the hospital even though he had serious autoimmune diseases in addition to covid-19, which she had to see based on the discharge letter.

There are certain doubts about whether the doctor who came with the ambulance was qualified for the job. It's possible she was hired even though she wasn't qualified because the hospital was understaffed, which is a chronic problem within our healthcare system.

If she was qualified, she should have known that his case needed to be referred to the hospital despite his blood oxygen saturation of 97% (a result that can change dramatically in less than an hour, as it did in the end), low blood pressure, an increased heart rate did not have to look critical. The usual practice of the ambulance is to take a patient with serious underlying diseases in combination with covid-19 and numerous complaints to the hospital to examine his condition in more detail because even minor deviations of key parameters can result in complications.

It was expected that during the summer, during the national holiday, at the height of the heat wave, the healthcare system in touristic Split was overloaded, but this cannot be an excuse for not admitting seriously ill people like Matijanić to the hospital.

In Croatia, there is a lack of necessary medicines for the seriously ill

Finally, as already reported by Index, Matijanić was told on August 2 that there are no drugs to treat the seriously ill, including Remdesivir.

Minister Vili Beroš denied this claim, with the explanation that there is enough Remdesivir or its version Veklury, and that directors must procure them from other hospitals if they lack them, and for specialist doctors to prescribe it to patients. If it is true that Remdesivir was still available on August 2 when Matijanić should have started it, it is still unclear how he never received it.  

Why didn't Matijanić get the medicine? Beroš: There is enough covid medicine in hospitals

But in this context, the Ministry's answer to the question of why there is no Paxlovid, which was approved by the American FDA at the end of 2021, and by the European EMA in January 2022, is also interesting. It is a medicine that, among others, was recently taken by US President Joe Biden and German Minister of Health Karl Lauterbach.

Since it showed excellent results in reducing hospitalisation and mortality by as much as 89%, it may have been able to save Matijanić's life, as well as that of many other patients who have died in recent days.

Many countries procured Paxlovid outside of centralised procurement

Index asked if there was a shortage of medicines in Croatia and received the interpretation from the Ministry that “the procurement of antiviral medicines Remdesivir and Paxlovid through the EC is currently being centralised” and that the department has done everything in this regard on time. However, it is known that the procurement of medicines does not necessarily have to go through the EC. States can procure medicine approved by the European agency EMA by themselves through direct contracts with manufacturers (by the way, Paxlovid was recommended as a medicine for covid-19 in the Ministry's guidelines back in February).

For example, Index received information that, in addition to centralised procurement, Paxlovid has already been procured by Austria, France, Italy, Germany, Belgium, Greece, Portugal, Ireland, and Spain, and that Slovenia will receive it at the end of August. Similarly, Croatia could have also bought the drug directly from the manufacturer, at least in some quantity, to bridge the period until central procurement is done and saved several lives, Matijanić's included.

For more, follow TCN’s dedicated News section.

August 15, 2021 - In 2018, Professor Tina Dušek, MD, Ph.D. organized the first Šolta Island Medicine Summer School to show young doctors that landing a job in a rural area was the best thing that could happen to them. The planned number of participants was 25. After receiving a staggering 300 applications, she knew she was on the right path.

If you are someone who grew up in a city, it is likely that the word ''island'' to you represents a picture of an everlasting summer. Salty air, gentle breeze, the sound of crashing waves. Peace and quiet. Who could want anything more?

For all their business during the summer, Croatian islands are experiencing depopulation. As much as people enjoy spending their holiday there, few would decide to extend their stay to all 365 days of the year.

All the things that attract tourists - the remoteness, the fact that there is no rush and no traffic, also mean the absence of many advantages of our modern-day life, one of them being the availability of state-of-the-art medical services. The thought puts off both ''regular'' people as well as budding medical professionals.

In order to change that, Tina Dušek, a professor at the Medical School of the University of Zagreb and an internal medicine specialist, with the support of the Croatian Society for Endocrinology and Diabetology organized the first Island Medicine Summer School (Croatian: Ljetna škola otočne medicine) in Stomorska on the island of Šolta, intended for medical students in their final years of study and newly-graduated doctors.

This September will see its third edition of Island Medicine Summer School, with the one last year being postponed due to the pandemic. 

Why a school of ''island medicine''? 

As explained on their page, ''the island symbolizes a geographically isolated area whose population has difficulty accessing larger health facilities. Such conditions - whether truly on an island or in a remote continental town - require the comprehensive training of a doctor, who must be an internist, a surgeon, an obstetrician, a radiologist, a psychiatrist, and more. In the absence of sophisticated diagnostic and therapeutic methods, the most valuable medical tool is the knowledge and experience, which we want to pass onto you''.                                                                                           

Island Medicine Summer School has two goals. One, to help young doctors gain authentic life and professional experience, and to increase their interest in professional engagement in geographically isolated environments, and the other, to contribute to the quality of life and health care in other geographically isolated areas.

