Hospitals protest against lack of funds

The Latvian government has earmarked an extra €8.7 million for regional hospitals after staff protested at plans to cut funds for emergency patients in the second half of 2011. Demonstrations by health unions at three regional hospitals in August 2011 were supported by the Latvian Hospital Association, local governments and the public. However, hospitals are sceptical of another government promise to allocate an extra €997,000 to emergency healthcare funding.

Unions announce protests

Valdis Keris, Chair of the Union of Latvian Health and Social Care Workers (LVSADA), announced on 10 August 2011 that employees in several hospitals would start peaceful protests against plans to reduce financing for emergency patients in the second half of 2011. At the same time, the hospitals and the local governments that run them said they would take the government’s Health Payment Centre (VNC) to court over its proposed budget cuts.

The Latvian Hospital Association (LSB) supported the protests by LVSADA, with the association’s director pointing out that regional hospitals have been underfunded year after year, with the number of patients needing emergency care being almost double that allowed for. Hospitals are not allowed to refuse admission of patients, but the lack of cash means hospital employees cannot be paid for their increased workload. This has led to four hospitals refusing to sign their amended contracts with the VNC.

One regional hospital, in Kuldīga, was supported by its local government when it announced it would no longer accept acutely ill patients from 1 September.

Doctors have asked the government to increase funding to cover the true number of expected emergency patients, and have also asked that health financing in 2012 should be at least 4% of gross domestic product (GDP).

Government promises fail to work

On 12 August 2011, the government promised to boost health spending in the second half of 2011 with an extra €8.7 million from its contingency fund on top of the €9.4 million it had already allocated, making a total of €18.1 million. However, hospital directors remained sceptical about these promises, because the government was unable to explain how and when the cash would be allocated.

Protest campaigns begin

The first protest campaign occurred on the same day as the government announcement, in Cēsis. More than 100 people, including local councillors and doctors from the hospitals of Cēsis and Ogre, took part in the protest, which was led by Valdis Keris.

More than 200 demonstrators took part in the second protest, which was organised jointly by LVSADA and Ogre Hospital. This was also joined by 20 people from Cēsis Hospital. Representatives from the Ministry for Health had some correspondence with the doctors at Ogre Hospital, but they did not take part in the protest.

A third protest, on 18 August 2011, took place at Kuldīga City Council when at least 300 local people, government leaders and patients picketed a meeting of members of the Latvian Parliament’s Social Affairs and Labour Committee to discuss the controversy.

Government yields to demands

In order to stop the protests from escalating, the government then specified exactly how the €8.7 million was to be used. In addition, on 26 August, the Minister for Health announced that financing for emergency healthcare in local hospitals, including Kuldīga, would be increased by €997,000.

Commentary

Despite the announcements, Ivars Eglītis, former Minister for Health and currently Director of Kuldīga Hospital, feels the protests have not yielded concrete results because there is no official document backing up the government announcements. Nevertheless, increased financing has been agreed as a result of active social dialogue, although the new funding can only be allocated after Parliament approves the state budget amendments. Furthermore, LVSADA, through talks with the Ministry for Health, has prevented the proposal of several amendments that would have worsened working conditions in the healthcare sector. It has also stood firm in its demand for increased financing for healthcare. Nevertheless, there is no unified view about how social dialogue should be conducted or of the results to be achieved. The directors of many regional hospitals do not participate in protest campaigns because they believe that they must resolve problems independently.

Raita Karnite, EPC Ltd.

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