Tag: Romanian healthcare system

  • New measures in the healthcare system

    New measures in the healthcare system

    The Romanian healthcare system needs shock treatment of its medical infrastructure, modern equipment and motivating its specialist staff, says the Social Democratic prime minister Mihai Tudose. In his opinion, considerable investment is needed in infrastructure to solve the problems that have not been addressed in this sector. He says the government is considering building the eight regional hospitals and the republican hospital laid down in the government’s programme. Mihai Tudose has also spoken about the need to have motivated medical staff who has to be well-paid in order to be highly performing.



    The prime minister recalls that in the first eight months of 2017, the average income in the healthcare sector grew by more than 35%. He says salaries in the medical sector will continue to grow following the application of a new salary law on January 1st 2018. He also believes modern and highly performing equipment is needed for correct diagnosis and implicitly for efficient treatment. To this end, Tudose has announced the signing of contracts to purchase new imaging equipment worth around 20 million euros for 34 hospitals around the country and in Bucharest. In his opinion, this is an important step towards ensuring quality medical services.



    Mihai Tudose: “It’s a step towards normality so that everyone in Romania who goes to the nearest hospital or who has an emergency can benefit from everything he or she is entitled to.”


    The healthcare minister Florian Bodog says the signing of these contracts is part of a goal set out at the start of his term to make sure that every hospital in Romania possesses imaging equipment.



    Florian Bodog: “Under the governing programme, all county hospitals in Romania lacking a CT scanner and an MRI scanner must be equipped with them. We will start providing these hospitals with such equipment so that they won’t have to rely on private providers.”



    The purchasing contracts are financed under a loan agreement worth a total of 250 million euros signed by Romania with the World Bank, which was accessed in 2014 and unblocked in 2017. Apart from purchasing imaging equipment, the agreement also provides for the building of new emergency rooms, anaesthesia and intensive care units, burns units and operating rooms, the upgrading of existing specialist centres and the purchase of the necessary equipment for these centres.

  • The Romanian healthcare system between expectations and reality

    The Romanian healthcare system between expectations and reality

    Affected by a number of public scandals such as the one of the diluted disinfectants or a most recent one, of corrupt managers, the Romanian healthcare system is in dire need of reform. This is something that everyone agrees with. The question is, however, when and where this reform will take place. As expected, opinions are divergent in this respect. A study conducted recently by the Foundation for European Progressive Studies in Brussels, the Friedrich Ebert Stiftung Foundation in Romania and the Democratic Left Foundation, reveals that 54% of Romanians are satisfied with the services provided by public hospitals, while 46% are not satisfied. People aged 50 to 80 are among the most satisfied with public hospital services, while only 43% of the young people share their opinion.



    Sociologist Iulian Stanescu tells us more about it: “Most respondents, about 80% of them, complain about the fact that public hospitals are not clean enough. Also, 80% of them are unhappy with the quality of healthcare services in state hospitals and with the practice of informal payments. In spite of the fact that less than one fifth of the participants in the study agree totally or partially with the statement that it is good for a hospitalized patient to offer gifts to the medical staff, quality research data indicate that the phenomenon is widely spread and that patients agree with it as they believe this phenomenon has become common practice. “



    The deeper discussions with the participants in the poll have revealed their opinion on the main problems in the healthcare system. Here is Iulian Stanescu: “The qualitative research showed a number of problems: the lack of medical personnel and the lack of motivation, the lack of equipment, the crowding, waiting time, bureaucracy, bad management and low salaries. All these problems have a cause, in the opinion of the people questioned: the poor financing of the healthcare system. In the last year, one third of the patients who needed tests could not get them, because the lab did not have room for them, or funding.”



    Part of the problem can be summarized by the phrase lack of access, according to Vasile Barbu, head of the National Association for the Protection of Patients: “The biggest problems emerge when we look for healthcare suppliers once we fall ill, and seek access to care. This is the biggest problem for patients. A lot of physicians have left the country. After consulting a specialist, we have to continue tests with another specialist. And this takes money and it is sometimes unaffordable.”



    The Romanian healthcare system provides a package of medical services in exchange for a co-payment shared by the employee who contributes 5.5% of the wage, and the employer who pays 5.2%. Unfortunately, the money from this contribution is not always sufficient. However, patients do not necessarily like changes to this system.



    Here is Vasile Barbu once again: “In theory, we have a generous package of services. In reality, it is not accessible. There are various barriers, bureaucratic and financial, which prevent access to these supposedly guaranteed services. It is very important to have a social insurance healthcare system based first and foremost on social solidarity.”



