Address by Prime Minister Edi Rama at inauguration ceremony of newly-built surgery hospital “Frederik Shiroka” at University Hospital Centre in Tirana:
I was just looking at this picture in the background, featuring wall cladding tiles like the ones used to pave the bathroom floor and it reminded me of the time when I took office as Mayor of Tirana and I had to visit the zoo. The lion’s cage floor had been paved with the very same tiles and the lion had practically found itself in a difficult position like no other species in the jungle would have ever found itself, since it could not walk, because it slipped any time trying to do so and it had turned into half-dolphin in Tirana’s zoo.
Of course, my story and this picture date back from a time when democracy arrived in Albania together with the majolica glazed ceramic tiles imported from Turkey as a burst of enthusiasm against those white and small locally-produced tiles, but it’s worth returning for a single moment to better figure out why it takes time and great patience to finalize a great project like this hospital, which, I am sure I do not exaggerate it at all to say is the greatest work in Albania’s health system over the past 90 years in terms of the project’s depth and the technological capabilities it makes available to physicians and the health personnel.
I feel very honoured and at the same time there can be no more encouraging compliment than the remark made by the professor, a leading and prominent figure of an important period in the history of Albanian surgery and his statement that “this is a dream come true.” But of course, it won’t end right here, because it has always been my dream for the University Hospital Centre to completely transform in its whole perimeter as a personification of our ambition for Albania and the health system in Albania. The work to construct the new surgery hospital facility has completed today, but the University Hospital Centre has become a true construction site. However, seeing crowded streets with people walking up and down around the hospital buildings, which is not the case in normal hospitals, this is a sufficient reason to find out that there is a need for continued work to transform both the internal infrastructure and surrounding space. To this end, the ongoing work to construct a new internal medicine hospital, which will represent another excellent model of transformation or the Pediatric Hospital building being constructed on the other side. But the work to rehabilitate entire outdoor premises in order to finally build a parking lot intended for parking all cars entering the hospital complex area, turning the perimeter within the University Hospital Centre into a space accessible and usable by ambulances only, and not cars, trucks or other vehicles. This is a must.
On the other hand, I am pleased to hear the professor acknowledge what you know better than everyone else and what I have learned about due to my official position, but many have no clue about the state of the medical equipment previously, with unsharpened scissors, failing surgical pliers or alcohol being used to sterilize the surgery instruments.
Today this is another aspect of a major transformation that has now become a reality thanks to that “cursed” model of public-private partnership, but which otherwise would not have been possible. When I took office, I was shocked to see postoperative infections rate also caused by the available surgical instruments back then. What a cost to the people’s health, what a cost to the households’ economy, what a cost to the hospital and what a moral cost to doctors themselves, who were thus denied of the professional satisfaction from their best performed duty just because they were not provided with the right surgical instruments that trigger no undesired reactions to the human body.
Today we have a set of surgical instruments and a sterilization system that I believe was unimaginable just few years ago.
On the other hand, I am pretty aware that the country’s health system is not represented by the major hospital centre, or the main ensemble.
It is a whole service network to ease the workload in the main ensemble and provide this extremely important hospital centre the opportunity to deal with what it has been tasked with and not with what it is not asked to do. Few years ago only, this hospital housed both the primary health care and emergency service to treat all kind of health conditions that were probably not urgent at all and for everything else.
Reducing this burden through gradual creation of the whole surrounding system is part of this process.
That’s why we have attached special attention to the family doctor, that why we are focusing on reconstruction of the health centres and health facilities, and this is the reason why we have place special attention to the renewal and full recovery of the regional hospitals so that we provide this University Hospital Centre the opportunity to deal with the duties it has been tasked with, provide the opportunity to improve know-how.
In addition to this, I would like to point out an element of a particular importance, that the newly-built premises, as well as the facilities of the new internal medicine hospital will offer more additional opportunities for the medicine students for their clinical practice and, with the digital operating room already available to doctors and the medicine students, and now live images of surgical interventions will be displayed on any screen for the students to see in their classrooms without having to assist in the procedure. Of course, their presence in the operating theatre is part of the whole, but at the same time, providing them with the opportunity to see the procedures for themselves via live images and creation of a digital archive of the surgical interventions to watch images showing the interventions performed by these honoured professors here will help them a lot.
A proper choice has been made – and I removed it from my speech notes because, since we didn’t consult with each other, Ogerta started her speech by citing a famous quote from Professor Frederik Shiroka – and, as I said, naming this hospital after him is the best choice and I am referring to his name to convey to everyone the message that at the end of the day knowledge is what makes a difference.
Listening to professor Besimi who focused on the conditions of the surgical interventions and imagining how hundreds of people are today safe and sound just thanks to those surgical interventions performed in those conditions, I think it should be borne in mind that it is too great a knowledge to transmit.
