site.btaNational Ombudsman Sounds Alarm about Current Problems in Healthcare

In a letter to Health Minister Hristo Hinkov, National Ombudsman Diana Kovatcheva drew attention to a number of problems related to patients' access to healthcare services, Kovatcheva's office said on Tuesday.

The public defender recommended providing for an additional possibility to prescribe and dispense antibiotics and diabetes medicines in view of Health Ministry plans to make these two groups of medication available only by electronic prescription.

She called for much tighter control over the dispensation of diabetes medicines and their use for overweight reduction. She warned that the random prescription and use of antibiotics and their dispensation without a prescription creates a deficit of supplies, particularly in winter and during an epidemic, and leads to antimicrobial resistance which makes treatments ineffective and creates risks for patients and public health in general.

Kovatcheva urged a comprehensive solution to the lack of patients' access to medical treatment 24/7. Besides that, she said, there are qualified and practicing physicians and dentists who have not signed a contract with the National Health Insurance Fund and/or do not have the necessary computer hardware, software and technical knowledge to use the electronic drug prescription system. The future requirement to prescribe antibiotics only by electronic means will violate the rights of such physicians and their patients, including children, related to the accessibility of antibacterial drugs for systemic use.

Infrastructure deficiencies and the absence of reliable internet service throughout Bulgaria may also prevent or delay the prescription of antibiotics, Kovatcheva warned. She pointed out that the absence of pharmacies in small and remote settlements is another cause for concern and may lead to violations of patients' rights.

The Ombudsman said that doctors who are members of the Bulgarian Medical Association show little interest in a mobile application for issuing electronic prescriptions, where registration requires them to have an electronic signature and steady internet service. The application is particularly useful during house calls.