ZAGREB, May 15, 2019 - Finance Minister Zdravko Marić on Wednesday said that it is obvious that the problem of the health sector debt cannot be resolved only on the revenue side of the health budget but that it requires intervention on the expenditure side too.

Speaking ahead of Thursday's meeting with wholesale pharmaceutical companies convened to discuss hospital debts for delivered medicines, Marić recalled that the Finance Ministry had already on several occasions made a contribution through extraordinary financial injections and by increasing the budget of the Croatian Health Insurance Institute by increasing health contributions on wages.

"The Ministry of Finance will always be a constructive partner in finding systematic solutions. We clearly showed our intentions on three occasions and participated on the revenue side. However, it is evident and being confirmed that the problem cannot be resolved only the revenue side but that it requires intervention on the cost side of the health budget," Marić told reporters.

He added that according to the latest data, the health sector's debts amount to more than seven billion kuna and that some hospitals have very long deadlines for payments.

Marić underscored that the problem of the health sector's debts and payment deadlines have not emerged overnight and need to be observed in the long term, adding that he is convinced that the health sector has certain recommendations and solutions.

"The system needs to be observed as a whole. The financial aspect, the debts and payment deadlines cannot be simply brushed off, and tomorrow, we will discuss that and see whether we can work something out," Marić said.

He added that compared with other countries, Croatia has a fairly high level of accessibility to health services and a very good and quality health service.

"The best confirmation and evidence of how good our doctors, nurses and medical staff are is the fact that they are quite sought after throughout the European Union," he claimed and stressed that an additional problem is how to keep highly qualified staff in the country.

More news about health sector can be found in the Lifestyle section.

ZAGREB, May 13, 2019 - Health Minister Milan Kujundžić on Sunday again warned about insufficient funds in healthcare, which is partly why medical staff are leaving Croatia, saying that for now a price increase of supplemental health insurance was not being considered but that outlays for healthcare must increase.

"We as a nation must decide if we want to keep doctors and nurses, superior medicine and new drugs. We must realise that they entail new costs," he said on Nova TV.

The incumbent government inherited the health sector's debt of 8 billion kuna and it has not increased it, but with outlays of 750 euro per capita, treatment cannot be as good as in countries which set aside 5,000 euro per capita, Kujundžić said.

He reiterated that the fastest effect would be achieved by raising excise taxes on alcohol and cigarettes, which Finance Minister Zdravko Marić has opposed so far.

Speaking of hospitals' debt to drug suppliers, which has reached 2.6 billion kuna, Kujundžić said a solution would be found either at state budget or Croatian Health Insurance Fund level.

The minister said that despite the financial problems, many things in Croatia's healthcare worked.

As for the large number of doctors and nurses leaving Croatia, he said the number of residencies had tripled over the past two years. This government has "a sound human resources policy and a significant number of physicians who left are coming back to Croatia."

Kujundžić said one should keep in mind that 85% of hospital revenues went on salaries. "It's difficult to raise salaries without stopping drug purchases," he said, adding the solution was in higher outlays for healthcare.

More healthcare news can be found in the Lifestyle section.

As Frenki Lausic/Novac writes on the 20th of April, 2019, the Croatian Government's convergence program for the next three-year period has identified the pension and health system as the two largest structural risks, both of which are associated with the country's worryingly negative demographic trends.

This government assessment came at a time when trade unions are busy organising a referendum on pension reforms, as well as during a somewhat shaky period in which Zdravko Marić, the Croatian finance minister, said that Milan Kujundžić, the minister of health, is an excellent minister but that the Croatian health system with over seven billion kuna's worth of debt is unsustainable in an interview for N1.

When it comes to Croatia's concerning demographic trends, the program states that, when comparing the European Union and the Republic of Croatia, in the period 2016-2070, the remaining life span after 65 years of age will be extended by 6.4 years in men and by 6.2 years in women in Croatia, whereas in the EU, it will be 5.3 years more for men and 5.1 years more for women.

