HOSPITALS TO BE TINKERED WITH AGAIN
Minister of Health Care Bozhidar Finkov will move to the Council of Ministers in mid-September two proposals for changing the statute of big local hospitals. One of the proposals concerns university hospitals, and the other - former united regional hospitals. The changes project that health care establishments would be deleted from the company registers, where they were entered in 2000 as commercial companies, and pass again to direct subordination of the Ministry of Health Care.If the Cabinet approves Minister Finkov's proposals, they will be entered in the draft for amending and supplementing the Act on Medical Establishments, which will be repaired for the 12th time within the last eight years.According to Minister Finkov, the present management of big medical establishments as commercial companies is not felicitous. As economists from the Ministry of Health Care explain, the scheme for financing the medical institutions will remain the same after the change. Now they are getting 80% of their funds under the form of subsidies from the state budget, and another 20% is ensured by the National Health Insurance Fund for medical treatment along the so-called clinical paths.The proposed changes in the ownership of hospitals are presented as insurance against the bankruptcies expected in the beginning of 2003 due to accrued liabilities to the Central Heating Utility, the National Electricity Company (NEC), and pharmaceutical companies. In this situation creditors could block the medical institutions' bank accounts and the possibility of selling out medical equipment in order to cover their debts should not be ruled out.The Bulgarian Doctors' Union took a stand against Mr. Finkov's proposals. If hospitals lose their statute as commercial companies, this means to stop the health reform. And we'll be again treated as twenty years ago, Dr. Atanas Kundurdjiev, Secretary General of the branch organisation, commented for the BANKER weekly. The Deputy Minister fo Health Care Slavcho Bogoev, who is responsible for the financial matters, said that as a result of good management several hospitals had even succeeded to post own proceeds amounting to BGN10MN. The Bulgarian Doctors' Union believes that the medical establishments should remain commercial companies. In oder to avoid bankruptcy, it would be only necessary to appoint as their directors people who have proven not only their abilities as medical experts, but possessing managerial skills as well.The branch organisation points out that most of the medical institutions' liabilities, accrued this year (BGN35MN) result from poor financial planning. Their total liabilities amount to BGN75MN now, BGN40MN of which have been inherited from the year 2001. The Minister of Health Care promised that these liabilities would be settled from the overfulfillment of the state budget's revenue side. Presently, 60% of the subsidies for hospitals are spent on salaries, 20% - for medicines, 10% for maintenance, and another 10% - for medical services.The other possibility for going out of the crisis, according to the Bulgarian Doctors' Union, is to vote in the 2003 Budget Act 6% of the GDP for the health care instead of the current 4.2% of the GDP, which makes BGN1.3BN for the year 2002.