In short, the Summer School prepares its participants to diagnose and treat patients in places without sophisticated diagnostic and therapeutic methods available.

''Bring medicine back to a human level''

As professor Tina Dušek explains, ''21st-century medicine strongly relies on arranging a dozen different tests and diagnostic procedures, a patient gets a referral for this and a referral for that. In the end, it results in moving away from person-centered care.

Our motivation was to think about medicine in ''island conditions'', that is, in absence of sophisticated diagnostic and therapeutic methods, the way it looked a hundred years ago, when a doctor or a medicine man, if you will, a healer, had nothing but his hands, his knowledge, experience, and his emotion to work with.

That is the idea of our Island Medicine Summer School – to bring medicine back to a human and humane level, where a relationship between a patient and a doctor is in the foreground and a starting point for everything else.''

One thing that professor Dušek has emphasized again and again throughout our conversation was the importance of human touch and empathy. It is easy to learn to do X if Y, to follow the steps you have been taught as a student. Prescribe this, refer to that specialist, make an appointment for a procedure - everyone can do that. However, there is more to a good doctor than issuing a correct diagnosis. 

The right approach is everything, according to professor Dušek. Empathy, emotional intelligence, the patience to stop and truly listen to what people are saying - that is what makes a great doctor.

''Small communities are excellent ground for making a lasting impact''

''On the one hand, we still have people who approach medical professionals with reverence and unease. On the other, young doctors are often still building their confidence and can also feel unsure on the best way to speak to a patient. That is why I think that getting a position in a rural area, a small town, on an island, is a great path to self-developing both as an individual and as a doctor. Small communities are perfect for those with the desire and ambition to make an impact, come up with a project that will add to society in some way. When you work as an island doctor, you get to know your patients, you develop a connection.

Sometimes, they will come not because they need medical assistance, but because they need someone to talk to. Doctors working in rural areas will have an easier time to stand out and to bring about a positive change, much more effectively than they would in a complex system such as a clinical center in a big city.''

''An overwhelming response already producing results''

I ask if they have already heard from former participants of past Summer Schools. Is the changing perception of working in rural areas already noticeable? 

''Yes, it is. Off the top of my head, there is one colleague who accepted a job on Murter and another who works in Sisak-Moslavina County. During our first year, in 2018. we received 300 applications. We try to choose candidates who have already shown interest in volunteering and working in the community. Grades are not the deciding factor here. As students are accepted based on a motivation letter, we also try to take into consideration that not everyone has a way with words. We try to give a chance to a diverse set of candidates. 

''Participants work in small groups intensively with instructors, solving professional tasks in a "problem based" form and practicing manual skills. The local community has welcomed our initiative, as we organize free blood pressure and blood sugar measurement.''

For more stories about great initiatives such as this one, CLICK HERE.

ZAGREB, 15 June, 2021 - The National Anti-Corruption Council on Tuesday interviewed the dismissed head of the radiology ward of Zagreb's Sisters of Charity Hospital, Dijana Zadravec, who presented her evidence of criminal activities used to siphon money from the hospital.

Zadravec, who has been on sick leave since May, told members of that parliamentary body that she learned yesterday from the media that acting hospital director Zoran Vatavuk had given her a warning before dismissal for harming the hospital's reputation, noting that the hospital's reputation was harmed by corruption and those who committed and covered it up.

Zadravec said that her fight against corruption started in 2016, when her persecution and harassment started as well.

She said that as the deputy hospital head she reported in 2016 the charging of fictitious overtime work which the then director Mario Zovak had covered up, adding that she had reported this to the prosecutorial authorities and the Health Ministry.

Zadravec said that in late 2020 she discovered a criminal network at the hospital, with public money being siphoned by doctors, which was why she reported them for abuse of office.

The doctor, who claims to have extensive documentation proving her allegations, says that offers to suppliers with whom the hospital did business without public tenders, since the last public tender was conducted in 2019, were signed by doctors Vladimir Kalousek and Branimir Čule, and that the offers exceeded HRK 30 million.

She also cited cases when less material was used for operations than the quantity ordered from suppliers.

Commenting on Zadravec's allegations, the State Secretary and chair of the Sisters of Charity Hospital Steering Board, Tomislav Dulibić, said that hospital documentation was being checked by inspectors from the health and finance ministries and the HZZO health insurance agency.

"According to preliminary information, no significant departures have been found, except for some minor irregularities. Eleven inspectors are working on this, invite them to testify," Dulibić told the Anti-Corruption Council.

