The Minister of Health, Alexandru Rogobete, stated that he is considering the possibility that emergency hospitals can organize, for certain departments, 12-hour guards. The measure would be optional and applied where there is availability and a clear vision from health facilities.
“We will give the possibility to emergency hospitals as for certain departments inside these hospitals, where it is possible and where it is desired and where there is a vision, guards to be organized in 12 hours. If I start with strict rules and we make another law that is so thick that no one can apply it, it will not be able to be applied. I want something simple, we give them the opportunity, as we did with the specialized outpatient clinics and where things work“, said Alexandru Rogobete, Monday evening, on Medika TV.
Talks about a fixed on-call rate
The Minister of Health also said that he is also analyzing the option of introducing a fixed rate for the payment of guards, instead of the current system based on percentages.
“I don’t rule out the option of a fixed on-call rate, let’s give up the percentage and based on something, let there be a fixed on-call rate that takes into account, even if it’s a percentage or I don’t know, here we have to think, here we still have to calculate, but there is also this discussion, I have it on the table, of a fixed rate that takes into account the gradation of the hospital, which takes into account the specialty, which takes into account other indicators and which is progressive”stated Rogobete, according to News.ro.
The minister drew attention to the fact that the current system of organization and payment of guards is unfair and outdated. He pointed out that the guards are paid at the level of 2017, and seniority is calculated in years, not according to the actual number of hours worked.
“There are several inequities regarding the guards that doctors do in Romanian hospitals and the strategy of the guards must be totally changed”said Alexandru Rogobete, Sunday evening.
Classification of guards, a proposed solution
The minister wants to introduce a clear classification of guards, depending on the type of activity carried out.
“First, I want to categorize the guards. Guard at home, because it is practiced all over Europe, monitoring guard and emergency guard. The monitoring guard means that the doctor only cares for hospitalized patients in the department he is responsible for, and the emergency guard means that the doctor also interacts with emergencies outside the health unit. Of course, paid differently”, explained Rogobete.
He took up the idea of paying a fixed fee, calculated according to the hospital’s rank, specialty and other performance indicators, such as the number of patients or the complexity of cases.
Position of the College of Physicians
The College of Doctors in Romania supports the recognition of guards as seniority, the payment of on-call hours at the level of the current salary scales and the introduction of 12-hour guards in hospitals with a high volume of complex cases.
“It must be understood by all the factors involved that the activity in a hospital is a continuous one that must be ensured. Involvement is needed at all levels and responsibility, so that the situation of the guards is resolved both for the benefit of patients and doctors, as well as for the proper functioning of the health system”CMR representatives sent.
