Work to improve the healthcare system of Pridnestrovie continues. Different ways and models were offered. It is necessary come to a consensus on the advisability of reducing the current excess of hospital beds at the moment as well as the need for a final transition to a three-level model in the provision of medical care to the population. Detailing is still in progress. Goals, objectives, activities, tools, the expected effect of the upcoming changes, possible disadvantages and ways to minimize them – all this was discussed.
The President held today an expanded meeting with the participation of heads of state authorities, ministries of financial, economic and social blocks, heads of state administrations of towns and districts of the republic, parliamentarians and chairmen of city district councils of people's deputies, as well as heads of medical institutions of the republic. Vadim Krasnoselsky classified today's working meeting at the site of the Pridnestrovian President's Administration as a hearing, noting that the situation in the healthcare sector is an acute and rather speculative topic, and therefore requires an open and detailed exchange of views. Vadim Krasnoselsky urged the participants of the conversation to be active, noting that "it is better to ask three stupid questions as it may seem to someone, than to make one stupid decision".
The discussion, in which more than fifty officials participated, was filled with specifics. The President insisted on this approach, emphasizing that there are no insignificant things and insignificant aspects in organizing the activities of such a significant sphere for society as healthcare. We are talking about ensuring the safety of the population, preserving the health and life of citizens, as well as creating decent working conditions and improving the level of qualifications and professionalism of medical sector employees.
The Minister of Healthcare made a presentation on the proposed optimization. Kristina Albul focused on the fact that the network of primary healthcare institutions has been expanding in recent years in Pridnestrovie. There are about a hundred rural outpatient clinics and feldsher-obstetric stations in the country as a whole today. The state has repaired 11 rural outpatient clinics and feldsher-obstetric stations since 2018, six modern modules were built under the auspices of the Capital Investment Fund. The polyclinic link is being modernized, the ambulance service network is being developed (the fleet has been replenished with four dozen modern automobiles). The state has spent 110 million rubles on the construction and repair of medical and preventive institutions since 2018. Work to improve the medical infrastructure continues. It was important at the same time to make an effective investment of funds, it was noted at the meeting: to repair and equip medical facilities that are in demand is necessary, to organize the number of inpatient beds corresponding to public demand, and to ensure the availability of quality medical care at the primary level. Experts ascertain a serious bloated number of beds (almost half are idle) today. The optimization proposed by the Ministry of Health is aimed at reducing the unclaimed bed capacity in the districts and greater centralization of hospitals that will be strengthened technologically and with personnel. The minister voiced proposals for a targeted reduction in the number of beds in specific medical facilities. 546 beds are expected to be reduced totally. It is important at the same time to understand the essence of the concept of “bed space”, the President emphasized. This is not about a bed for the patient, but about the full range of medical services provided. The released areas are supposed to be re-profiled, including in palliative care departments for example. An important role is assigned to day hospitals in polyclinics and rural outpatient clinics. At the same time, reception and resuscitation departments, an operating unit, a clinical diagnostic laboratory, an X-ray room and an ambulance station will function in all districts.
An important issue pointed out by the initiators of optimization: doctors lose their qualifications, which negatively affects the quality of medical care with a minimum workload and a shortage of practice as a result. This aspect is a weighty argument for supporters of optimizing the network of obstetric hospitals. It is proposed to concentrate obstetric care in three centers – in Rybnitsa, Bendery and Tiraspol.
The level to which this or that medical institution will be assigned is determined based on the demand for medical and preventive institutions, the availability of qualified personnel and material and technical equipment. The participants of the meeting clarified the criteria, asked what requirements are imposed on institutions of each level and whether there are equipment standards, noted that it is necessary to clearly spell out the list of services provided. Important issues are routing, logistics, provision of specialized transport. They talked about the prospects for increasing the level of remuneration of workers in the healthcare sector and about the measures taken to retain existing specialists and graduates of medical educational institutions in the republic. The agenda includes issues related to the retraining of doctors and nurses. They recalled during the discussion the importance of such a preventive element as clinical examination. They raised the issue of the need for informatization of the healthcare sector. Narrower topics were discussed as well. They spoke about a decrease in the incidence of tuberculosis in the republic for example. This is a consequence of the mask regime introduced during the coronavirus pandemic among other things.
Representatives of the districts spoke about the concerns of the local population regarding the discussed optimization. Citizens have fears that medical care will be less accessible to them. The President emphasized that the staff of medical institutions and the population must be informed in a timely and complete manner about the essence and mechanism of the upcoming innovations, the fundamental goal of which is to improve the quality of medical care. The Minister of Health was instructed to detail the project, providing the future "passport" of each medical institution – its place in a single system, functionality, population coverage, list of services, staffing. Chief physicians play an important role. Their opinion, as the main executors, is paramount, Vadim Krasnoselsky emphasized, recalling the responsibility that the heads of medical institutions bear. Their participation in the discussion of the upcoming optimization of the healthcare system at all stages is mandatory, the President recalled.