It has been stated that the life expectancy at birth in 2016 was 81.1 years for women and 75 years for men, which is less than the average for the EU, where the expected life expectancy at birth for women was 83.7 years, for men 78.3 years. However, data for the Republic of Croatia showed that life expectancy up to 2070 will be 9.4 years more for men and 7.8 more for women, while for the EU, life expectancy is expected to grow to 7.8 years more for men and 6 more years for women.

In this context, the results of the long-term projections for the Republic of Croatia for the period 2016-2070 show that without the calculated effects of the reform which came into force at the beginning of this year, pension expenditures from the first pillar should be reduced from 10.6 percent of GDP, which is what it was back in 2016, to 6.8 percent of GDP to the year 2070.

At the same time, transfers from the national budget to cover the deficit would gradually fall from the current 4.8 percent to about 1.2 percent of GDP by the year 2070. Expenditures for pensions from the second pillar should gradually increase to 1.6 percent in 2070, which means that overall retirement expenditures from the first and second pillars in 2070 would amount to 8.4 percent of Croatia's GDP.

Thus, looking at the situation macroeconomically, the pension system would remain viable, but with inadequately small pensions. That is why the government states that measures from the latest pension reform will increase pension adequacy and, accordingly, retirement expenditures in the first pillar.

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Click here for the original article by Frenko Lausic for Novac/Jutarnji

ZAGREB, April 16, 2019 - Prime Minister Andrej Plenković and Zagreb Mayor Milan Bandić on Monday signed a framework agreement on cooperation in preparing the project "Building the national children's hospital," which is the first step in implementing the project for the construction of the hospital in Zagreb's Blato neighbourhood.

The government-sponsored project is worth 42.3 million kuna, of which 85% will be financed by the European Regional Development Fund. The rest of the funds will be secured from the state and Zagreb city budgets.

The new children's hospital will also provide care in gynaecology and obstetrics.

After signing the framework agreement, Plenković said this strategic government project was aimed at providing the youngest patients with the best possible care.

Health Minister Milan Kujundžić said the new national children's hospital would provide all forms of treatment of children's diseases in one place.

More health sector news can be found in the Lifestyle section.

As Poslovni Dnevnik writes on the 13th of April, 2019, the national children's hospital project is now finally entering a much more serious phase, and the Croatian Ministry of Health and the City of Zagreb, which are partners on this strategic project, will finally present it to the public in full, according to a report from Vecernji list, citing an international public bid to draw up a feasibility study for the huge project in Blato, Zagreb.

The feasibility study is necessary for this project because it will properly specify the requirements of the architecture, the urban planning, the ecological impact, the traffic situation, and all of the other parameters which need to be carefully considered and constructed, and one of the feasibility study elements would be the preparation of medical documentation.

Fifteen of the major international bidders are expected to report their segment-based studies, each within its own respective scope, and therefore a comprehensive study will ultimately define just what will go where, and where exactly to begin with construction. The start of work on feasibility studies from the project's partners, the Croatian Ministry of Health and the City of Zagreb, will be presented on this coming Monday, as was confirmed to Večernji list by Vili Beroš from the Ministry of Health.

"We received 42 million kuna from the Competitiveness and Cohesion 2014 - 2020 project, which is now a European project, and its initial presentation is common within such projects," explained Beroš.

The announcement of this tender was preceded by an electronic public consultation with all interested parties.

The core of Croatia's brand new national children's hospital would be the current Zagreb Children's Hospital, Klaićeva.

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We will not wait for European funds. The new National Children's Hospital will be built with funds from the state budget “because sick children cannot wait.” This was said last year by Minister of Health Milan Kujundžić, announcing that the construction works in the Blato district in Zagreb will start this year, reports Večernji List on April 7, 2019.

However, it is clear that there will be no construction works this year and that the sick children will indeed have to wait, probably for at least a decade. That can be seen in the documents which will be signed by the state and the city authorities on April 15. The documents define the co-operation in the development of the future children's hospital. The first stage includes preparation of all necessary documentation in order for the construction to begin at all.

