site.btaHealth Ministry Extends Lv 28.5 Mln to Municipal Hospitals

Sofia, January 15 (BTA) - The Ministry of Health will extend 28.5 million leva for activities of municipal hospitals in 2018, the ministry said in a press release Monday. The funds will be provided under a procedure of the Methodology to Subsidize Medical Establishments in 2018. The sum will cover costs for emergency medicare, activities of municipal medical establishments beyond the scope of mandatory health insurance in remote locations, as well as activities related to medical expert opinion, among others. The number of subsidized medical establishments is expected to exceed 100, which amounts to over 83 per cent of all municipal medical establishments on the territory of Bulgaria.

Beyond the methodology, the ministry does not have the right to extend subsidies because this would fall within the scope of irregular state aid for which Bulgaria would be sanctioned by the European Commission, the ministry recalls.

Mayors and municipal councilors will be acquainted with the measures for recovery of state hospitals to use them as a starting point for coping with the dire financial straits of their municipal medical establishments. The final decision for restructuring, however, rests with the owners - the respective municipalities.

The clinical pathways according to which municipal hospitals operate will be considered during the negotiations for the National Framework Agreement. At the same time, the ministry will also update medical standards. In this way, municipal hospitals will be able to operate in the conditions of financial stability and predictability, the press release reads.

At September 30, 2017, there were 121 functioning municipal hospitals with total due payment amounting to 100.270 million leva and arrears of 44.178 million leva.

The Health Ministry's press release came out in the wake of a national protest declared by the Management Board of the Association of Municipal Hospitals in Bulgaria. At noon on Monday, doctors and nurses from municipal hospitals in over 20 cities protested for an hour against the state policy on municipal healthcare. Under the motto "Stop the destruction of municipal healthcare!", they demanded an additional subsidy of 30 million leva to be used for the hospitals' financial health and the payment of employees' extra activity in the last two years.

The protest was supported by the Confederation of Independent Trade Unions in Bulgaria (CITUB). In a joint declaration released on Monday, the nationally representative employer and trade union organisations, the leaderships of CITUB, the Podkrepa Labour Confederation, the Bulgarian Industrial Capital Association, the Bulgarian Industrial Association, the Bulgarian Chamber of Commerce and Industry, and the Confederation of Employers and Industrialists in Bulgaria proposed an
immediate meeting with the leaderships of the Health Ministry, the Ministry of Finance, and the parliamentary Healthcare Committee relevant to the funding of local hospitals.

The organisations also insisted on the urgent need to discuss effective measures to prevent the liquidation of municipal hospitals in dire financial straits and the approaching crash of municipal healthcare, initiation of legislative revisions,
target funding for protected medical establishments not in regional centres and urgent changes in the prices of the so-called underfunded clinical pathways.

Approached for comment by reporters on Monday, Deputy Health Minister and head of the National Health Insurance Fund's Supervisory Council Zheni Nacheva said that the Health Minister will hold meetings with representatives of municipal and regional hospitals. These hospitals should optimize their activity and, if necessary, resort to restructuring, she added. The Health Ministry has analysed the state hospitals state and it will recommend the same approach to local authorities, Nacheva said.

Also on Monday, BSP for Bulgaria Deputy Floor Leader Dragomir Stoynev expressed his parliamentary group's support for the protest of municipal hospitals. He told a news conference that in a letter sent to National Assembly Chair Tsveta Karayancheva, BSP leader Kornelia Ninova has requested that a discussion on the state of municipal healthcare be organized in Parliament Thursday. Socialist MP Georgi Mihaylov noted that the municipal hospitals do not accept the Health Ministry's proposal that they be transformed into healthcare centres with some 20 beds. According to BSP for Bulgaria, the problem also has a demographic side because the closure of hospitals contributes to the corresponding areas' depopulation.