    The medical staff have their own demands too. We spoke about them with Dr. Eleodor Carstoiu, representing the ROMEDICA trade union: “One problem is regulating our activity, that of a physician or a nurse. There are no such regulations in Romania. Right now our activity runs in relation to the number of beds, which has no connection with the medical activity in Romania. The medical trade has evolved in the last 30 years, and in the past 10 years bureaucratic burdens have been added to that. The number of documents that have to be filled in has grown exponentially, at least in the past few years.”



    According to trade unions, this kind of issues could be settled only by a change in legislation, a change that should take into account a clearer definition of malpractice. Here is Eleodor Carstoiu once again: “The legislation we have at present is totally lacking, and it leaves room for abusive situations looming over our head. Which is why we need malpractice legislation that should be at least at a European level. The third problem that concerns us is that of training. Medical school takes 6 years, but offers no particular expertise to the student. A graduate is simply handed a piece of paper that doesnt even allow him to practice medicine. We want that to change. After school there is a period of 3 to 7 years of training in a given area of medicine. This training is unsatisfactory. In addition to that, a physician learns throughout life. We believe that this lifelong learning should be better organized.”



    Irrespective of any legislative changes that may occur or not, patients believe that this should not affect healthcare financing. According to the European Foundation for Progressive Studies, 44% of respondents believe that financing should be mostly public. Less that one fourth of respondents supported a partial or fully private form of healthcare financing. The ratio in public opinion terms is clearly in favor of mostly or fully publicly funded healthcare.


  • April 9, 2016 UPDATE

    April 9, 2016 UPDATE

    GOVERNMENT – Romania’s technocratic government held an informal meeting on Saturday, to discuss the European agenda and preparations for Romania’s taking over the presidency of the European Council in the second half of 2019. Attending the meeting was also Romania’s Ambassador with the European Union, Luminita Odobescu. Romania’s President, Klaus Iohannis, has asked the Government ever since last autumn, to start preparations early. Iohannis said at the time that Romania’s taking over the European Council’s presidency was a huge responsibility for that country.




    HEALTHCARE – Quality standards in the Romanian healthcare system will be introduced in two years, head of the National Authority for Quality Management in Heathcare, Vasile Cepoi, has said. According to Cepoi, these standards will apply to hospitals, family doctors, outpatient care and pharmacies. The medical system will not be able to operate and ensure quality services unless all its structures apply the new standards, Vasile Cepoi has said.




    RATING – The international rating agency Standard&Poor’s has decided to maintain Romania’s rating at BBB minus, with a stabile outlook. This is the first rating in the category of those granted to countries recommended for investment. In general, a credit rating is used by sovereign wealth funds, pension funds and other investors to gauge the credit worthiness of Romania thus having a big impact on the countrys borrowing costs.




    FESTIVAL – The “Ion Creanga” National College in Bucharest is hosting, on April 9 and 10, the 20th edition of the Japanese Culture Festival “Taiju Matsuri”. Participants will have the chance to learn more about the Japanese culture through Japanese language classes, origami and kimono workshops, film screenings and shows. The theme of this year’s edition is centred on the five basic elements in Japanese philosophy: fire, water, air, earth and void.




    FRIGATE — A Canadian frigate part of the NATO Standing Maritime Group in the Mediterranean Sea is currently in the Black Sea Port of Constanta. For three days, Craig Baines, Commander of the Canadian Fleet Atlantic, will have meetings with officials of the Romanian Naval Forces. The Romanian and Canadian marines will train together to perfect tactics and procedures specific to anti-submarine fight and maritime traffic monitoring.




    HANDBALL – On Saturday, the Romanian women’s handball team, CSM Bucharest qualified to Champions League Final Four after defeating the Russian team Rostov Don away from home, 29-28. In the first leg, CSM Bucharest grabbed a 26-25 win. On Sunday, HCM Baia Mare, also away from home, face Montenegro’s Buducnost Podgorica, after a 29-24 win for Buducnost in the first leg.



    (Translated by E. Enache)


  • Patients’ Right to Medical Services

    Patients’ Right to Medical Services

    Life expectancy in Romania is lower than in other countries in Europe; a Romanian lives on average 7 years less than a German, 8 years less than a Spaniard or a Frenchman and 9 years less than a Swiss. According to a report of the European Commission and of the Organisation for Economic Cooperation and Development, Romania fares better in terms of diabetes and cancer rates, but has a big child mortality rate.



