Prime Minister Karen Karapetyan visited the Ministry of Healthcare to discuss reform process and future plans with the senior staff of the Ministry.
The Premier was first briefed on the work done to improve financing and financial oversight mechanisms in the health sector. A study was said to have been carried out within the framework of strategic issues in order to make budget estimates, and a timetable was developed to improve the financing mechanisms.
Details were given of the insurance plans of actions and mechanisms that are proposed to be phased in. In particular, 100 thousand public servants will benefit from a comprehensive welfare package, under which public servants will be able to choose a medical facility where they can get adequate treatment. The package has already been submitted to the Government. Another key package deals with in-patient services due to 612 thousand citizens with disabilities and other vulnerable groups. The latter will be presented to the Government this July.
As part of operational issues, the meeting reviewed the cost of State-ordered services, evaluating the effectiveness of budgetary programs. It also provides analysis of business plans and the introduction of quarterly reporting, financial reporting systems, medical facilities and state order of mandatory external audit requirement for companies with state participation.
The Prime Minister wanted to know the way funds are being distributed under the State order mechanism. The Head of Government said that during his visits to the provinces he had the opportunity to understand the rationale behind the distribution process, which as a matter fact is not targeted and effective. The system needs to be changed fundamentally in order to prevent illegal circulation in this area.
“Have you developed a strict and rigorous management plan that should state as follows: You, the medical institutions, must boast a specific commercial component, otherwise as far as I have not built up an ideal system, you will be looked upon as a black structure and will not get a State order. If I were in your place, I would mark up the commercial component for those who may come to take the State order next year,” Karen Karapetyan said.
Healthcare Minister Levon Altounyan reported that a draft reform package in the system of State order is due to be sent to the Government this July, with the launch scheduled for October. The Prime Minister told him to speed up efforts in this direction.
With reference to the activities of central and local health clinics, the Premier noted that clinics should act within the framework of a common health policy in both Yerevan and the provinces.
“As the agency supposed to formulate the philosophy and policy in this area, it is up to you to make decisions and monitor the process. There is an imbalance that needs to be addressed over here,” Karen Karapetyan emphasized.
In response, Levon Altounyan said that the Ministry sees the solution in the introduction of standards. Morms have to be established for attendants, doctors and services. The process is due to be complete by this yearend.
Stressing the importance of correct and balanced management of the situation, the Prime Minister stated in part, “I expect that very soon you will decide what to do. You may need to hand over a couple of clinics for trust management or otherwise turn to one or two international operators in order to bring about a change in the management culture.”
The Prime Minister was also informed on the results of the ongoing structural reforms and optimization of the healthcare system. An analysis was said to have been carried out with the ultimate goal of determining the optimal number of medical centers, doctors and wards, as well as taking into account the specificity of medical care, access to medical employment and standard definition. The surveys have shown that the size of the savings will amount to 30 percent.
Reports were delivered concerning disease control and prevention, medicines and health products industries, centralized procurement platform, practices and guidelines, e-health (E-health) of the actual work performed on the system until 2018. Designed work plan and existing problems of health PIU programs.
In response to the questions about the drug market and the e-health system, the Prime Minister was reported that the price of some medicines was down after introduction of the centralized drug procurement system. The E-health is also expected to be introduced in 2 stages – firstly for State order implementing facilities, then for all licensed institutions and pharmacies. 6 Marzes have already switched over to this system this week. The full launch of E-health is expected in October, 2017. In addition, the programs intended for 100 thousand public servants and 612 thousand vulnerable citizens are proceeding in parallel with the launch of e-health system.
Summing up the discussion, the Premier said that the Ministry of Health is moving in the right direction and urged them to speed up the pace of reforms.