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Health Care in Latvia: the Chronicle of Crisis

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Presentation by V. Keris, Dr. habil. med., Chairman, Trade Union of Health and Social Care Employees …

Presentation by V. Keris, Dr. habil. med., Chairman, Trade Union of Health and Social Care Employees
of Latvia (LVSADA) during the conference on "The impact of the crisis on employment in the Baltic states" in Vilnius (19 Nov 2010)

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  • 1. HealthCareinLatvia: theChronicleofCrisis
    V. Keris, Dr. habil. med.
    Chairman,
    TradeUnionofHealthandSocialCareEmployees
    ofLatvia (LVSADA)
    1
    Vilnius, 19.11.2010
  • 2. Content
    Situationinhealthcarebeforethecrisis (2006 – 2008)
    Consequencesofcrisis (2009 – 2010)
    Conclusions
    2
    Vilnius, 19.11.2010
  • 3. InitiativeofWorldHealthOrganisation: HealthWorkersSaveLives! (2006)
    Thedecadegoalinallcountriesis to buildhigh-performirngworkforcesfornationalhealthsystems to respond to currentandemergingchallenges
    (WHO. TheWorldHealthReport 2006)
    Vilnius, 19.11.2010
    3
  • 4. HumanResources: 2008*
    Doctors(/100 000 pop.)
    Latvia – 311
    (2009. – 272)
    EU – 324
    Estonia - 335
    Lithuania - 370
    Nurses(/100 000 pop.)
    Latvia – 534
    (2009. – 507)
    EU – 775
    Estonia – 640
    Lithuania - 711
    Vilnius, 19.11.2010
    4
    Inyear 2008, Latvianhealthcareneeded 300 doctorsand 5500 nurses, whencompared to average EU figures
    *sources: www.who.int; MinistryofHealth, RepublicofLatvia (MH)
  • 5. MaternalDeaths*(per 100 000 livebirths)
    Vilnius, 19.11.2010
    5
    *source: www.who.int
  • 6. HealthCareinLatviaand EU: 2008*
    Theproportionofgovernmentalexpenditureisinverselyassociatedwithnumberofliveslost, whenpopulationofLatvia (2,28 mlj.) iscompared to similarsizeofpop. in EU 12 and EU:
    (13.7–11.1)x2280= 5 928
    (13.7–9.6)x2280= 9 348
    Vilnius, 19.11.2010
    6
    *source: www.who.int
  • 7. A Steady, InverseAssociation...
    Governmentalexpenditure (% of GDP)*
    Crudedeathrate (per 1000 pop.)**
    Vilnius, 19.11.2010
    *source: EUROSTAT
    **source: www.who.int
    12
  • 8. EmergingHealthCareProblemsinLatviaAlreadyRecognised: 2008
    Criticallyhighmorbiditywhencompared to averagefiguresof EU
    Thehighestmortalityin EU
    About 32% ofworkingphysiciansareintheageofretirementorcloselyrelated to; only 11,5% ofphysiciansare < 35 y
    (Government’sOrder Nr. 82, 20.02.2008)
    Vilnius, 19.11.2010
    8
  • 9. EU HealthInitiative: 2007 - 2008
    Decision No. 1350/2007/EC oftheEuropeanParliamentandoftheCouncilestablishing 2nd programmeofCommunityactioninthefieldofhealth (2008 – 2013). Aims: 1. (..) contribute to increasedsolidarityandprosperityinthe EU byprotectingandpromotinghumanhealthandsafetyandimprovingpublichealth
    Green Paper ontheEuropeanWorkforceforHealth [COM(2008) 725]: ensuringbetterworkingconditions, increasingstaffmotivation
    9
    Vilnius, 19.11.2010
  • 10. ConsequencesofCrisis (1):SocialDialogue
    NationalTripartiteCooperationCouncil’sreccommendations
    Government’sresponse
    Cutsexpenditureonhealthcare
    Cutsremunerationofmedicalstaff
    15.04.2009: develophumanresourcesforhealthcare
    12.08.2009and01.04.2010: develophumanresourcesforhealthcare; increasegovernmentalexpenditureonhealthcare
    Vilnius, 19.11.2010
    10
    PrimeMinistersinceMarch, 2009: Valdis Dombrovskis
  • 11. GovernmentalExpenditureonHealthCareinLatvia*
    Vilnius, 19.11.2010
    11
    1 LVL = 0.7028 EUR
    **according to GDP forecastforLatviaissuedby IMF
    *sources: www.csb.gov.lv; MH
  • 12. GrossRemunerationinLatvia, LVL*(1 LVL = 0.7028 EUR)
    Vilnius, 19.11.2010
    12
    2010/2008: -8.8%
    2010/2008:-19.9%
    **January - June
    *sources: www.csb.gov.lv; Government’sRegulations
  • 13. ConsequencesofCrisis (2): StructuralReformofHealthCare*
    Acutecarehospitals(/100 000 pop.)
    Hospitalbeds(/100 000 pop.)
    2010: 558
    2008: 746
    (Estonia – 571;
    Lithuania – 683;
    EU – 531;
    EU 12 - 667)
    2010: 0,9
    2008: 2,9
    (Estonia – 2,8;
    Lithuania – 2,5;
    Netherlands – 0,6)
    Vilnius, 19.11.2010
    13
    *sources: www.who.int; MH
  • 14. RelativeRiskofCaseFatalityandNumberofAcuteCarePatients, 2010* / 2009, (%)**
    14
    Vilnius, 19.11.2010
    + 800 potentiallyavoidabledeaths
    Medicalstaff: -14.8%
    *January - June
    **Sources: Questionnaireof LVSADA; MH
  • 15. Conclusions
    GovernmentofLatviaignoresreccommendationsofsocialpartners
    Government’spolicyisincontradictionwithhealthinitiativesof WHO and EU
    Healthisnotthesector to bereducedduringthecrisis
    15
    Vilnius, 19.11.2010
  • 16. Comment
    ArminFidler, ChiefAdvisor to theWorldBankonhealthissues: “Thosewhoallowthecrises to reducethestandardofhealthcarearegettinginto a long-termproblemwithpotentiallycatastrophicresultsforthesocialsituation.”
    12th EuropeanHealthForumGastein, Austria
    Source: EuropeanHospital, Vol. 18, Issue 5/09
    16
    Vilnius, 19.11.2010
  • 17. ThankYouforAttention!
    17
    Vilnius, 19.11.2010