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J. Sejonienė, a 39-year-old physician and vice chairman of the board of the Lithuanian Medical Movement (LMS), was elected a member of the Seimas this year along with the Lithuanian Christian Democrats of the National Union.
The party member sees many loopholes in the health system and possible solutions to them, but identifies managing the Covid-19 pandemic as the main and most important job.
Curious, how did you, a veteran doctor and union representative, decide to go into politics? Perhaps you have not endured how the medical situation has been in recent years?
You see, I went to LMS because those issues are really concerning. Problems not only for doctors but also for patients. The LMS did its best to address them to the best of its ability.
But, you see, the activities of a non-governmental organization are quite limited, you want real solutions. In my opinion, the legislative activity, the position of a member of the Seimas would facilitate the correction of errors and the ideas raised by the LMS would be easier to implement.
Have you heard at least one suggestion from TS-LKD leaders to become Minister of Health? Maybe at least the president of the Health Committee?
It is still a very early moment, we are not yet divided. Coalition-building work is certainly underway, with a combination of key value positions, key work that could be addressed, and how the future coalition can address it. Certainly, possible positions of myself or others have not yet been discussed.
And would you take on that task yourself if the party proposed it and the coalition partners agreed?
I work very responsible, I know it very well. Especially in this difficult situation for the whole country and the world due to the deficiencies of its governance. I would definitely consider such a job if it was offered to me.
This is by no means my only decision, it would also change the life of my entire family. But I have to consider it because I think the LMS is also binding. As other honorable politicians say, you have to answer for your words. This, I think, should not only criticize, but also be prepared to deal with problems and take responsibility if necessary.
You mentioned the shortcomings of the fight against the pandemic. As a medical representative, you are well aware of what physicians have had to deal with during this pandemic. Evaluate the mistakes that the Health Department and hospitals have been unable to avoid when preparing physicians to work with Covid-19 patients.
The shortcomings were first highlighted, of course, during the first wave, when institutions were neither financially nor adequately equipped with personal protective equipment. There was a lack of knowledge about work organization, employees lacked knowledge about infection control: how to take care of themselves, how to protect patients.
This is definitely the first wave of health centers, the most difficult, apparently because of it. Of course, both in terms of guaranteeing conditions for employees, and in terms of safety and motivation, in terms of remuneration.
Some of the problems persist. Healthcare is currently facing the most strain as the number of Covid-19 cases being diagnosed today is much higher than it was in the spring. Clearly, treatment facilities are filling particularly quickly with patients in need of hospital care. Intensive care and resuscitation departments fill up especially quickly.
We have the problem that there are infrastructure deficiencies, we have many institutions, we have many beds, but it is not clear what the quality of those beds is, because the treatment of patients with Covid-19 requires special conditions.
We are already facing the problem of staff shortages and there is also the problem of employee fatigue. Because some of the staff, especially in large institutions, have been working with patients in difficult conditions since March.
And from the management side? We see an increasing morbidity curve from Covid-19. You, in the place of the Minister of Health, what decisions would you make? Or should the decisions not be in the hands of a minister?
Currently, the head of the Center for Emergency Situations is the Minister of Health, and apparently those decisions are the ones that depend the most on him. Although, of course, we note a lack of communication between the individual institutions that should be involved in emergency management. Lack of coherence.
As we saw in the spring, during the first wave, particularly drastic measures were taken over time. However, whether all were suitable and did not last long was another question. There is also inconsistency in the recommendations. The population is very distracted when those recommendations change very frequently, are inconsistent and even, I would say, contradictory.
I believe that measures must be taken first as soon as possible and be as gentle and least damaging as possible for society. For now, I think the measures have been delayed, they have been taken too late, when we already have almost a thousand cases a day.
Second, we will only see the effectiveness of the measures after a while. This delay will be even more significant.
We found that things that may not have as significant an effect on the spread of infection, such as mandatory use of outdoor masks, are limited. At that time, the massive sporting event restriction was taken only very recently.
