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Sunday, June 16, 2024

Robert Golob’s populism: he would establish a medical faculty in Koper, but would not address the situation of doctors

By: Gašper Blažič

In recent days, we have reported that five surgeons at the Šempeter hospital resigned just a few days after Prime Minister Robert Golob’s ambitious health care announcements. It appears that the Prime Minister is grandstanding before the public, claiming he will quickly solve the healthcare crisis and attributing all problems in the healthcare system to the existence of private healthcare.

In other words, Prime Minister Robert Golob is not willing to address the core issues of the healthcare system but resorts to populism and quick “solutions” to “appease” an increasingly agitated public.

He continued in this manner during today’s responses to parliamentary questions. During the National Assembly session, while discussing measures to strengthen public healthcare, Golob reiterated the same old platitudes and suggested solutions such as separating public and private healthcare and changing the concession system. To increase the number of doctors, he announced the opening of a third medical faculty in the country, with an agreement to be signed with the University of Primorska on Wednesday, and the first generation of students expected to enrol in 2027. However, it seems he does not want to address the core issue, which is the poor position of doctors.

In response to a parliamentary question from Tamara Vonta (Svoboda) about the government’s planned measures to strengthen public healthcare, Golob reiterated that healthcare is “the top priority of this government”. “This has not changed since day one, regardless of changes in the team,” he said. He explained that the government’s work plan for this year includes 12 laws in this area and that the government “will also approve certain new laws or frameworks this week”.

He spoke about the anticipated changes to the Health Care Act. The Prime Minister believes that the prepared frameworks will be approved by the coalition this week and will be discussed by the government next week. “This law will bring such radical changes to public healthcare that it will transform the entire landscape, the entire system,” he stated.

According to Golob, this is one of the toughest challenges because “dual practice has expanded beyond all limits”. This refers to doctors employed by a public institution who also work elsewhere. The Prime Minister emphasised that “not all dual practices are wrong, and even fewer are harmful”. He considers some to be very beneficial and will continue to support those. These are the practices where doctors work outside their primary institution in other public healthcare institutions, thus helping the public healthcare system function, he explained.

“However, there is another category of dual practices that are not beneficial to the public healthcare system and are even less desirable,” he noted. Therefore, according to his announcements, the legislative text will draw a clear distinction between public and private healthcare. He assured that private providers or concessionaires who have their employees will not be affected by this law in any way.

However, they will encourage the separation of public and private sectors to ensure “clear accountability and to prevent anyone from redirecting their patients from public healthcare to private healthcare for profit, thereby depriving patients of quality care, which is already being observed,” he stated.

In connection with this law, Golob emphasised the importance of the law on quality and safety in healthcare, as unfortunately, the quality is not the same in all institutions. He noted that too often the most difficult cases remain in public institutions, while seemingly simple cases are handled privately under inadequate supervision, performed by employees from public institutions. “These are practices we will put an end to,” he asserted.

Golob also announced significant changes in the management of concessions. “In recent years, we have witnessed a pronounced trend where concessions, granted to a doctor based on their credentials, were simply resold on the market. We will put an end to this practice. A concession is nominal, granted to a specialist and their team, and cannot be a matter of market behaviour,” he stressed.

“These two changes will be radical for the functioning of our public healthcare system because we will finally achieve clear accountability regarding who is employed where and for whom they perform their activities,” Golob stated.

He pointed out that Slovenia significantly lags behind comparable European countries in the number of doctors per thousand inhabitants. They plan to address this by educating more doctors in Slovenia.

He announced that “on Wednesday, they will sign an agreement with the University of Primorska in Koper to open the third medical faculty”. The work will begin during this government’s term, with 100 new enrolment places expected. The funding for the new building is already secured in the development programmes plan for the period 2024-2027. The first generation of students is expected to enrol in 2027. “This is the best possible answer to how we will increase accessibility – by educating more doctors in Slovenia,” Golob emphasised.

The draft principles for the amendment of the Health Care Act, sent for coalition coordination, have elicited numerous responses in recent days. Coalition partners emphasise that this step follows the commitment in the coalition agreement to distinguish between public and private healthcare. They believe this will strengthen public healthcare. Meanwhile, healthcare organisations warn against the collapse of public healthcare.

The opposition has been critical as well. The SDS party considers the complete separation of private and public healthcare to be one of the most harmful promises made by the current government in their coalition agreement. NSi MP Vida Čadonič Špelič described the proposed principles as “confusing”. “Until we see it written down, we no longer believe Robert Golob,” she said.

According to her, if the coalition led by the Prime Minister genuinely wanted to make progress in public healthcare rather than moving towards its privatisation, they would follow NSi’s proposals and utilise all available resources to reduce waiting times. Čadonič Špelič is also critical of Golob’s announcement today about the medical faculty in Koper, seeing it as an election promise and a distraction. “The doctors he talked about today will not be in the system for another 10 years. By then, the public healthcare system will have collapsed. Additionally, where will the Prime Minister find the resources, professors, and assistants to staff another faculty with experts?” she asked.

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