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Apart from the portability of two years of doctors working in public health, Gabriella Lantos, a health expert who explained on the hvg.hu podcast, how you can incorporate serious structural changes, considers that the introduction of the Health Services Law is good :
- complete separation of public and private health,
- the cessation of gratitude money,
- the loss of influence of the medical barons,
- and the transformation of small hospitals that function unsustainably
new legislation passed by parliament on Tuesday.
According to Lantos, a strict restriction on hiring a second job, which is a central element of the law, places metropolitan doctors in private practice, whose incomes exceed 50 percent of their private income, in front of a serious decision.
In Lantos’ language, they are only highly influential physicians, called medical barons, who have been most characterized so far by diverting their patients between their private order and public health, asking for up to 2,300,000 HUF for surgery at the expense of the hospital team and staff. .
According to Lantos, now that it will be prohibited by law to treat a patient treated in private practice by the same doctor in public care, this more common form of gratitude money may disappear. Interested physicians can decide:
- entirely in private health: continued in private hospitals or jointly established private practices,
- or trying to stay in public health.
The expert believes that the former is more common in professions in which doctors do not need serious surgical training to practice. These include dermatologists, diabetologists, or cardiologists.
Doctors who “need professional training in surgery” and will no longer have the opportunity to bring their patients to the hospital from their private practice will find themselves in a more difficult position.
Those of them who remain in public health and do not transfer to a private hospital will also have to deal with the loss of gratitude money, although Lantos says that gratitude money will only be completely depleted from the system over a longer period of time. . It can persist for a long time in the “much more conspiratorial way” between doctor-patient family couples.
So the reform will definitely hurt a part of the medical community: experienced doctors who have been working for a long time, but according to Lantos, that was exactly the mission of the presidency of the medical chambers, which was chosen by a two-thirds majority. :
“That these people, whom I call doctors, should have much less influence and income, and that all those who have worked invisibly in the health sector should have much better luck.”
– he explained, referring to beginning or young doctors, who, according to him, the possibility of a salary increase and faster professional development will be more likely in Hungary in the coming years.
According to the health expert, the eligible point of the law is that it does not allow the employment of “personal taxpayers” employed as employers in public health. However, in some areas, typically in anesthesiology, emergency or intensive care, this is now the typical practice, with specialists working in several public institutions working at the same time.
However, according to Gabriella Lantos, it is not at all a problem that the ban on working in several institutions at the same time leads to an overwhelming shortage of smaller rural hospitals offering less attractive salaries.
According to him, the process results in a kind of natural selection, a serious reduction in capacity, as a result of which “in the spring it will be possible to clearly see the size of the doctor in Hungary to maintain the health system.”
“Until now, this has not been seen because doctors are now being exploited incessantly and working in 4-6 places. It really will be a moment of truth. “
He explained.
After the tipping point, Lantos said the process could begin, at the end of which small hospitals struggling with a shortage of doctors will be forced to close due to inoperation, and care and staffing will be carried out in the regional central hospitals.
Lantos would consider it ideal for small rural hospitals to become “true health centers” with ambulatory care and surgical care in one day. The wards would be converted into chronic care facilities where convalescent patients sent home from central hospitals could be cared for. When this does not work, nursing homes could be established.
The expert, who affirms that “he cannot be accused of being friendly with the government”, now sees that “the government has done well” by avoiding political negotiation to convert the closure of unsustainably small hospitals and the structural reform of care of health urged for a long time in a professional matter.
The only thing that he believes should be “immediately removed from the law” is the compulsory assignment of physicians working in public health to any other state / municipal institution for a maximum period of two years. This, according to the expert, is a very serious violation of the right to privacy that could be successfully challenged in court at any time. In this interview with 444, Zoltán Szabad, president of the Hungarian Medical Union (MOSZ), also criticized this point of the law, although it was accompanied by several other provisions.
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