He said that the decision to carry out the inspection at the hospital was made a couple of weeks ago, noting that the relevant proceedings were underway.

The chair of the Anti-Corruption Council, Nikola Grmoja, asked if anyone had responded to Zadravec's claims, to which Zadravec said that after she reported the false charging of overtime work, Health Ministry inspectors were called in and concluded that the matter should be investigated by the hospital director.

Allegations should be investigated as soon as possible 

After conducting the interviews today, the Anti-Corruption Council adopted a conclusion asking the ministries of health, finances and economy as well as the prosecutorial authorities and the USKOK anti-corruption office to determine facts related to the case as soon as possible.

Zadravec was told to submit copies of the reports she had sent to the competent authorities as well as the text message in which, she claims, Parliament Speaker Gordan Jandroković lobbied for Zovak's reappointment as the hospital head.

The Anti-Corruption Council will send the audio recording of today's hearing to the prosecutorial authorities, and it will ask the Health Ministry to submit all documents on inspections conducted at the hospital since 2016 or explain why no inspections were conducted.

The Council will also ask the government to secure additional conditions for the employment of financial investigators at courts in four big cities.

For more about politics in Croatia, follow TCN's dedicated page.

ZAGREB, 14 May, 2021 - The head of the Zagreb-based Hospital for Infectious Diseases, Alemka Markotić,  said on Friday that the European Commission would in future be authorised for the purchase and distribution of the Pfizer vaccine and that Zagreb would be one of the centres included in producing DNA templates.

That means that only mRNA vaccines will be used in the EU, not because the AstraZeneca vaccine is not of a good quality but to ensure secure production and the possibility of responding quickly to new variants of the virus given that a vaccine can be produced within 100 days, said Markotić.

In addition to a high level of antibodies that remain for about six months, it is worthwhile developing cell immunity, which need not be the case with certain vaccines, she said.

"In 2022 and 2023, Zagreb will be one of the centres that will be included in the phase of producing DNA templates, which is important for Croatia's tradition and for Zagreb regarding the production of vaccines," she underscored.

For more about health in Croatia, follow TCN's dedicated page.

ZAGREB, 11 May, 2021 - The 35 million kuna contract on the elaboration of a feasibility study for the construction of a new complex housing the hospital centre in Osijek was signed on Tuesday in that biggest eastern Croatian city.

The document on preparing the feasibility study was signed by Health Minister Vili Beroš, the Osijek Hospital Centre head, Željko Zubčić and the representative of the consortium of bidders. As many as 30 million kuna will be provided from European funds, whereas the health ministry will cover the remaining 5.2 million.

Regional Development and EU Funds minister, Nataša Tramišak, said at the contract-signing ceremony that the co-funding from the EU funds was ensured through the "Slavonia, Baranja and Srijem" project.

She said that the construction of the future hospital centre was estimated at two billion kuna, and the exact sum would be known after the Osijek hospital centre provided full information.

Zubčić said that the new hospital centre "is a greenfield investment", and would be built at a new location. He said that the new hospital complex "is a necessity for Osijek and Croatia's east.

The elaboration of the feasibility study is expected to take a year.

(€1 = HRK 7.5)

For more about health in Croatia, follow TCN's dedicated page.

ZAGREB, 4 May, 2021 - Health Minister Vili Beroš on Tuesday said that the solution to acute problem of the shortage of radiologists in two hospitals in Zagreb was within the responsibility of those hospitals and that he expects those institutions to provide patients with appropriate and immediate health services.

"The solution to the acute problem of the shortage of radiologists at the Sisters of Mercy hospital and the clinic for treating cancers, which is part of that health institution, is up to the administration at the hospital and I expect them to provide all the patients with the appropriate medical services, and in particular oncology patients and those with grave diseases," said Beroš.

He underscored that patients have to be above organisational problems of an institution.

Beroš underscored that patients must not be left without services because of organisational problems or human relationships.

"That's my clear message to directors and all their associates who are responsible for managing those processes in hospitals. Problems have to be resolved," said Minister Beroš.

He added that Croatia has an increasing number of younger radiologists with experience in working in clinical centres and health institutions that could be the core of creating a system based on the example of developed countries with advanced health systems.

"Creating an efficient system of radiology services at the country level that could provide efficient, quality and financially rational services to a larger number of health institutions that are faced with a shortage of staff such as radiologists, which surfaced in the Sisters of Mercy hospital, are an inevitable step towards resolving this and similar problems," he underscored.

He underscored that as Minister of Health he has already "launched certain activities to provide organised radiology services based on the experiences of other countries that have proved to be efficient and economically justified and are appropriate to our needs and capacities.

For more about health in Croatia, follow TCN's dedicated page.

ZAGREB, 14 April, 2021 - Health Minister Vili Beroš said on Wednesday that the government and representatives of drug wholesalers had reached agreement on a debt settlement scheme.

