Andrei Vitushka: There should be wider discussion of reform in the Belarusan medical system

In today’s situation it is hard to talk about motivation of Belarusan medics to do a quality job, believes the specialist of the Republican theoretical and practical center “Mother and child”.

Over the last time the problems with Belarusan medicine have been widely discussed. EuroBelarus Information Service has talked about the burning issues in the Belarusan health care system with Andrei Vitushka, the resuscitation specialist of the Republican theoretical and practical center “Mother and child”.

- International experts say that only 10-15 per cent of health maintenance is due to medical system. The rest depends on people’s lifestyle. However, health care system should work out this 10 per cent. There are a lot of peculiarities that demonstrate problems in the Belarusan health care system.

- What are the most urgent?

- Well, according to the experts of the World Health Organization, the first objective of the health care system is to ensure the health of the population within its capacities; the second is to ensure financial security of the ill person; and the third objective is to ensure the needs of the population in treating different illnesses in the optimal way. We should provide effective well-developed and well-functioning responsive system; and, certainly, what we see in outpatient clinics indicate we have problems with the responsiveness.

Mostly it is the result of the imbalance in the system. Whereas in the developed countries the focus is on the out-patient treatment, and bigger part of funds (up to 80 per cent) is directed to the out-patient treatment, in Belarus it is in-patient treatment that is underscored. Belarus is traditionally among the world leaders in bed population ratio, which is due to the focus on infectious diseases, and is our Soviet legacy. Whereas our European neighbours consider first-order medics with wide competence to be the most important. Up to 70 per cent of problems with the state of health can be solved in the out-patient clinics; it is cheaper also. Whereas in-patient treatment is becoming increasingly more expensive, as it requires high-technology equipment, highly skilled specialists and more complex pharmacological substances. Thus, in the US and in the EU hospitals are equipped so that the person leaves the ward as soon as possible.

In this connection one more imbalance in the Belarusan health care system has to be mentioned: having so many hospital beds, it is quite problematic to maintain them. State funding is much higher in European countries: in Belarus health care system gets no more than 4 per cent of the state budget, which corresponds to 6-8 per cent in Germany and 10-15 per cent in the US. Belarusan health care system becomes increasingly more susceptible to external imbalances and economic situation.

- Lately there was a lot of talking about the modernization of our health care system. How are things going on with that?

- The level of equipment was increased; however, such high-quality equipment has to be maintained, which immediately increases expenses.

- Can switch to paid medicine improve the situation?

- Unfortunately, optimum health care finance system doesn’t exist. Most countries use the mixed model – with certain state support, but with both voluntary and obligatory insurance at the same time. And elaboration of Belarusan model of health care system should be broadly discussed, both by the society and by respective specialists.

- Why does shortage of personnel remain to be a problem, if medical universities permanently turn out the same number of specialists?

- Indeed, personnel imbalance is one of the most serious problems in the Belarusan health care system. Of course, it is more prestigious to work in some hospital in Minsk than in an out-patient clinic somewhere in the village. But I think that motivation is among the key problems in the Belarusan health care system. Medicine is the sphere where people’s interaction is important; and to make the system work effectively, people should be highly motivated. In the current situation of wage levelling and in the situation when salaries of medics are 20 per cent less than the average salary of the industrial workers, it is hard to talk about motivation of Belarusan medics to do a quality job.