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Ceturtdiena 18.10.2018 | Name days: Rolanda, Rolands, Ronalds, Erlends

Lithuania: rural ambulatory care precincts under threat

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Lithuanian Health MInister Aurelijus Veryga

Linas Jegelevičius for the BNN

An overhaul of Lithuania’s hospital network, the brainchild of Lithuania’s Health minister Aurelijus Veryga, has yet to override many hurdles and some say it has stalled amid the overwhelming resistance, however, the new «victim» of it may be the country’s ambulatory care centres that are on the bottom chain of medical services and which are especially popular among the rural population.

A newspaper published in the Plunge municipality in northwestern Lithuania reported this week that local Health Centre readies to close down several health ambulatory care precincts in the district.

With the outcry threatening to damage local politicians’ standings in the upcoming municipal Council elections, the municipality’s Council ordered to shelve the plans for now.

Yet the suspicion is that, with the reform of hospitals moving slowly forward, ambulatory care centres may be the first fall victim.

Approached by BNN, Alina Žilinaitė, a communications specialist of the Health ministry, denied however that the Ministry is behind the plans.

«We haven’t given any instructions in the regard. It is exclusively up to local health providers what to do with ambulatories and local health precincts. It is however understandable to the Ministry that with insufficient funding, some local health centres have no other option than to close them as, with fewer people in small villages, their maintaining is too expensive,» she accentuated.

Despite the criticism on his hospital reform, minister Veryga stands ground, arguing that it is needed as many beds in hospitals remain empty and others are occupied unnecessarily.

Besides, services in some hospital are unsafe, according to Veryga.

«There are hospitals where heart attack mortality is 100 per cent within 30 days from the arrival to such an establishment. And there are institutions working effectively, with the mortality rate standing at just 7.42 per cent. So the difference is over ten times,» he has said.

«The regions are losing part of their population, the rest of the population is older, thence these services need to be somewhat different…If we agree to provide different medical services in each of the municipalities, the quality of medical services would improve and the medics‘ salaries would go higher,» Veryga defended his plan.

According to him, 4,500 publicly-financed hospital beds are unused or patients are hospitalised unnecessarily every day.

Back in July, the Lithuanian parliament has approved the amendments to Law on Medical Care Facilities drawn up by the Health Minister, enabling the Health minister to decide on the network of such facilities.

The amended law foresaw that rural hospitals after reorganisation would have provided only essential care and nursing and the focus would have been put on out-patient care.

The amendments envisaged among other things that health facilities within the minister-approved network will be given priority in signing contracts with Territorial Health Insurance Funds (THIFs).

According to the amendments, Private inpatient facilities were given the right to conclude contracts with the THIFs only if they provide services that cannot be ensured by public hospitals.

Many of the amendments were planned to be put in effect from 2019, however President Dalia Grybauskaitė in July used her presidential power and vetoed the contentious bill.

The head of state sent it back to the parliament for its reconsideration, citing its incompatibility with the Constitution as the reason. Grybauskaitė then said that she supported a health sector reform, but criticised provisions giving priority to state-owned health facilities in signing contracts with Territorial Health Insurance Funds (THIFs) for health services’ costs to be covered by compulsory health insurance.

Lithuanian MPs upheld presidential veto of healthcare network in mid- September of hospitals and other healthcare facilities.

Minister Veryga as well as some members of the ruling coalition have also been criticised for other contentious initiatives aimed to wean off bad health habits of the population.

At the beginning of the year, the Lithuanian government introduced what is thought the strictest alcohol laws in the European Union, raising the legal drinking age from 18 to 20, restricting opening hours for off licenses and banning all advertising for beers, wines and spirits.

In another controversial legislative bid, plain cigarette packaging would be introduced and the display of cigarettes would be banned and smoking in residential balconies, outdoor cafes, beaches and other places would also be prohibited.

The amendments to the Law on the Control of Tobacco, Tobacco Products and Related Products envision the commencement of the restrictions from November, 2022. However, they have to pass the lawmakers’ clearance yet.

In another quest to make Lithuanians more health-conscious, Dainius Kepenis, a member of the ruling Farmers and Greens party, has recently rolled out a far-reaching plan consisting of 100 proposals. It envisions issuing of health plans to every Lithuanian citizen, prohibition of high-fat foods and employment of alternative medicine.

The lawmaker believes that with the plan fulfilled the rate of cardio- vascular deaths and illnesses will drop by 80 per cent in Lithuania just in three years.

Some critics pointed out however that the legislators, an avid healthy lifestyle supporter himself, did not say anything as to where to necessary resources for its fulfilment can be obtained.


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