Non-governmental think-tank the Health Policy Institute (HPI) considers the legislative changes being proposed by the Health Ministry to be lacking a clear concept. At a Wednesday press conference, Tomas Szalay of the HPI stated that one year since the beginning of its term of office, the government should have introduced a clear vision of the health care system. Instead, the ministry has simply been changing current legislation. Plentiful amendments to health care laws originated from proposals for change to individual parts of the health care system, and the ministry did not evaluate them critically prior to incorporating them into draft amendments, thinks the HPI.
The HPI objects to the planned reversal of the transformation of public hospitals into joint-stock companies. Mr. Szalay pointed out that transformation according to current legislation did not mean a change to property relations, only a change in legal form. Joint-stock companies can operate more effectively because they do not have soft budgetary restrictions, their accounting is done based on standard rules, and they have a higher degree of responsibility for their economic results, as well as for health care provision. Without transformation, a private investor cannot enter a hospital and health care facilities cannot acquire funding for their development, according to Mr. Szalay. He also stressed that current legislation stipulates that the state's share in health care facilities cannot fall below 51 percent, so that the state maintains control in hospitals.
The HPI also sees problems in the intended creation of a central register of patient medical data. According to the ministry's plans, the register is to contain complete health documentation of all citizens, including foreigners, who reside in Slovakia. The entire database is to be administered by the National Center of Health Information (NCZI). The HPI believes this concerns very sensitive data that can be misused, and it is questionable whether the NCZI is technologically prepared to manage, let alone protect, such a large database. "Introduction of the eHealth electronic system would first and foremost require clear conceptualization and legislation," Mr. Szalay stated. He also pointed to the fact that impact analyses estimate zero effects on public finances; however, installation of the register will cost billions of crowns, Mr. Szalay commented.
The HPI thinks the minimum public hospital network draft will have to be significantly changed following interdepartmental review. At present, apart from other things, sums of lines and columns in the draft itself do not add up. On the other hand, Mr. Szalay approves of the reduction of sickbeds for individual public hospitals as stipulated in the draft, as well as the outline of so-called high-end hospitals that are to serve the whole of Slovakia or entire counties.
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