Today LAWG organized a press conference during which independent experts, doctors and patient representatives expressed their evaluation of the work of the Ministry of Health over the past year. In their opinion the year was marked by many discussions and the implementation of a lot of new work. However, the biggest problems within the Lithuanian healthcare system remain.
Evaluation of medicine reimbursement system: positive developments, but a lack of smart budgeting remains
“The Ministry gets pluses from our side for their declared wish to reduce patient co-payments on reimbursable medicines and for the recently adopted medicines policy guidelines. Other positive developments include a desire to reduce the preferential VAT tariff on non-reimbursable medicines. We hope that the Ministry wouldn’t hold back with these plans as the governing units before them have done” said the conference organizers’ representative Rūta Pumputienė. “On the other hand, we also see clear weaknesses too. Although everyone knows that Lithuania remains on the edge of access to innovative medicine in Europe, no specific actions have been taken to tackle this. We haven’t seen any real plans or any real initiatives in respect of coping with this problem. Until now we neither haven’t had effective budget planning that would take into consideration both the needs of the patients and the situation within the market. Instead, the Ministry is planning to treat patients the same as the last year, meaning that without any strategic thinking, without thinking how to reallocate saved funds in the best possible way” said Pumputienė.
Evaluation of Ministry’s strategic planning: the direction is good, but there is a lack of specificity
Liudas Jurkonis, a life sciences expert at EY, has emphasized the fact that professional strategic planning within the healthcare system, just as in other areas, guarantees effective resource management and, overall, a successful system. “Good strategic planning ensures effective resource management, enabling and motivation within the private sector, increasing competitive advantage and attracting new talent to healthcare sector. Most importantly, it increases some much-needed trust within the system.” “Today in Lithuania we have over 200 various strategies, but implementation is often lacking. After analyzing the strategic action plan of the Ministry of Health, one should start with compliments, because the indicators are clear, which ensures better accountability from politicians. However, connection between the indicators is sometimes lacking. For example, the Ministry wants to both reduce expenditure and increase it” said Jurkonis.
Patients representatives’ evaluation
Šarūnas Narbutas, the head of Lithuanian Cancer Patients Association, said that one thing that has improved a lot since work began within the current leadership at the Ministry is communication with patient organizations before making important decisions. “The Minister’s team’s goal to reduce medicine prices, revive the e-health system for a new life and curb the role of ineffective leaders of medicine institutions are viewed very positively by patients. However, the real results of the actions taken today won’t be felt or seen this year. We will have to wait for the positive impact” said Narbutas.
Evaluation for Artificial Insemination Law: good that the law was adopted, but it’s doubtful if it’s actually good
The obstetrician gynecologist Gražina Bogdanskienė expressed satisfaction that the Artificial Insemination Law has finally been adopted, for which the current leadership of the Ministry of Health can be complimented. “The first twin sisters who were born after using AI in Lithuania are now 23 years old. It’s sad that it took Lithuania almost the same amount of time to finally adopt the Artificial Insemination Law. The fact of the adoption itself is positive, but whether the law is actually good is a separate question” said Bogdanskienė. “The first clear issue is accessibility. Today compensation for this treatment is only for married couples or those living in a civil partneriship. Paradoxically, we do not have a Civil Partnership Law in Lithuania, therefore unmarried couples cannot receive this much needed treatment. The second problem is the requirement to store embryos forever. Embryos drastically reduce in quality after about 10 years, so why do we have to store them forever? The third problem is sperm donation. Private medical institutions are not allowed to import sperm from European sperm banks to Lithuania, whilst there are no sperm banks in Lithuania” remarked Bogdanskienė.
Rheumatologist’s evaluation: many unknowns remain
Professor Irena Butrimienė, the head of Vilnius University’s Hospitals Santara Clinics Rheumatology Center, said that patients are worried if the possibility to receive the best treatment and the best medicines remain, and about the possible co-payments for biological medicines, which have made a revolutionary breakthrough in treating autoimmune arthritis. “Specialists who have worked hard to prepare detailed descriptions of specific illness treatment are worried if it is going to be prepared appropriately, so that the treatment procedure is smooth, that rheumatology day-stationaries are prepared on time whilst the prescription of biological therapy drugs is uninterrupted” said Butrimienė. “These descriptions will come into force (if the Ministry signs the orders) on January 1, 2018. So far, we have seen debates on specific documents and analyses of the impact of this order with regard to the budget of the National Health Insurance Fund of Lithuania. Without approved documents, medical institutions cannot start preparations for structural reforms and restructure patient flows as the procedure of medicine compensation changes.”
Evaluation of oncological patient treatment: a revolution within oncological treatment by medicine is needed
Birutė Brasiūnienė, the doctor, oncologist, chemotherapist and Director of the National Cancer Institute’s Chemotherapy department said that Lithuania is in need of a multidimensional modernization of chemotherapy. “We need a more global outlook towards increasing the efficiency of oncological treatment by medicine, starting with centralized medicine dilution systems and ending with better access to innovative medicines. The healthcare system must adapt to today’s patients’ needs, whilst health policy needs to be developed taking into account all the opinions and knowledge of the representatives of Lithuania’s oncological institutions.” Other issues, mentioned by the doctor, included decreased access to clinical trials, access to some medicine programs and a flawed medicine approval system: “Today we see a huge bureaucratic machine in Lithuania. Instead of treating the patient, doctors are required to spend huge amounts of time working with documents” said the doctor.
Evaluation from Young Doctors Association: preparatory system for young doctors remains problematic
Aurimas Pečkauskas, a representative of the Lithuanian Young Doctor’s Association, said that the preparatory system of young doctors remains problematic. Among the most pressing issues are that internship studies are too short, the social status of residents is unstable, competence-gaining is unclear and not always adequate and a lack of tiered liability for their actions. “The professional training of high-quality health system specialists could be the key to ensuring much-needed changes within the Lithuanian health system. Every year around 500 people graduate from medical universities, so in total we have around 2,500 residents. In order to improve their preparation programmes, we need a multidisciplinary outlook and changes within all segments of the preparatory system” said the representative.