The paperwork will cost 42.3 million kuna, of which the City of Zagreb is responsible for covering 26 million and the Ministry of Health 16.3 million kuna. They will actually spend considerably less, since 85 per cent of the cost, or a total of 40 million kuna, has been granted by the European Union funds, so the city will allocate for the preparatory works only four million and the Ministry 2.4 million kuna. The deadline for all the documents to be ready is 57 months starting from last March.

In other words, the deadline is December 2022, while the money for the hospital construction itself would be withdrawn from European funds "in the next programming period," which will last from 2021 to 2027.

One of the documents expected is a study which will show whether the new hospital should be located in an entirely new building, or whether the never-finished University Hospital located at the site could be used for this purpose. Through the decades, 157 million euro has been invested in the complex of the university hospital which was never completed. In the 1980s, all citizens of Zagreb paid 1.5 per cent of their personal income for the university hospital. By 1992, about 50 per cent of the building was completed, and then everything stopped. The current owner of the site is the City of Zagreb.

The construction of the children’s hospital would cost around 130 million euro.

There are funding problems with another major city project, the new Sljeme cableway which is currently being constructed. The city will reportedly transfer the project to the ZET public transport company, and it that way “find” the funds missing for its completion. The project is supposed to be completed by the City Day next year, but the budget includes just 80 million kuna for the cableway, which covers just one-fifth of its total cost. The plan is to secure additional funds with a loan which should be taken out by ZET.

Translated from Večernji List (reported by Mateja Šobak).

More Zagreb news can be found in the Lifestyle section.

ZAGREB, April 5, 2019 - Agreements granting the Health Ministry a total of 45 million kuna from EU funds for the purchase of six speed boats for the provision of emergency medical aid along the Adriatic and twelve biochemical blood analysers for emergency diagnosis on the islands, were signed at the Ministry of Regional Development and EU Funds on Friday.

The funds will be used to procure speed boats, ensure berths in home ports and purchase blood analysers that can quickly determine whether a patient needs to be transferred to a hospital on the mainland, it was said at the signing ceremony.

The boats will be stationed on the islands of Mali Lošinj and Rab, in Zadar, Šibenik, Supetar and Dubrovnik and will serve all inhabited islands, with a total population of 122,000, and visitors during the tourist season.

The agreements were signed by Health Minister Milan Kujundžić, Regional Development and EU Funds Minister Gabrijela Žalac and the head of the Central Finance and Contracting Agency, Tomislav Petrić.

The speed boats and blood analysers will significantly improve emergency treatment of patients on the islands and facilitate the work of physicians in establishing a diagnosis and deciding on the condition of patients, Minister Kujundžić said and added that he expects the boats to be operational in two years’ time while the analysers could already be available at the start of this year's tourism season.

Minister Žalac expressed her satisfaction that the entire amount of 45 million kuna will be secured from the Competitiveness and Cohesion operational programme, noting that the number of agreements for European funding for healthcare infrastructure had accelerated this year and last.

"Together with the Health Ministry, we have advertised six of the planned calls for bids and contracted 51 projects amounting to 1.7 billion kuna, which is 85% of the envelope envisaged for the health sector in this financial period. We expect to contract the remaining 15% of the healthcare allocation by the end of the year," Žalac said.

Considering that emergency medical services have to be available to all citizens, Žalac announced the possibility of establishing a helicopter emergency medical service in the next financial period which would complement today's agreements and would facilitate the emergency medical care of patients on the islands.

More news about EU funds can be found in the Business section

ZAGREB, April 3, 2019 - Finance Minister Zdravko Marić on Wednesday recommended the introduction of cost-saving measures in the public healthcare system that was faced with a high debt exceeding seven billion kuna.

"Debts in the healthcare system have been accrued for years. We are the first government to have managed to cut the healthcare debts without raising the public debt. Nevertheless, the debts are still at high levels and exceed seven billion kuna, concerning (the debts of) the Croatian Health Insurance Agency (HZZO) and the public healthcare institutions," Marić told reporters outside Government House.