The issue of the debt made the wholesalers restrict and defer the deliveries of medicines to hospitals in late March.

"Today's meeting is one more step towards the debt settlement," Minister Beroš said adding that only together the two sides could solve this decades-long issue which became exacerbated during the COVID-19 pandemic.

Finance Minister Zdravko Marić outlined the elements of the scheme.

In the next three months we will transfer some funds to the Croatian Agency for Health Insurance (HZZO), and the Health Ministry so as to enable the cash flow in those institutions and enable them to pay liabilities towards wholesalers and providers, Marić said adding that those funds would be ensured through the redirection and reallocation of outlays in the state budget.

The monthly allocation for hospitals will be HRK 600 million and an additional 300 million for pharmacies.

In June, the government is likely to conduct a budget revision whereby an additional cash inflow for hospitals and pharmacies will be ensured so that debt deferment period lasts no longer than 180 days for hospitals and 120 days for pharmacies.

In June alone, 135 million kuna will be directed to pharmacies and HRK 760 million to hospitals, with the plan to respect the deferment periods in the remainder of the year.

Marić hopes that this scheme will remove any need for any new meeting with wholesalers on the debt.

The finance minister also expects reform efforts in preventing any  further accumulation of liabilities and in this context he mentioned the plan to cut the deferment period to 60 days.

The wholesalers' representative Diana Percač thanked the ministers for efforts to provide funds to cover the debt.

She also pledged the continuation of the delivery of drugs to pharmacies until the end of this year.

(€1 = HRK 7.571658)

For more about politics in Croatia, follow TCN's dedicated page.

ZAGREB, 10 March, 2021 - The university hospital centre in Split recently performed its first transplant of stem cells, and the patient concerned is a 62-year-old woman, who is recovering from the surgery very well, the centre's director, Julije Meštrović said at a news conference on Wednesday.

The operation was performed 16 days ago, and this is the first time to have a stem cell transplant outside Zagreb.

This is a great success for the medical profession in Split and Croatia, he said.

Three hospitals in Zagreb perform stem cell transplants, and the first surgery of this kind was conducted in 1983.

The Split hospital expects to annually carry out 10-15 transplants of this kind.

For more about health in Croatia, follow TCN's dedicated page.

ZAGREB, 3 March, 2021 - The Civic Liberal Alliance (GLAS) party said on Wednesday Health Minister Vili Beroš and the government have once again put people in a situation where they do not know whether the medicines they need will be available or not, and the hospitals will again have to pay millions in court and debt enforcement costs.

"Debts for the goods delivered are not being repaid for more than 365 days, which is six times longer than allowed by law, and have now reached HRK 6 million. Even more tragically, the drug wholesalers must pay their dues to the state - taxes and contributions - in time," the party said in a statement.

Commenting on this situation, Minister Beroš, as usual, denied the amount of the debt and shifted the blame onto the citizens, claiming that they were not paying enough while using health services too much, GLAS said.

It recalled that the citizens contribute HRK 30 billion to the healthcare system annually, with the insurance policy holder with an average monthly wage paying HRK 1,600 monthly towards health insurance. For that money the citizens have the right to expect at least the minimum health service and they certainly do not need anyone to criticise them for contributing too little, the party said.

GLAS called on the health minister to thoroughly analyse the healthcare system and present the structure of costs to the public to see where the vast sums of money were going.

ZAGREB, 3 March 2021- The State Secretary at the Health Ministry, Željko Plazonić, said in the parliament on Wednesday that there would be no drug shortages and that citizens would be able to obtain the necessary drugs. 

Plazonić made the statement in response to a statement by MP Davor Nađi of the Fokus party, who, during a debate on changes to the Health Insurance Act, warned about the debts to drug wholesalers and uncertain supply.

Of all EU countries Croatia has the largest number of particularly expensive drugs for the treatment of malignant diseases whose cost is covered by mandatory health insurance, Plazonić said.

Health protection for digital nomads?

As for amendments to the Health Protection Act, which will ensure the right to health protection for digital nomads with temporary residence in Croatia, some opposition parties wondered if this would contribute to an increase in the health system's debts given that digital nomads would have access to cheap medical services under unclear criteria.

"Thousands of citizens have to wait for specialist examinations and we are now providing cheap insurance and medical services to foreigners who say that they are digital nomads," said Hrvoje Zekanović of the Croatian Sovereignists.

Marija Selak Raspudić of the Bridge party said that Croatia was copying Estonia, one of the pioneers of citizens' electronic status, without having a clear plan on how to regulate the status of digital nomads.

"How comprehensive is that approach, how much will digital nomads profit from it and how much will Croatia's economy profit?" she asked.