It would be desirable for infection control and management to be viewed in a more professional, scientific than political way. Because the political situation has led to many of those actions or not actions.
To handle such a situation, there must be a constantly working team of scientists, specialists in various fields. It should be consulted regularly.
The activities of the National Public Health Center (NVSC) have received much criticism during the pandemic. Clearly, they lack both the capacity and the resources to demotivate staff. What changes do you think should be implemented in this center?
First, a long-term strategy would be clear funding for public health, as well as the National Center for Public Health, to meet the needs. Of course, suddenly those specialists will probably no longer meet. I am grateful to the volunteers involved here.
What has not been done and what would probably have greatly facilitated the work of the NVSC is the introduction of mobile applications and electronic systems that would allow more efficient management of large flows of patients and their data, and more effective communication with the NVSC itself. .
One problem that arises during a pandemic is ensuring care for patients with other illnesses. We know that hospitals are now overcrowded in principle and polyclinics also have to limit their work. How, in your opinion, could other patients be cared for?
Hospitals are not elastic and services cannot expand, and people do not have to expand. The more Covid-19 patients we have, the worse the provision of hospital care to patients with other diseases will suffer. That is why it is necessary to control the epidemic.
It will not be administered by a single person or by any commission or institution. There is a clear need for mobilization of all citizens and the will to control it. Like in spring. I understand the public fatigue, the outrage, I understand how unpleasant the restrictions are, especially if they also have a negative economic effect on the population.
But it will still have to be done by all the focused residents. The sooner we do this, the fewer Covid-19 patients there will be in hospitals and the more efficient and better care will be for patients with other diseases.
But until we do, I think the essential link in health care right now is primary health care and family medicine. I believe that this chain must be kept particularly effective to maintain the management and treatment of patients with other diseases.
With a slight departure from the pandemic, what fundamental changes do you think are needed in health policy and the health system?
There are many problems. From the perspective of both patients and healthcare professionals. Medical care should not be patient or employee centered.
We need to understand that only by ensuring good conditions for employees will we motivate them to work efficiently, efficiently and provide quality services. I think it would benefit both doctors and patients.
What are the biggest problems? I would put more emphasis on accessibility not related to services, although it is also very important. I would put more emphasis on the quality of service that needs to be improved.
Second, it is clear that a sufficient number of staff must be guaranteed. Because really Lithuania faces a very bad situation due to the lack of nurses.
But it’s probably based on salaries, they are not competitive.
Insurance. Salary is the main and best reason to attract and retain an employee in the system. To improve the working conditions of doctors, the proportion of salary increases, which is also increasing by LMS – 3 VMU, must be maintained (average salary – past aut) doctors, 1.5 VMU nurses should use real time and look for last year’s earnings.
Employees are not just doctors and nurses, they are teams and employees in various fields working in healthcare. For them, those wages should also increase.
Regarding the quality of services, we need to provide patients with the services that best suit their expectations and needs. We need to evaluate very well the structure of our services and those that currently exist to see if they meet the needs and make them more effective in that area.
Also the financing of health care itself. If we want to have a health system as good as that of other countries, we must invest in it accordingly.
Process efficiency. Certainly, all is not well in the health system. Certainly not all funds are used efficiently. It is these processes that must be reviewed.
And definitely pay close attention to disease prevention, as the most effective system would be if the population was less sick. This is a particularly big challenge, as Lithuania has a negative trend: an elderly and rapidly aging population.
You have listed the key issues. But it would be naive to hope that they can be solved in time. What would be the priority from which you would like to start your work at Seimas?
There is no other priority at this time than the actual management of the pandemic situation. I don’t think you can talk about any other job, bigger or smaller, because we have to do everything, otherwise life will stop again.
This is the first task that the new Government, the new Seimas, will undoubtedly undertake to fight for an effective management of the pandemic, the economic situation and negative social processes.
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