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Ērglis: there should be a university law, not an association to aid a monopoly

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Baltic news, News from Latvia, BNN.LV, BNN-NEWS.COM, BNN-NEWS.RUThe initiative to create a medical resources association and excluding from it University of Latvia, which contributes a lot to the country’s medicine by developing the founding disciplines of chemistry, biology and physics, is a direct threat to the development of Latvian medicine, said Latvia’s leading specialist in cardiology Andrejs Ērglis in his interview to BNN.

«I’ve known Mr Šmits for a long time. I respect him and we are good friends. But this is a matter that divides us,» – says the cardiologist, adding that the matter and initiative to define university hospitals is not a new one, and that a discussion is necessary to be held with experienced specialists.

«It is necessary to define university hospitals – there is no doubt about that. By I am absolutely against the monopoly of a single university – Riga Stradins University hospital in this case! There is a thousand reasons for my opinion.»

Andrejs Ērglis emphasizes that there is now a very ugly situation in Latvia. «Even though I represent University of Latvia and this may sound interesting, no one can deny that the role of this university is priceless for the development of Latvian medicine. Medicine does not include solely treatment – it also provides the application of different sciences in future or modern medicine. This is why hospitals should not be separated from the University of Latvia.»

Demagoguery that other universities will not be prohibited from cooperating with other universities is incorrect. According to Ērglis, promises will not do this time. The agreement has to be confirmed in legislation.

The role of universities and their competition

Andrejs Ērglis believes the roles of both universities should be increased. At the same time, the cardiologist emphasizes that Pauls Stradins’ University Hospital, which is planned to be added to this association and which is represented by Ērglis, has performed the function of an education and science centre in the past.

«It would seem that Riga Stradins University Hospital is trying to fill employ gaps that are related to scientific work. If we look at international recognition, the hospital’s scientific accomplishments have been recognized with highest praise. In medicine, this is often related to practical work – clinical science, where the university plays a major role with basic sciences.»

The cardiologist is sad that there has not been much cooperation between the University of Latvia and Riga Stradins University. For example, University of Latvia is proud of its scientific faculties.

«I believe it is very important to include three main sciences in Latvian medicine – real biology, real chemistry and real physics. This is where people work with research, not just teaching. I am shocked that why people cannot understand why the Cardiology Centre requires biology. But we work with cells! Why does the Cardiology Centre require engineers of the highest level? Because we work with the most advanced engineering equipment that requires specific knowledge to operate effectively. All base sciences dictate the quality of modern medicine! People who do not understand this talk about first-year students. We should focus on post-graduate and Masters Education.»

Ērglis believes RSU focuses too much on education of foreign students. This, he believes, explains the desire to create the aforementioned association. «RSU’s chosen path is their choice. Focus on education of Asian students. Maybe this is necessary – I cannot say. However, this path cannot exist at the expense of Latvian patients».

Ērglis emphasizes that Pauls Stradins University Hospital has a significant capacity as it is, which is commendable in its own right. «This is one of the last institutions to which patients are transported from other hospitals with the most complicated diagnoses. This is why it must not be given away to any associations. This hospital should be the place for the best of the best from all universities to focus on,» – says the cardiologist.

Goals and motives

Even though there are many unclear aspects to the formation of this association, Ērglis sees this as an opportunity for RSU to pull out the hospital from the list of scientific institutions.

Motivation is also influenced by different project applications that promise large amounts of money, which is possible to obtain by forming such associations, says Ērglis.

«In spite of all this, the formation of an association cannot be a marginal and unipolar decision. I do not agree with such a decision! The University of Latvia does not agree as well! Even more so – even without the two universities I do not agree to have a hospital be taken away from the list of scientific institutions, because the hospital is one of the most highly-praised scientific institutions. This is our pride and joy. And we need to preserve and strengthen it, not ruin it.»

Flaws of the system and overshadowed matters

The initiative to create an association is being handled with haste, without holding discussions. «This should not happen, because Dins Šmits and [Chairwoman of Children’s Clinical University Hospital] Anda Čakša are too closely related to RSU. It looks as though they are creating their own association. This is not their directly their fault, it is part of the system as well. It cannot be that there is one person in a large system who dictates who is to be appointed the head of the hospital.»

Ērglis believes, the next step should be the creation of a Law on University Hospitals, which would make sure managements of hospitals are selected the same way as rectors.

«I believe the matter of how far we are in the construction of new hospitals is far more important than the creation of an association! We need to know what happened with this large project and how much has been accomplished on a European level. What is currently being built – administrative building and polyclinic – is but one-fourth of the entire hospital.»

