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Saturday 24.08.2019 | Name days: Boļeslavs, Bērtulis

State Audit: Latvia’s Healthcare Ministry is fighting problems that existed ten years ago

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Baltic news, News from Latvia, BNN.LV, BNN-NEWS.COM, BNN-NEWS.RUAlthough since 2005 there have been adopted to ensure Latvia has a sufficient number of doctors with appropriate qualifications, the State Audit found in an inspection that this goal still has not been reached.

Though the number of doctors in Latvia meets the requirement set by the World Health Organization per 1 000 residents in Europe, reality shows that specialists with appropriate qualifications, especially in regions, are either unavailable entirely or are very limited.

Planning documents are being developed but human resource supply remains short

The audit concluded that the goal established more than ten years ago by Healthcare Ministry – to provide the country’s healthcare system with sufficient human resources with appropriate qualifications to meet demand – still has not been reached. The problems identified a decade ago remain topical today. This includes insufficient number of nurses, disproportionate number of doctors and nurses, high inequality with presence of medical personnel in regions and Riga, low wages, and inefficient switch of generations.

The proportion of medical specialists in Riga and Pieriga continues increasing, but their shortage remains observed in all sectors. The situation in regions was not changed much by Healthcare Ministry’s activities to provide employment to people outside of Riga. State Audit therefore believes Healthcare Ministry and municipalities have to find new solutions to improve the situation, because ensuring accessibility of healthcare services for all residents is the responsibility of municipalities.

The analysis performed in the audit shows that the healthcare sector lacks at least 3.5 nurses and approximately 300 midwives. Only 65% of new specialists with appropriate qualifications remain in Latvia after graduating, and only 52% of nurses and 54% of midwives become employed in Latvia after graduating. The switch of generations is not going efficiently enough – 55% of healthcare and support personnel are older than 50 years.

Wage level is a significant aspect to motivate youngsters to start a career in healthcare and thereby preserve existing human resources. Originally Healthcare Ministry planned to significantly increase wages for healthcare personnel in 2009. Unfortunately, the first steps for increasing wages did not come sooner than 2018. Lasting negligence has created a shortage of medical personnel and has negatively affected the profession’s prestige, State Audit notes.

Development of medical education does not help resolve human resource problems

Industry-specific regulation of professions would serve as foundation for a proper education system. The audit found that Latvia’s healthcare industry has two times more regulated professions and 1.5 times more specialties, sub-specialties and additional specialties than in Lithuania and Estonia.

State Audit notes that Latvia still lacks coordinated planning of studies compliant with industry needs, because education institutions that prepare doctors are subordinated to two sectors – education and healthcare, whereas placement planning is handled by Healthcare Ministry. This means the situation when the number of graduates from state-funded healthcare studies is larger than the total number of available spots in the country’s universities, which does not limit the use of state budget funds accordingly.

Auditors point out that new doctors enter Latvia’s labour market late. In Latvia, the length of education programmes in different medical professions exceeds the minimal length detailed in the Directive on the recognition of professional qualifications, whereas in most cases the minimal length of studies in Lithuania and Estonia meets the minimal length of studies.

The entry of nurses and their mobility on the labour market is made difficult by the complicated process for acquiring a nurse’s profession and associated certification system. Nurse education system prepares nurses on different levels. However, the nurse profession is also rather fractured. Healthcare Ministry does plan to improve nurse education in the future by introducing a base specialty – general care nurse.

Certification and re-certification – transparent and significantly improved

In order to work full-time in a specific healthcare position, medical personnel have to not only register with healthcare personnel register, but also acquire a certificate that proves their professionalism.

Nevertheless, auditors add that the initial certification procedure for medical personnel who want to receive a certificate immediately after graduating is only formal and creates unnecessary burden because acquired theoretical and practical education and experience do not differ at the end of studies and at the moment of certification exam. However, young specialists have to pass two exams in the end.

Medical personnel have to renew their certificate every five years. However, re-certification requirements are formal, they are either partially or systematically ignored, because not all certification institutions check the information provided by medical personnel in regards to work experience and not all professions are provided with professional assessment criteria, State Audit notes.

Auditors say it is not possible to revoke certificates in the event if regulations and ethics norms are breached, because there is no efficient cooperation and information exchange between Health Inspectorate and certification institutions authorized to revoke issued certificates.

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