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Health Minister Uhliarik under fire

HEALTH Minister Ivan Uhliarik has had a rather difficult start to the new year: first, local media reported that Czech hospitals were fishing to hire Slovak physicians en masse; then reports surfaced about Uhliarik’s purported preferential treatment of a pharmaceutical firm for which he had previously worked; then the Sme daily followed with a front-page article reporting that Slovak ambulance services lacked supplies for urgent treatment of patients needing transport.

HEALTH Minister Ivan Uhliarik has had a rather difficult start to the new year: first, local media reported that Czech hospitals were fishing to hire Slovak physicians en masse; then reports surfaced about Uhliarik’s purported preferential treatment of a pharmaceutical firm for which he had previously worked; then the Sme daily followed with a front-page article reporting that Slovak ambulance services lacked supplies for urgent treatment of patients needing transport.

The Health Ministry denounced the Sme report about the ambulance services and threatened to take legal action against the newspaper for “scaremongering”. It stated that Minister Uhliarik had acted in the public interest when he granted fast-tracked re-categorisation to a drug made by Pfizer, the firm that was his previous employer.

Prime Minister Iveta Radičová demanded explanations from Uhliarik and after their January 17 meeting commented that no laws had been violated and Uhliarik still enjoyed her trust. But the next day, the opposition Smer party said it might seek to sack the health minister, a nominee of the Christian Democratic Movement (KDH).

Sme initially reported that a competitor of Pfizer had registered a vaccine similar to the Pfizer product for a lower price, which created a situation in which parents of children in need of a pneumococcal vaccination might have had to pay an extra charge for the Pfizer drug. Sme wrote that in a last-minute move, Pfizer had requested permission from the Health Ministry to sell a re-categorised product and Uhliarik’s ministry promptly approved the request. The daily reported that other companies usually had to wait nearly 100 days for such approval, including the time spent in proceedings before the categorisation commission. Sme noted that Uhliarik had worked for Pfizer in the past and that his brother still worked for the firm.

Uhliarik insisted that the ministry acted in the public interest. “I haven’t done anything wrong; neither I nor this ministry or other people here; we proceeded in line with the law,” he said, as quoted by the SITA newswire.

The minister claimed that he acted in the best interests of patients and even the state budget because the ministry has saved funds. He stated that the ministry under his leadership scrapped Pfizer’s monopoly on this medication and also secured a lower price for the vaccine that will save health insurers about €1 million each year, SITA wrote.

The ministry’s official news release also called reports that Pfizer’s Prevenar vaccine was approved in a single day a “myth” and stated that all the documents, which are publicly accessible on the internet, prove that the ministry had been continuously dealing with issues surrounding the pneumococcal vaccine since a September 2010 meeting of the categorisation committee.

The ministry stated that the fact that the final application, “as a result of negotiations with the producer and pressure by the ministry to reduce the price, were delivered to the ministry only in the month of December and seemingly handled in couple hours” does not change the fact that the whole issue had been resolved in a comprehensive manner.

Pfizer vigorously rejected charges of cronyism or violation of any laws during the categorisation process for Prevenar.

Uhliarik’s arguments apparently persuaded Radičová and the prime minister’s spokesman released a statement stating that the ministry had decided in the public interest and in accordance with the law to make both vaccines available and, when prescribed, to be fully covered by Slovak health insurers while at the same time lowering health insurers’ costs for the drugs, the TASR newswire wrote.

The opposition Smer party is apparently not convinced about the propriety of the action of the health minister and its leader, Robert Fico, has suggested that several deputies from the Freedom and Solidarity and Most-Híd parties are also unhappy with Radičová’s statement of trust in Uhliarik. The signatures of 30 MPs are required to summon a parliamentary session to discuss no-confidence in a government minister and Fico has said he would like to call such a session in February.

SITA reported that Fico called Uhliarik’s action a “textbook example of cronyism and corruption”, insisting that the minister had personally arranged the exemption for the large pharmaceutical firm for which he had previously worked and which currently employs his brother.

Transparency watchdog groups said that this particular case reveals a need to address how drugs are categorised in Slovakia and called for much more light on the entire process.

Gabriel Šípoš, the director of Transparency International Slovensko and Angelika Szalayová, an analyst with the Health Policy Institute, both stated that the whole process of categorising drugs in Slovakia should have more clearly defined and have legislatively-mandated rules, saying that several steps in the categorisation process are not covered by regulations or directives but only by some loose professional guidelines, SITA wrote.

Radičová stated that the actions and procedures of the Health Ministry should not evoke any doubt in the public and that a revision to the law on health care will be prepared.

Katarína Zollerová, the spokeswoman of the Health Ministry, confirmed to The Slovak Spectator that a proposed revision to the law is expected to undergo interdepartmental review in February.

“The main goals of the revision are to increase transparency within the process of categorisation, such as publishing audio recordings and [participants’] names and the way that members of the categorisation commission voted,” Zollerová said, adding that the ministry is also considering stricter regulation of drug prices and new tools that should lead to more effective use of public health-care funds as well as assuring accessibility to the categorised drugs.

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