Czech health sector in critical condition

Leoš Heger, photo: CTK

Efforts to diffuse growing tension in the health sector over a deepening financial crisis appear to have failed. The health minister’s announcement on Thursday that projected cuts in payments from insurance companies would be less severe than expected did little to stem the growing tide of discontent. The Czech Medical Chamber responded by saying doctors would start handing in their resignations on Monday.

Leoš Heger,  photo: CTK
At a press briefing in Prague on Thursday, Minister Leoš Heger told hospitals they would get 2.1 billion crowns less for care provided from health insurance companies next year – a reduction which he said would prevent health insurance companies falling deeper into debt, while allowing hospitals to provide the same level of care. The minister said it was up to hospital directors to make the necessary organizational changes.

“The hospital wards that are hardest hit will have to tap into their reserves, organize their work better and try to provide more treatment within outpatient care. We think this cut should not affect the level of care provided or threaten the stability of health institutions.”

The reduction is expected to start a gradual overhaul of the health sector involving the closure of smaller hospitals and a greater concentration of specialized care in the big regional hospitals. The government claims that Czech health institutions conduct more medical procedures and keep patients in hospital longer than strictly necessary – for their own financial benefit. They point out that with 5.2 beds per 1,000 inhabitants the Czech system is way ahead of most European states including Switzerland, Italy, Denmark or the Netherlands. This has raised the ire of many specialists who do not want to see their wards closed down and who say that the cuts will cripple them to such an extent that within six months they may only be able to offer acute care, with planned operations being systematically delayed. Moreover, a lower income from health insurance companies has definitely dashed any hopes they may have had of higher pay. Close to 4,000 of the country’s 16,000 hospital doctors have threatened to resign and seek work abroad if they do not get a pay rise next year. Roman Prymula, head of the teaching hospital in Hradec Králové, says he is worried about the prospect:

Roman Prymula
“Our biggest concern is the departure of specialists – especially of anesthesiologists. They service all surgical wards and if half of them leave, as they are threatening to do, then we will only be able to perform acute operations. Anything more would be beyond our capacity.”

The Czech Medical Chamber, which has fought a losing battle for higher salaries, has said doctors will start handing in their resignations on Monday. If the mass exodus is as massive as some predict, the Czech health sector could find itself in very big trouble. And it will be patients who will inevitably pay the highest price; one of the popular slogans doctors carried at protest rallies read “our exodus will be your exitus”.