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Saturday 25.05.2019 | Name days: Junora, Anšlavs
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State Audit: Medical Treatment Risk Fund does not function in patients’ interests

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Baltic news, News from Latvia, BNN.LV, BNN-NEWS.COM, BNN-NEWS.RUMedical Treatment Risk Fund was formed in Latvia to ensure patients are able to receive compensation for potential damages caused during the medical treatment process, but it does not perform its main function because it does not work in patients’ interests, as concluded by Latvia’s State Audit in an audit performed to analyse Medical Treatment Risk Fund’s paid compensation and the process’ compliance with regulations.

The money the fund offers is vital for the health and life of many patients because they allow taking action immediately to reduce and prevent possible negative consequences. In certain cases, waiting for decisions regarding payment of compensation results in said money being received by inheritors of patients that needed the money, State Audit concluded evaluating the work performed by the fund’s remuneration system.

Over the course of five years, Medical Treatment Risk Fund has received requests from more than 900 patients and more than 200 decisions were made in which damage was recognized and compensations worth EUR 4.4 million were paid. The audit evaluated accessibility of the fund, the time it takes to assess patients’ requests, the procedure for determining the amount of remuneration and the formation of fund’s finances.

The Medical Treatment Risk Fund was created with a goal to provide patients with an opportunity to defend their rights without turning to the court. The fund is state responsibility, but its function is directly dependent on the speed and capacity of both the Health Inspectorate and National Health Service.

For patients to become eligible for remuneration, they have to turn to the Medical Treatment Risk Fund and describe the damage that was done to them. The fund has a duty to make sure patients submit all the necessary documents and comply with submission terms. The Health Inspectorate then performs analysis and determines the level of damage done to patients. Once this is done, Medical Treatment Risk Fund makes the final decision regarding either payment of compensation or refusal. The maximum period of time for this process is six months. The term is complied with only in 24% of cases. The term is usually extended to one year in cases in which additional time is needed to perform assessments, but in 33% of cases decisions take more than one year, auditors say.

The Health Inspectorate’s evaluation and preparation of reports takes the longest to prepare. On top of that, the time needed for examinations tends to increase every year.

While in 2014 it took eight months on average, in 2017 it took more than a year. The process and its length are influenced by Health Inspectorate’s capacity and disorganized internal processes.

The audit revealed that the shortage of experts significantly influences Health Inspectorate’s work. This is also a problem for the entire industry. To resolve this problem the inspectorate started signing contracts with professional associations at the end of 2018 to assist in examinations.

The audit report mentions that one reason that has a major delaying effect is the too general regulation regarding the calculation of the severity of the damage done to patients’ health. Regulations that govern this field are too complicated and unclear for even the most knowledgeable patients to follow. This is why it will not seem fair and objective in any case when the full requested compensation amount is not paid.

In accordance with Cabinet of Ministers requirements, the annual amount of fees provided by healthcare institutions to the Medical Treatment Risk Fund needs to be established clearly, considering the number of expected and justified remuneration requests, number of employees in every given healthcare institution and their speciality. In reality, National Health Service does not perform outlooks. Instead the service bases its estimates on the same assumptions made in 2013. According to said established estimate, the average number of justified remuneration requests does not exceed ten.

The current financial flow of the Medical Treatment Risk Fund does not imply the fund has ever had a shortage of funds to pay compensations. The State Audit explains that one of the reasons for this situation is that decision-making processes are drawn out. On top of that, the fund does not take responsibility for breaching terms. As a result, the size of compensations do not exceed annual budget’s available funding amount, causing a surplus of funds to build up. However, if the remuneration request process became shorter, there could be a shortage of funding to cover all requests, auditors warn.

The fund’s finance accumulation process shows a priority care for the state budget, not the patient. The period of time detailed in the Cabinet of Ministers requirements is 90 days. According to auditors, this period of time is unbalanced and does not help protect patients’ interests.

The other reason why money stays in the fund is that society is not provided with sufficient information regarding the fund’s existence and objectives or their rights. Surveys performed by the audit show that only 14% of respondents have heard about such a fund in Latvia and only 9% of respondents are aware of the fund’s main function.


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