He dismissed media speculations that the debt in that sector was the cause for his dissension with Health Minister Milan Kujundžić.

Marić insists that he has a good relationship and communication with Kujundžić, however, he explained they could not have the identical opinion on everything.

In terms of the revenue side in the healthcare system, a lot has been done, however, it cannot solve all problems, and cost-saving is necessary, Marić said noting that there is room for belt-tightening.

Certain cost-saving can be performed through the optimisation of conditions for work (of hospitals), he said.

Marić recalled that in 2017 the government redirected 1.5 billion kuna to the healthcare system without a rise in the public debt. Also, during 2018, some 500 million kuna was redirected to the healthcare system for the purpose of debt reduction, he added, announcing some more funds for that purpose in 2019.

More healthcare news can be found in the Lifestyle section.

ZAGREB, April 2, 2019 - Responding to a warning from wholesale drug suppliers that deliveries of drugs and medical supplies to hospitals will be suspended unless a solution is found with the government to settle hospitals' debts to wholesale drug suppliers, the Croatian Health Ministry said in a statement on Monday that drug supply was not in question.

"The Health Ministry is aware of the big and long-lasting problem of hospitals' drug debt," the ministry said, adding that it was working intensively to find a solution to the problem in cooperation with wholesale drug suppliers, the Croatian Health Insurance Institute and the Finance Ministry.

It recalled that owing to financial stability, the government in 2017 secured funds to settle the hospitals' debt to wholesale drug suppliers in the amount of 1.27 billion kuna. In 2018, the government provided 487 million kuna for that purpose and the HZZO secured an additional 100 million kuna.

"We stress that regardless of the complexity of the problem, citizens have no reason to worry that they will not be able to obtain drugs because the supply of drugs needed by patients is not in question," the ministry said.

The total debt of hospitals towards the four largest wholesale drug suppliers reached 2.2 billion kuna (300 million euro) at the end of last year, of which 85 percent had matured, and is increasing by 150 million kuna (20 million euro) per month, wholesale drug suppliers said earlier in the day.

More news about Croatian healthcare system can be found in the Lifestyle section.

ZAGREB, March 19, 2019 - A national children's hospital in Zagreb, a national cancer prevention plan, improvement of emergency medical services, introduction of mobile clinics and changes to the law on mandatory health insurance are only some of the projects Health Minister Milan Kujundžić announced for this year at a business breakfast held by the American Chamber of Commerce in Zagreb on Tuesday.

Addressing the event, which focused on the sustainability of the national healthcare system, Kujundžić said that everything was ready for the project to build a national children's hospital in Zagreb and that an international tender would be advertised in the coming days.

"A feasibility study has been prepared and money for it will come from EU funds. In the next few days an international tender will be advertised so that we can apply for EU funding," he said.

Kujundžić noted that the feasibility study cost 37 million kuna and that the construction of the hospital and its equipment would cost around 100 million euro.

Speaking of projects that had been implemented over the past two years, Kujundžić cited amendments to healthcare legislation, the introduction of priority waiting lists, functional integration of hospitals, an expensive drugs fund and the procurement of expensive equipment.

We are especially proud of priority waiting lists for specialist examinations which helped treat around 22,000 seriously ill patients in 2018, said the minister.

Speaking about day hospitals in different parts of the country, Kujundžić said that specialists from Split already worked at the day clinic in Zagvozd and that specialists from Dubrovnik would be working in a day clinic that would start operating in Metković today.

With regard to other demands for better healthcare in Metković, Kujundžić said that a framework had been defined to link the town's emergency service, laboratory and day clinic with the hospital in Mostar, in neighbouring Bosnia and Herzegovina.

The minister also mentioned projects to build hospitals in Pula and Rijeka, higher allocations for expensive medicines, a project to introduce the first robot surgical team, and an increase in the number of specialist internship programmes.

Kujundžić also said that an agreement on speedboats to transport patients from islands to the mainland would be signed in the next few months.

He dismissed speculation that the supplementary health insurance fee would be increased.

More news about Croatian healthcare system can be found in the Politics section.