According to Ērglis, an association can put at risk the entire practice of development of Latvian medicine and construction projects of new hospitals. Without motivational energy, it will be necessary to provide attention to different legislative changes, because the state guaranteed loan, for example, is allocated to the hospital, not the association.

He believes the place of cardiology is unclear in the association. This will also likely divide and pit against each other many industries, which can be a major threat to the entire system. The cardiologist mentioned the opinion of British journalist and Eastern European affairs expert Edward Lucas that it is necessary to provide attention to small things a country is burdened with.

«We cannot allow the system to be ruined or let hospitals be ruined as well, even if there are good intentions behind it (teaching foreign students). We should also keep in mind that we do not teach them for our sake, because the time it takes to study – six years – does not provide a doctor. Hospitals train doctors. Hospitals have the most advanced technologies and the biggest scientific accomplishments. No one wants to be operated on by a doctor who studied for a mere six years. In terms of medical tourism, we cannot provide large-scale improvements specifically because there are no particularly large hospitals. This is why we should focus on that, not the creation of unipolar associations that only increase competition,» – adds Ērglis.

Discussions and possible fragmentation

When asked about the reasons why LU is not taken into account in the formation of this association, Ērglis expresses complete shock: «We do not know! Mārcis Auziņš, rector of the university, has met with the government numerous times. We have written several letters. President of the Latvian Academy of Sciences Ojārs Spārītis has written a letter. Professor Jānis Stradiņš has told me that he definitely supports the hospital’s remainder as a sovereign scientific institution. This is why I cannot understand why LU is being ignored.»

He believes it is necessary to speak with people who work in the field of sciences and who know what happens there and in pedagogy.

«Unlike other disciplines, Latvian cardiology is developed on a world-class level – people come to learn from us. This association will not bring us any specific benefits. I sympathize with Dins Šmits, but the fact is that this idea is very one-sided and non-democratic. I cannot understand how RSU can simply say something like “Yes, we’re going to create an association without you!” It is completely unreasonable! It cannot be justified!»

«It is clear that everything needs to be discussed properly. I had thought this cannot be done through the press or society. It is possible, however, that my logic is flawed. The maternity department is a clear example of that. I believe such matters should be discussed in the hospital prior to coming forth with different statements and then having to listen to the people who have worked in the hospital for any years.»

Ērglis admits that management is very important. However, medical work is far more important to a hospital. «Medical treatment cannot exist without science and pedagogy, but I do not believe that hospitals should be converted into foreign student education facilities. We need to handle our own problems. Only then will we be able to educate people in the rest of the world.»

One of the concerns that bother medical personnel is whether or not buildings have a purpose, because the hospital will lose people. «This is a real risk to lose a part of cardiology, maybe even others,» – says Ērglis, adding that if nothing is done, the formation of the association could end with serious consequences. «It could become a reason for political instability. The University of Latvia will not agree to this, and neither will some of the doctors.»

Solutions and examples

The cardiologist believes discussions should begin with a Law on Medicine. «There is no need to create any associations. It is necessary to define a law that would govern university hospitals. There should also be a law on medical treatment that would include both universities’ interests and keep their sovereignty – they belong to the Republic of Latvia.»

«I am very troubled by this war – it is the very last thing Latvia needs at the moment. We need to be allowed to compete freely with each other. This is exactly what they do not want to do. It is a clear sign of political involvement in medical and scientific competition. No matter how this is resolved it will have an impact on the future generation. There has to be an atmosphere of freedom. If the foundation is set in an improper way, everything from it will develop wrong,» – believes Ērglis.

According to him, as long as an official tells the scientist what to do, there will not be any development. «It is not something an official has the right to manage! Strategy is not something officials should manage! Hospitals should be sovereign institutions!»

In regard to the strategy, Ērglis would recommend concentrating more on providing a higher level of medical services.

«There is a difference between quality and quantity. I believe Latvia should not copy China, USA and Russia and focus on quantity. The same applies to food products. We need to choose the quality niche. This is because of our size and infrastructure. We do not need extensive. We need intensive,» – said the cardiologist.

As an example, Ērglis mentions Switzerland: «People believe the Swiss economy is dictated by the banking sector. However, the banking sector provides the Swiss economy no more than 9% to 11% of GDP. The economy is stimulated the most from technologies with high added value. This includes physics, clocks, machinery and other equipment.

Latvia should become the same example. And this is why we should act differently – focus on training our own specialists more than foreign ones, so that bigger specialists would come to us to invest their money. This will give us an opportunity to dictate our own conditions in Latvia.»


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