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Drug centre's funding slashed in half

A cash-strapped Health Ministry is being forced to make some tough decisions. While doctors long complaining of minuscule wages have been pacified, Slovakia's largest drug treatment centre - which recently had its funding cut nearly in half - is in a state of disbelief.
On May 9, the Health Ministry decided to increase health sector wages by 20% to 45% as of June 1, a decision which will cost 1.8 billion Slovak crowns ($37.5 million) per year. But a week before, it cut funding for the Bratislava-based Centre for Treatment of Drug Dependencies (CTDD) by 46%, from 1.6 million Slovak crowns ($33,300) a month down to 884,000 crowns.
"I can't imagine why such a dramatic cut wouldn't be consulted with us beforehand," said CTDD head Ľubomír Okruhlica. "This can have dangerous consequences for both the addicts we currently treat, as well as future addicts who may one day need our help."


Ľubomír Okruhlica, the head of Slovakia's largest drug addict treatment centre, says that Slovaks feel addicts should fend for themselves.
photo: Ján Svrček

A cash-strapped Health Ministry is being forced to make some tough decisions. While doctors long complaining of minuscule wages have been pacified, Slovakia's largest drug treatment centre - which recently had its funding cut nearly in half - is in a state of disbelief.

On May 9, the Health Ministry decided to increase health sector wages by 20% to 45% as of June 1, a decision which will cost 1.8 billion Slovak crowns ($37.5 million) per year. But a week before, it cut funding for the Bratislava-based Centre for Treatment of Drug Dependencies (CTDD) by 46%, from 1.6 million Slovak crowns ($33,300) a month down to 884,000 crowns.

"I can't imagine why such a dramatic cut wouldn't be consulted with us beforehand," said CTDD head Ľubomír Okruhlica. "This can have dangerous consequences for both the addicts we currently treat, as well as future addicts who may one day need our help."

Mária Husárová, head of the ministry's economic department, said that there was "no connection between increasing doctors' wages and decreasing funding for the drug centre." She added, however, that "with our limited financial resources, every increase in one area must be balanced by a decrease in another."

Slovakia has allocated steadily less funds towards health over the past decade. According to the 1999 Global Report on Slovakia, published by the IVO think tank in Bratislava, Slovakia spent only 6% of GDP ($235 per capita) on health care in 1998, compared to 7.9% in the Czech republic ($295), 7.9% in Austria ($1,813), and 10.4% in Germany ($2,363). This year, the ministry was given a budget of just 17.3 billion crowns, about 2.1% of expected GDP.

The ministry says that its hands are tied, and that in running the impoverished Slovak health sector it is forced to make difficult funding decisions based on whose needs are more acute than others.


CTDD currently treats 2,000 addicts; cuts threaten to force 1,000 out.
photo: Matthew J. Reynolds

But Okruhlica believes that one reason his centre was singled out for a cut is the prevailing feeling among the public that it should not be charged with the care of addicts.

"We understand there is a lack of money in the state sector," he said. "But it's much harder for us as a drug treatment centre to get money because when funds need to be cut somewhere, we are the easiest target. The public feels 'why should we pay for them? It's their own fault that they are addicts.' Therefore, we get cut out."

Helena B., a 43 year-old resident of the Bratislava suburb of Petržalka, is of that opinion. "Why should I sponsor their treatment with my taxes?" she asked. "It's their own fault that they started doing drugs. I don't think we should have to pay for their bad habits."

Such feelings anger Ivan Novotný, head of the private AT Sanatorium alcohol and drug treatment centre, who feels that Slovaks who are willing to abandon the addicted had better make sure the disease never touches their own lives.

"If such people don't want to give money to treating the country's drug addicts," he said, "they'd better be very sure that they are able to keep their own children from getting loaded."

Fear for the future

The CTDD today treats about 2,000 patients a year, more than the combined total of Slovakia's other six drug treatment centres. Okruhlica says that although the cutbacks have not yet affected his centre, he fears for his patients in the future.

"So far we haven't had to release any patients due to the cut-backs," he said. "But if the funding remains as it is now, we'll have to cut the number of patients we treat by half."

Rudolf Štefanovič, head of the ministry's operations department, said that he understood the centre's significant role in Slovak society, and promised to "recommend that the economic department prepare a new funding proposal."

When asked by The Slovak Spectator when and if the decision may be changed, he said he did not know.

In the meantime, the CTDD will have to make do with the limited funding, which has Novotný calling for a change. Doctors, he says, should not face a lack of funding which forces them to decide who to treat with their limited resources.

"We should create a policy which would prevent doctors from being pushed into these positions, where he has to decide between the survival of one [drug addict] and the death of the another because he can't afford to treat both."

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