“In the now-former Minister’s tenure of just over a year, we saw a number of promises to improve the patients’ access to healthcare services and the working conditions for healthcare professionals. These promises gave us hope for a modernisation of the public healthcare system, following the example of other European countries. Now we are back to square one,” representatives of the Professional Association of Private Doctors and Dentists of Slovenia said in a press release. They were reacting to the recent resignation of the Minister of Health and the decline in the quality of the healthcare staff.
The Professional Association of Private Doctors and Dentists of Slovenia (Strokovno združenje zasebnih zdravnikov in zobozdravnikov Slovenije) responded to the resignation of the Minister of Health Danijel Bešić Loredan in a press release. They are critical of the critics of his resignation, who, they say, are more concerned about healthcare institutions than patients. Although they see the resignation as a “return to square one”, they themselves assure that they will continue fighting for Slovenian patients, who deserve quality and accessible treatment, as well as for the interests of healthcare professionals in the future. They are concerned about the existence of state-run healthcare institutions which do not provide treatment and services in themselves, the association said, criticising those who criticised the Minister’s resignation. The services, they said, are provided by “enthusiastic medical teams (doctors, dentists, nurses, technicians, physiotherapists, etc.), whose numbers in the Slovenian public healthcare system are declining irreversibly,” they warned.
The association explained that at the beginning of 2023, the healthcare sector was asked to prepare and agree on key points to build a strong, accessible and quality public healthcare system. The proposed changes put patients (rather than providers) at the centre of the public healthcare system and increased flexibility in the recruitment and performance of doctors and dentists, following the example of public healthcare systems in Western Europe. This would also reduce the outflow of staff from the public healthcare system. As they explained, the document was initially coordinated at the Coordination of Doctors’ Organisations and then, in a slightly amended form, finally approved in May 2023 at the General Assembly of the Medical Chamber of Slovenia as the most broadly democratically elected body of the medical profession. However, no official response to the document has been received to date. Not from the Ministry of Health, the government, or any other state institution.
The government does not want to listen to them
They pointed out that, judging by the latter, the medical profession as such is practically not taken into account in the proposals for healthcare reforms. “More or less the same few individuals are constantly being invited to various round tables and meetings. In most cases, they have also co-designed the public healthcare system over the last thirty years and, as such, are also partially responsible for the current situation,” they were critical. They also pointed out that doctors and dentists working in the private healthcare sector are not included in any working groups, their proposals are not taken into account anywhere, and all this despite the fact that they have repeatedly offered their help and expressed their willingness to cooperate.
“Unfortunately, it has become clear to us that the widespread or simply the loudest opinion in our country is that the only real public healthcare is state-owned healthcare. One that is delivered exclusively in state hospitals and health centres. The focus of the system will thus clearly not be on patients and their needs, but on public healthcare institutions,” they wrote, explaining that the ruling party seems to want to restrict or even prevent private actors from operating in the healthcare system by any means necessary.
The government’s aim is to preserve the monopoly role of public institutions
However, the proposals to strengthen state-run healthcare are not proposals that would improve working conditions and increase employment flexibility, which would attract staff and improve the quality of patient care. “They are proposals to limit the work of private doctors and dentists within the public healthcare system.” The aim of all this, they say, is “to maintain the central and monopolistic role of public institutions in the delivery of public healthcare, regardless of whether patient care is any better as a result.”
This will lead to the collapse of Slovenian healthcare
They argue that all this is leading to the collapse of Slovenian public healthcare and that healthcare cannot be saved in this way. In their opinion, this will further encourage good staff to leave, and in addition, a parallel healthcare system will be built up even faster, “so that public healthcare will end up being available only for certain complex medicine, and for those patients who cannot afford private healthcare,” they explained.
The association also remains focused on patients
Regardless of the gloomy outlook for Slovenian healthcare, the association will not stop advocating not only for private doctors and dentists but also for patients. They deserve, they say, “quality, safe, adequate professional and above all solidarity-based treatment. Patients, as the central stakeholders of any healthcare system, should always be at the heart of public healthcare. As such, they should also be guaranteed the constitutional right to freely choose their doctor or dentist, regardless of their place of employment, and to freely choose their health insurer, as is the case everywhere else in Western Europe,” they wrote, adding that healthcare workers also have the choice to work where they have better conditions. “At least this freedom cannot be taken away from us in a democracy. What awaits us now is only the death of patients while they are waiting to get to the doctor and the gradual disintegration of what we used to be proud to call public healthcare,” they concluded.
Ana Horvat