A.Veryga threatened to cut funds for medical institutions, and they reply that they cannot work due to the minister’s decisions

Although the quarantine in Lithuania was lifted on June 16, patients are still not free to receive part of the planned or inpatient treatment services.

Ultrasounds are not available since January

Vida Augustinienė, President of the Council of Representatives of Lithuanian Patient Organizations (LPOAT), agreed that access to doctors is difficult.

She shared personal experiences.

Let’s say you still can’t get to your family doctor at one of the polyclinics in the capital. You could only be offered a remote consultation by phone.

“It just came to our attention then. Also, at the Polyclinic Center, I was scheduled for the ultrasound on April 9. It was her, of course, it didn’t happen at the time. And then, at the front desk, I asked, said to see a family doctor, the family doctor said the doctor himself would report when it was possible to come. However, so far there has been no ultrasound since January. And when I last spoke last week, I also asked, “Oh, how is my ultrasound, what to do next because nobody tells me anything, “he said, the doctor went on vacation for three months. Well, it all ended with that,” said V. Augustinienė.

The LPOAT President emphasized that doctors receive fewer patients, most services are provided remotely.

“It just came to our attention then. It’s even worse in the districts,” he said.

It is alleged that due to the requirements established by A.Veryga, medical institutions cannot function normally due to a lack of specialists.

“And here is another forbidden hand from coming to the districts of large medical institutions. This is how such a closed circle comes out. But we continue to hear that the minister tells us to work there at full speed. But how can they work if not Are they allowed to work? This is the biggest problem. As I say, it counts how many people died from coronavirus, and there is no information on how many people died from other diseases without receiving the necessary medical help in time, “said V. Augustinienė.

In his opinion, decisions such as the most urgent resumption of scheduled treatment should not be limited to SAM behind closed doors.

They should be discussed with the heads of medical institutions, related associations and patient organizations.

“And only after discovering all the reasons why medical institutions don’t work, they not only threaten to stop paying, etc. Stop paying, it will get worse. Then people won’t have it at all. This gives the impression that, under the cover of a coronavirus pandemic, the process continues and the objective is to limit the work of patients in these areas and close them permanently, “said V. Augustinienė.

The plan was not carried out.

During a government meeting on Wednesday, the head of the State Health Insurance Fund (VLK), Gintaras Kacevičius, presented information on the provision of health care services in June.

It shows that, for example, the number of expensive exams and procedures provided on an outpatient basis in June 2020 was 42,289, compared to a total of 45,937 in the same month in 2019.

It is also noted that in June, compared to the same month last year, less expensive examinations and procedures were carried out on the funds of the Mandatory Health Insurance Fund.

Suppose computed tomography, magnetic resonance.

It is true that in general less were performed (24.1% less in total compared to June 2020 and June 2019) only in public personal health institutions.

At that time, 7.9 percent of the expensive exams and procedures were performed at private health institutions, comparing the aforementioned period. plus.

For example, they performed more magnetic resonance imaging and hemodialysis procedures.

VLK data shows that public health care institutions were far from meeting ambulatory service contracts in June.

For example, Republican and regional level hospitals contracted at 56.2 percent, at the district level: 53.6 percent. Polyclinics: 49.3 percent.

The outpatient service contract of a private institution fulfilled 94.4%.

The Kardiolita company stands out here, as it fulfilled 146.6% of such contracts in June.

According to VLK calculations, in June specialist doctors provided almost 42 percent. fewer queries than in the same month in 2019 (360 thousand in June and around 618.6 thousand in June 2019, respectively).

A vicious circle was formed

Commenting on the situation, the head of Pakruojis Hospital, Vygantas Sudaris, the head of the Lithuanian Association of District Hospitals (LRLA), emphasized that he did not understand what was happening in Lithuania.

He said that the day before yesterday, the representatives of VLK had presented the same information to the Government to the heads of the associations of the two medical institutions, to several mayors of the municipalities.

“And we all emphasize that there are ministerial orders that restrict activities, limit the number of patients due to hygiene, cleanliness, etc. requirements, labor cyclicality. Now we start working in June, when the quarantine ended: 14 days. This was evaluated over a fourteen day period and the following conclusions are drawn. (…) There was even an instruction of up to 50 percent: no more services to update at first. Then it changed a little bit again. There were all kinds of requirements: at least beds to have an area per patient, to accommodate almost one patient per hour. Is this how institutions can resume operations when there are restrictions? “, I ask.

According to V. Sudaris, if the restrictions remain in medical institutions, those who comply with the law will be punished, and those managers who do not comply and, if by accident, COVID-19 will end up there, they will face criminal responsibility.

“How to treat hospital managers and doctors? You can answer? I really don’t understand, “said the LRLA chief.

According to V. Sudaris, in the report presented by VLK, the Pakruojis Hospital is in the middle.

He mentioned that about 50 percent of the office was renovated. Hospitalization services.

However, the hospital chief emphasized that these were only the data for the two weeks of June.

“Let’s say that the Panevėžys Hospital did not allow specialists to work with us due to cyclicality. It was automatic and there were no such services. Šiauliai Hospital renovated, allowed specialists to drive. Primary centers may not have given as many referrals, it is unethical to evaluate the 10 business day period and draw conclusions. And that, I would say, the institutions have been able to update practically from scratch. It works very well, “he thinks.

Will Pakruojis Hospital be able to return to SAM’s required healthcare delivery indicators without losing some of its funding? V. Sudaris assured that everything possible would be done.

“But look, now, if the requirement to see a patient every 40 minutes persists, it is not physically possible. Then we will have to attend to more patients and not follow the instructions of the minister. What to do? We will try to reach it, but if it spills Accidentally, COVID-19 will probably accuse me of not complying with the conditions. Then the National Center for Public Health will nail me to the cross, “said V. Sudaris.

He noted that in district hospitals, on average, about 80 percent of the funds received from VLK go to salaries.

Suppose that if Pakruojis Hospital were to be funded on the basis of the services actually provided, as V. Sudaris considered, it might be necessary to reduce employees’ wages or to give up part of them.

At the same time, he emphasized that there is no dialogue with SAM. There are no contacts on any relevant topic.

The government will monitor

After the Government meeting, A.Veryga addressed the municipalities and the medical institutions that belong to them, urging that the provision of services to patients be resumed as soon as possible.

At the same time, he added that this must be done in accordance with the necessary security requirements, ensuring adequate infection control.

According to a report distributed by the Ministry of Health (SAM), it was announced that in July, to receive 1/12 payment for services, medical institutions must provide at least 70 percent. stationary and at least 80 percent. ambulatory services volumes.

The Government is reported to have decided to closely monitor the return to scheduled service provision, and if service interruptions persist until September 1, 1/12 of the payment may be waived and the payment may be changed for services rendered.

“There is no quarantine in the country, life is slowly returning to normal, although the coronavirus has not disappeared, care must continue, but it is necessary to provide services to patients.” After all, people cannot be without treatment services, they are necessary. Therefore, the country’s municipalities and their medical institutions must do everything possible to ensure that patients receive as many services as possible and that they are updated as soon as possible. Additional human and administrative resources are also needed to allow patients to contact and call or register at a treatment center. Therefore, we will continue monitoring the situation and evaluating the efforts of the institutions, “explained A.Veryga.

According to him, the Government will be informed before the 25th of each month and a decision will be made on what to do next if the institutions continue to be slow to resume services to patients.