The Health Minister stated that the restructuring of the hospital system is necessary but it has to be based on very complex analyses and evaluations and to be done in agreement with local authorities, because the latter might take over a series of obligations and prerogatives.
Eugen Nicolaescu claims that in the case of 75 per cent of the hospitals closed down in 2011 by the PDL government the decision had nothing to do with health or with people, being based “on political reasons and in order to chalk up the reduction of financing and of the number of hospital beds in the relation with the IMF.” “The hospitals were closed solely based on political decisions that had nothing to do with reality. (…) I am disturbed by the fact that hospitals were closed without discernment, without any kind of logic, without any kind of criterion,” Nicolaescu stated yesterday, being quoted by Mediafax. He pointed out that the restructuring of the hospital system is needed, but it should be based on very complex analyses and evaluations done in agreement with local authorities. “From my point of view the Health Ministry (MS) should not be a midwife. It would be absurd for the ministry to enter over 350 hospitals and to tell them what, when and how to do it,” the minister stated, pointing out that he is in favor of a professional management and of the local authorities being allowed to do their job. Nicolaescu thus expressed his anger with the fact that professional management in hospitals is not being respected and that emergency ordinances brought “politicians back at the helm of hospitals again.” Another problem that Eugen Nicolaescu raised refers to the fact that emergency hospitals should be under the authority of the MS, arguing that they concern “Romania’s strategic health interest,” emergency medicine being the state’s exclusive prerogative, and municipal hospitals should be under the administration of local authorities. “I believe the hospitals that shouldn’t have been decentralized were decentralized and the hospitals that should have been decentralized were not. (…) From my point of view it’s a big mistake probably done to suit one or the other’s interests but certainly not in line with Romania’s strategic health interest,” Nicolaescu said. He added that he will write a memorandum on this issue and will discuss with the Administration and Regional Development Minister Liviu Dragnea in order for them to jointly establish a framework with which “to operate in Romania so that people will no longer do what they please.”
Hospitals, financed on basis of their classification
In what concerns the financing, the Health Minister announced that starting this year hospitals will be for the first time financed in relation to their class, so that tariffs for a medical case should not be smaller in health units class I than in health units class IV. At the same time, Nicolaescu pointed out that starting this year the anesthesia and intensive care wards of the 53 strategic hospitals will be funded from the state budget: “This means extra funds for those hospitals and obviously they will all be able to enter the budget.” The Health Minister also announced that the budget for financing special ambulatories and daytime hospitalization will grow by 50 per cent this year in order to discourage fictitious hospitalizations. “This means that we are rebalancing hospitalizations, we are rebalancing the services done by hospitals, we are discouraging fictitious hospitalizations but also those done only for the sake of rendering services and of subsequently hiking costs. With such measures the costs can be diminished and the health units could fall within approved budgets. It’s a strictly managerial measure of control and transparency,” Nicolaescu argued. According to him, there will be an attempt to resume an older order that was ignored, an order concerning addressability within emergency care units: “Usually the patient arrives there on his own feet, when and how he wants, because family medicine is not working, because it was discouraged, the special ambulatory is not working because it wasn’t financed, the permanence centres are not working, the multifunctional centres are not working. So the system is completely confused, it lives in chaos.”