The reform measures announced in health have sparked the first reactions. The unions do not want to hear of bonus cuts, the payment according to the performance or the abolition of permanent centers. Stopping the migration from state to private, on the other hand, is expected by the heads of hospitals, but there are reservations that the implementation will be succeeded.
Health measures are already born photo discussions: Archive
A number of measures announced in the governance program to stop the waste and cover the gaps in the state system are already seen with a critical eye of the health unions. The Sanitas Federation appoints the government program – “Paveling program” and sanctions the fact that crisis measures in Romania each mean cutting from workers and new taxes for honest citizens.
Payment depending on the performance and optimization of the bonuses of the staff in the hospitals according to the number of medical services provided is an idea that is upset by the trade unionists. How the performance will be measured, they want to know them, also stating that they have requested clarifications, but that they have not been granted.
“They will start to discharge hard, just to re -enter a few hours away.”
“Will they count disorders, hospitalizations and decide that where most are, will the salaries be the highest? The issue is simple to adjust in small hospitals where they will start to discharge hard, just to re -enter a few hours away! I asked for clarifications and no one offered them. The speech of the political class repeats obsessively: performance, performance, but without explaining to us, health professionals, which means more precisely. I have repeated attention that payment according to performance is difficult to implement correctly. It can be reached serious abuses in which only certain doctors who are loyal to the political leadership will receive that payment according to the performance ”, It draws attention to the Sanitas Federation, in a Facebook post.
It will be difficult to quantify the activity between the sections, say the trade unionists. “How is the performance between the sections: Dermatology VS ATI or cardiology vs nephrology? How is performance measure in palliative or medical-social services? How is family medicine performance measure? Bucharest? ”, They want to know the workers in the health system.
“Now it is clear! You want to take us from the bonuses!”
The optimization of the bonuses, another measure that is also included in the government plan, will translate into a cut of bonuses, the unions are afraid.
“What do you mean the optimization of bonuses? Do not say the reduction directly, even if you mean it! I understood from the public discourse that it disturbs that bonuses can reach up to 85%. No, you do not refer to the public administration, because there are capped at 1,500 lei and do not exceed 15% for harmful conditions. You refer to us, but you said it among the teeth! Now it’s clear! You want to take us out of bonuses! We do not want increases either, in their place we want the correct salaries and normalization of working conditions (although we know that it cannot be in health). And we do not want to work at night or in the days when everyone else “goes out for a beer”, but the disease does not only hit the day, on working days, and we have to ensure the continuity of this system “, says Sanitas.
The closure of the permanent centers in the urban localities in which there are hospitals – a measure with which, in fact, even in the comments of the post, many agree – it is also criticized. If the two exhibited measures are corroborated – the 20% reduction in the number of continuous hospitalization beds and the closing of the permanent centers, the risks are huge, say the trade unionists.
“Do you also consider the number of citizens to die by 2030? Some of hunger (those who run out of jobs) and others with days (those who have nowhere to be treated). How can you suggest the reduction of permanent centers in the urban environment when you say that there is an increase in preventive medicine? Permanent centers can attract a good part of the benign cases that reach UPU/CPU ”, says sanitas. The example of the permanent centers that operate in the west of the country is given and which would show it the figures, “I reduce the fixed pressure on the public hospitals and offer faster, but also cheaper care.”
Many other questions would have to ask, the trade unionists say. They finally speak of the lack of social dialogue they hit.
“The consultations were just fictitious, again I was ignored. We are tired of letting us wait, sometimes with the hope that the “new” will take a real social dialogue, and at the end of the expectation, instead of dialogue and real solutions, in common, to receive
Similar alarm signals also draw representatives of the “Sanitary Solidarity” Federation.
And their certain measures seem to them “problematic ”. “Reducing bonuses for employees in hospitals who have debt“It is an ambiguous formulation, it reports the trade unionists, and the payment “Depending on performance” For doctors it cannot be discussed, but it can only be spoken of “Additional payment according to performance ”.
Stopping the exodus to private, the measure that hospitals would need
The measure that would affect the private health sector – the private health systems that will want a contract with CNAS will have the obligation that at least 80% of the staff employed will be full -time – is, on the other hand, expected by the heads of public hospitals. They have been facing a very large crisis of specialist doctors, in many specialties, relying to cover the guards, and the doctors’ migration to the private environment (where the revenues are higher and where they are not facing the Burnout) would be the main problem. “It should be recognized that the depriveds are developing on the back of the public system. This delimitation would help the public system, but it depends on how these measures will be put into practice,” I say those who are looking for desperate solutions to be able to ensure continuity in providing medical services in public hospitals.
The elaboration of regulations that pass the constitutionality notice and the management of social pressure are now decisive. Packages of benefits for doctors who choose the public system could also be helpful, and those who have managed to come up with additional payments confirm that such measures are effective.
At the Slatina County Emergency Hospital this year, the granting of stimulants to residents who come and make guards, so that for about 300 lei/guard, with the support of the County Council, another 1,000 lei are granted, and the guards have become attractive to the young doctors.
At Corabia City Hospital, on the other hand, a small hospital, where the deficit of doctors is a problem not only for covering the guards, but also the degree of occupancy of the beds depends on it, it would take more. The manager Marian-Petre Ilin says that a big problem is the one related to the presentation of residents to the job, a matter that should be regulated at the system level. Residents paid by the hospital throughout the studies, “who were not in our hospital one day ”, I convey at the end of the internship that they chose to practice in another hospital. “The problem is that I have the position in structure. I have a doctor, but in fact I have no doctor ”, reports the manager.
