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EDITORIAL

Health care: Excellent it is not

At first, one was inclined to feel sorry for Health Minister Tibor Šagát, seeing him pilloried in the press for mismanaging the president's case. After all, how could the minister be to blame if the president's ambulance had to wait two minutes outside a hospital? But on reflection, and especially after hearing his arrogant defence, Šagát is one bungler this country could do without.
"I regard my steps as excellent," a twitchy Šagát said in front of the cameras June 26.
It's perhaps a stretch to say the two phone calls over 10 days Šagát placed to inquire after Schuster's health were 'excellent' work. But it's laughable to apply such a superlative to the man who has allowed the health care sector debt to grow from 13 to 15 billion Slovak crowns in two years, and who only managed to avert a nationwide pharmacy strike on June 28 when Prime Minister Mikuláš Dzurinda promised to take out a loan to pay the worst of the outstanding bills. The rest of the debt will be taken care of by 2004, but the government will not pay more than 80% in current prices.

At first, one was inclined to feel sorry for Health Minister Tibor Šagát, seeing him pilloried in the press for mismanaging the president's case. After all, how could the minister be to blame if the president's ambulance had to wait two minutes outside a hospital? But on reflection, and especially after hearing his arrogant defence, Šagát is one bungler this country could do without.

"I regard my steps as excellent," a twitchy Šagát said in front of the cameras June 26.

It's perhaps a stretch to say the two phone calls over 10 days Šagát placed to inquire after Schuster's health were 'excellent' work. But it's laughable to apply such a superlative to the man who has allowed the health care sector debt to grow from 13 to 15 billion Slovak crowns in two years, and who only managed to avert a nationwide pharmacy strike on June 28 when Prime Minister Mikuláš Dzurinda promised to take out a loan to pay the worst of the outstanding bills. The rest of the debt will be taken care of by 2004, but the government will not pay more than 80% in current prices.

People who have read this newspaper for more than a few months may have noticed that all stories on health care follow the same pattern. Employers, particularly the government, don't pay their contributions to health insurance companies, which in turn can't pay hospitals or pharmacies. The ministry proposes 'systematic reform steps' such as reorganising the health care network and making people pay more for drugs - but does nothing to solve the debt problem. Pharmacies and doctors threaten strikes, the government coughs up a token sum, and we're back to square one.

What Šagát and his ministry colleagues do come up with are foolish rules that anger doctors rather than help patients. One fine example is a rule that hospital directors cannot work emergency shifts - meaning that the directors are worse off as a result, and hospitals have to hire other warm bodies to do the work.

Another edict last month said that doctors had to choose between private clinic work and state hospital employment. It's hard to see what the problem is if a doctor holds a clinic in his house a couple of times a week after he gets home from work.

Slovakia is not alone in its health sector problems - a European Commission report this spring faulted health care planning and expenditures across central and eastern Europe, and noted that EU candidate countries spend only 4.5% of GDP on health compared to 8.5% in Europe. But true to form, the Slovak public learned of the report's conclusions not from the Health Ministry but from the Slovak Association of Doctors three months after it was tabled.

But as Schuster lies in a coma in Austria, and millions of Slovaks wonder why it takes a high-profile medical screw-up to bring the health sector mess to light, the man who knows - the excellent Tibor Šagát - is more concerned with his political future than with that of the country's crumbling hospitals.

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