Amendment Not Yet Adopted, Doctors Already Leaving

Doctors who are already partially working in the private sector are leaving the public sector. Due to the amendment to the Health Services Act (ZZDej), which will bring a separation of public and private sectors, they want to settle their status as soon as possible. Two radiologists are thus leaving the Šempeter hospital, and resignations are also being announced elsewhere.

The director of SB Nova Gorica, Dimitrij Klančič, said that the radiologists intend to leave solely because of the amendment. They are already partially in private practice, as they are employed at the hospital at 40% and 60%. He might convince one of them to stay, but discussions on this topic have not yet started. The notice period is two months. Klančič believes that during this time, they will find appropriate solutions with the Ministry of Health. He emphasized that two colleagues are taking their specialist exams next month, and they also have eight residents. Waiting times in the radiology department are currently under control.

The biggest problem will be ensuring continuous healthcare, i.e., night shifts, holiday shifts, and weekend shifts, as they are already struggling with a shortage of surgeons. Recall that in May, five surgeons resigned: two abdominal surgeons and three traumatologists. The situation is being resolved with external collaborators.

Not All Will Leave

The departure of these surgeons was also prompted by Prime Minister Robert Golob's announcement of a stricter separation of public and private healthcare. The government now wants to implement this with the amendment to the Health Services Act. What its final content will be is unknown, as the public consultation on the draft concluded yesterday. The Minister of Health, Valentina Prevolnik Rupel, has already announced that they do not intend to deviate from the provision that prohibits doctors employed in the public network from providing self-pay services.

It is a fact that some doctors will leave the public network because of this, which is also recognized by the ministry. The minister predicts that the health system will fluctuate for some time because of this, especially during the transition period when it will be necessary to adapt to the changes and the new way of working for doctors. However, decision-makers believe that this will certainly stop the departure of doctors to the private sector in the long term and help preserve public healthcare.

The President of the Strategic Council for Health, Erik Brecelj, further encouraged the departures – which we have already witnessed and will witness even more after the adoption of the amendment – last week. During the council session, he said in response to the fact that the management of some public institutions is threatening with resignations because some departments might collapse due to the departure of doctors: "I would invite the director who threatens to leave based on the law to do so as soon as possible."

The fact is that not all doctors, due to the nature of their specialization (e.g., emergency medicine...), have the option to work in the private sector, but most of those who already work there will certainly move there. Therefore, clinics will mostly be left by orthodontists, maxillofacial surgeons, orthopedists, radiologists, plastic surgeons, dermatologists, i.e., all those who can live well on the market because there is high demand for their services. Some who now work partially for concessionaires will move there permanently. However, their plans might be complicated if the proposed restriction on the scope of the concessionaire's program based on the number of employed healthcare providers is adopted in the amendment.

What will happen is difficult to predict until the content of the draft law is finalized.

Lowering Service Prices

The ministry has announced that it will respond to the departure of radiologists from hospitals – three also left the Celje hospital in the summer but agreed to cooperate on a smaller scale – by lowering the prices of radiological services in cooperation with the ZZZS in the amendment to the regulation on mandatory health insurance service programs. Radiological services are currently paid based on realization (unlimited), and the prices are too high, which is why radiologists are leaving public health institutions, the ministry emphasized. This amendment will be adopted in three weeks. At the same time, guidelines will need to be adopted on when certain radiological examinations can be referred. We have already reported that the number of such examinations is increasing, and a large proportion of them are considered unnecessary by the profession.