    In the rural regions, where 46% of Romania’s population lives, and 50% of its children, child mortality in 2013 stood at 10.4 per thousand as compared to cities, where it was 6.8 per thousand. The main cause is premature birth, which occurs in 10% of the cases. The factors causing this phenomenon include the life style, the lack of information and lack of attention paid to prevention, and last but not least, Romania’s under-funded healthcare system. Many infant mortality cases could be prevented in rural regions by developing mother & child assistance programmes, and by fitting maternity hospitals and wards with high-tech equipment.



    These are the conclusions of a series of debates organised by World Vision Romania jointly with specialised committees in the Romanian Senate, under the title, ‘Patient Rights: between Theory and Practice’. On this occasion participants urged all decision-makers to improve the access to high-quality healthcare services, particularly for the vulnerable families in the rural regions. The organisers set out to reveal the gap between theory and practice when it comes to the patients’ right to high-quality medical services. The World Vision Foundation is mainly operating in rural areas, where children have low access to basic services, including medical ones, as World Vision executive director Daniela Buzducea said:



    Daniela Buzducea: “In a survey that we published last year and which was called ‘Child Well Being in Rural Romania’, we show what we have found out, namely that one out of five children up to five years old has never seen a doctor; and we know that toddlers always need to be seen by doctors to get their vaccines in time, to be monitored. Unless we identify in time the problems that might appear in children at an early age, not only are future interventions more expensive, but they can also impede a child’s development and potential to make a contribution, in social and economic terms… No serious investment has been made in parent training, so as to help them know how to properly bring up their children. There are many parents who still don’t know that whether they have a health insurance or not, under the Romanian legislation, their children have a right to healthcare services and treatment. Pregnant women also have a right to medical treatment, whether they have insurance or not. Sadly we have lately witnessed an anti-vaccination trend and I believe that authorities should think about how to inform people better on the importance of vaccination. There is no survey to justify the parents’ lack of interest or unwillingness to have their children vaccinated.”




    The debates have also been attended by doctor Vasile Ciurchea, president of the National Health Insurance Agency, who among other things referred to the health insurance cards, which have become compulsory as of May 1st. He also discussed the expenses for patients’ treatment abroad, which stand at 70 million euros per year. Vasile Ciurchea admitted there are many towns and villages in Romania without family physicians; in the Danube Delta, for instance, there are only three doctors:



    Vasile Ciurchea: “At national level, 300 towns and villages have no family physicians. There are such places in Moldavia, the Apuseni Mountains, and in some other remote, isolated regionsAnd in order to motivate healthcare personnel to remain in these rural regions we have introduced significant bonuses and incentives. Those doctors who choose to go to the Danube Delta, a region with special conditions, can get a bonus of up to 200%, because they must deal with a large number of patients; one doctor has about 45 hundred patients there, and we are trying to convince the local authorities to contribute money to motivate physicians to go there.”



    Tuberculosis is a curable disease, if detected at an early stage. Unfortunately, Romania registers the largest number of cases, as one in five Europeans diagnosed with tuberculosis is from Romania. Three people die of tuberculosis in Romania every day. Untreated cases are a threat to those around, as only one individual infected with TB can infect up to 15 people around. The need to get local authorities involved in containing and eradicating tuberculosis by financing free psychological and social support services for patients was the main topic of discussion at a roundtable that has been recently organised by the Romanian Angel Appeal Foundation.



    TB patients already benefit from free of charge psychological and social counselling services in four specialised hospitals across Romania (Bucharest, Bisericani, Baia Mare and Leordeni) as well as from financial support to undergo treatment. This is due to a programme started last year by Romanian Angel Appeal Foundation, under which 1,000 TB patients get help to cope with the disease. Here is what physician Cristina Popa, a doctor at the “Marius Nasta” Pneumophthysiology Institute in Bucharest, one of the four hospitals which provide such services, has to say:



    Cristina Popa: “More than 200 patients have been enlisted in the project and 163 social surveys have been made. Also, 172 people received financial support of 100 lei each, which means that every month they took the proper medication correctly, and 26 patients have attended professional training courses. Most of the 218 patients are men. My personal observations with respect to this programme are related to the fact that when there is teamwork or a collective approach, patients get accurate information from several sources, there are more standpoints and consequently the quality of the medical service is better. Furthermore, there is a direct and open communication between the team members and the patient. We believe that a very important role was played by the nurses in the treatment rooms, who monitored the patients. This boosted people’s confidence in medical services. I dare say the programme has produced good results, even though two of the 218 TB patients have abandoned the treatment. This accounts for 1% of the total number of patients, in the context in which The National Programme for TB Control tolerates a maximum dropout rate of 10%”.



    A huge step forward that Romania has taken in the fight against tuberculosis is a National Strategy for TB Control adopted by the government for 2015-2020. The budget allotted to this strategy is around 1.5 billion lei.