Health Congress, but public hospitals remain a medical disaster

The First Health Congress brought together policy makers, health experts, healthcare professionals, service users and other stakeholders in a common forum to share experiences and engage in dialogue about system challenges health, BUT two important things were forgotten in a Congress: the Public Health Platform-Program and the participation of professional medical experts, both opposition and independent. It just resembled a Congress of a political Party where everyone talks but says nothing. The only interesting part was the words of the Prime Minister that... ``not on April 1, but on April 30, specialist doctors will start receiving 50 thousand new lek plus in their salary. I repeat, they are new, meaning they are $500 a month plus, that's $6,000 a year if my arithmetic is correct and that's from april. Meanwhile, we will keep the promise of a 7% salary increase for general practitioners and nurses.

And the next phrase: "We have increased salaries by 63% since 2013. Autonomy is a new mechanism that has now begun to be tested in the memorial hospital and will create the possibility to have better, but not equal, salaries in the health system . Autonomy will increase the salaries of those who work more, who do more visit operations, but in the meantime we must guarantee a more dignified salary ceiling. This April, specialist doctors will receive a new 50,000 ALL in addition to their salary. We will keep the commitment to 7% for GPs and nurses. We are preparing a proportional increase with this for specialist doctors and at the beginning of 2024, a similar increase for general doctors and nurses.'' Congress was held, but the problems of management and medical care for patients in Public Hospitals remain unsolved for many reasons.

The situation is catastrophic. Why do we mention the word catastrophic? I mention this because it has been 32 years since the transition from free health care to capitalist health care, paying a health tax to have health care, was made with mistakes and major legal violations, so the following measures must be taken: There are bribes that go up to 50,000 euros a week of the four University Hospital Centers of Tirana, money given by patients who have been paying health insurance for years but who pay because they do not receive proper medical care from the doctor and nurse; inside the pavilions there is not even a thermometer and the hygiene services for the toilets are woeful because the toilets are not cleaned; medical patients received money for each service, even those like the ``Tire model'' ask for money; medicines are missing, which patients are forced to buy outside the public hospital; public laboratories for analyzes do not work well, even hospital ones, so patients are forced to do them outside the hospital or they are done with a lot of trouble inside, thus questioning PPP for the analyses, many say that the analyzes are not done with quality; there is a lack of professional control in these centers for the daily work of doctors and nurses, thus causing problems in the medical care of patients; Public Hospitals are run by political people and not by a Professional Board; Hospital pharmacies are a problem along with tenders for which they are delayed and some of the hospital medications may go out of hospital pharmacies and be sold in city pharmacies. So there is a task of dividing the medications which are hospital and which are not; The medical personnel of public hospitals do not have a `Badge', so it is not known who is a doctor, or a nurse or a sanitary worker and a health worker of the hospital and who is not; The salaries that the Prime Minister talked about in the Congress is a positive step, but they should be adjusted and added to the VKM, as well as bonuses for medical work and additional medical consultations; Medical personnel in hospital centers must be selected through competition and annual exams to stay in the hospital; The dual employment of doctors and nurses should be regulated by Ministerial Order; The efficiency of all PPPs must be reviewed; The minister should have meritocratic advisers with experience and ethics and not party militants; Last, but not least, is the activation of the Health Reimbursement Card, which will put an end to bribery, as well as the re-adjustment of the medication reimbursement book by the Health Insurance Fund and through it the coverage of medical services in Hospitals using the Health Card; The PIH remains a big problem, its funds are reduced; The increase in GDP for Medicine would help a lot both for salaries and for the coverage of Medical Care Reimbursement of the population. Briefly, looking at all these deficiencies and unresolved problems some even 32 years old, the Law on Hospital Autonomy can be questioned because the tendency - after this law has been approved - for Public Hospitals to practically turn into some pseudo-private hospitals, where it will be legislated not only bribery, but patient expenses would increase even more despite the payment of the Health Insurance tax, which so far is a small 3.5% but does not fully serve the sick. In a capitalist system it is necessary to have public hospitals that function properly and compete with private hospitals. Albania needs public medical services. Underestimating the public function of public hospitals and turning them into semi-private autonomous hospitals just because someone or a group of private interests are looking for this version of public hospitals in a camouflaged way, will not serve the Albanian people, therefore it is necessary to make a real reform in the public health system and a platform that will be implemented for the benefit of the population,