To conclude, in order not to take more time, I would like to add the fact that despite the investments, which you know very well that investing in health is never enough, there is one cabinet member who is declared an enemy in every government of every country around the world, that is the Minister of Finance and then there are other cabinet members who ask for more and more funds. And, as far as I have been told, the first one who always wants more and is increasingly unhappy with what he gets is the Minister of Health, because even in the most developed countries, with the most advanced health system, investing in health it’s never enough.
We have currently invested 30 million dollars to support construction of this facility, an extremely large amount compared to the investments in the past, but a very small one considering the needs of the entire health system. While people rightly ask for more and want everything to be done right now without caring about related cost to the improved quality and increasing volume of the health services.
It is important that we will not cut projected budget spending due to the emergency situation in the aftermath of the earthquake, which has seriously challenged the government and the whole state, as we need to address the colossal need for reconstruction.
You might have heard the proposals, calling for termination of the partnership contracts, but I don’t know whether there is a single doctor or a nurse who would agree that we stop funding the medical instruments and go back to the unsharpened scissors, failing surgical pliers or alcohol being used to sterilize the surgery instrument. Why? Because it is a public-private partnership. I would like to explain it once again, as I have always done, but whoever is not willing to understand, he of course doesn’t understand. He who doesn’t wish to see, he doesn’t, and he who doesn’t wish to listen, he doesn’t, but if today we have the capacity to supply all our operating rooms with first-class medical instruments, this is thanks to the investment made by the private sector and not by the public sector.
The public-private partnership is not about giving budget money to the private sector, but it is an agreement based on the understanding and good will that the private company invest to provide what the state can’t afford at a certain moment, and the government pays it back in tranches and once full payment is settled the investment becomes a state or a public property. In other words, these whole sterilization systems will become a state-owned property. How on earth one could terminate such an agreement, program and process? What for? This is certainly a challenge, just like the system’s maintenance is. The lack of proper medical equipment has been a long and sad story, including the poor maintenance of the existing equipment.
For this reason, I have asked the Minister to launch a process for integrated maintenance of the medical equipment. Little has been done to say that much has been done in the wrong direction to create systems available to physicians, and so the more I know this system internally, the more I see the whole functioning of this system internally , the more I feel really bad when doctors are insulted, when doctors are maltreated, when doctors are subject to all sorts of criticism and labelling due to a perpetually nourished perception of the difficult conditions, but if you look at how much doctors have done and how poorly they have been rewarded by those who were supposed to provide them the proper instruments, then the work of the doctors is much more respectable and even admirable.
Of course there are doctors who violate ethics, but if we were to refer to figures, an unsuccessful surgical intervention makes the media headlines, but this is not the case when it comes to other 60,000 surgical interventions each year. As many as 60,000 surgical interventions, plus 30,000 minor interventions are performed by doctors and health personnel each year. Our challenge is to make a system operational, making most of your know-how with your maximum motivation.
Maintaining the equipment is a major challenge. Breaking all those shells created over the years due to the spheres of influence and underground connections, both in terms of supply of drugs and equipment, is a challenge.
Significant progress has been made when it comes to the quality and price of medicines. We certainly need to do a lot more in order to further strengthen and improve the system. Of course we still face many problems, especially in the regional hospitals and health centres outside Tirana with doctors forcing patients to buy their medicines at private drug stores although hospitals are supplied with these medicines. There are of course sporadic cases, but the situation is incomparable with the past. But what we need to do with the equipment is a must. An integrated and guaranteed maintenance of the whole system, as the rational part of this world does because we are not rich and cannot continue to fall into the trap of the one who does not have and it costs him or her a lot more than what he or she spends.
Thank you very much for your patience and attention and I would like to conclude by remarking about the digital revolution in the online delivery of the public services, which will significantly improve the public service delivery and will become very helpful for the citizens and businesses in all sectors.
To date we have had a tremendous influx of people having to report in a dizzying array of governmental and state offices just to fill in an application or obtain all kind of state documents and certificates from service windows. The application for all this array of documents, from now on can be made from home via a personal computer or a smart phone and it is the public administration employees the ones who will carry out the entire procedures to provide the required documents.
By the end of this year, the entire application process for state documents will be overhauled and in a three years’ time I am confident that every response will be provided online only, so that nobody will have to report in person at a state institution to obtain a document. So, if we have included the majority of applications for services provided by the immovable property registration office, one of the state offices with the longest wait time, in a very near future every applicant will be able to obtain an electronically stamped document via his or her smartphone or computer. All service windows will be shut down so that no interface contacts with window clerks take place.
Thank you very much!
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After 90 years of neglect, a new temple of surgery has been built at the site of the old surgery facility at University Hospital Centre, featuring state-of-the-art equipment manufactured according to European standards to deliver specialty care for patients.
This is the new “Frederik Shiroka” Surgery Hospital, a government major project on a 120-bed facility, which would take health care services in Albania to a whole new level.
Surgery Hospital facility features seven operating theatres, namely General Surgery, Special Surgery and Urology. All rooms are equipped with state-of-the-art technology that will ensure maximum quality in performing the surgical procedures, as well as introduction of new techniques.
The new hospital is also home to a special 8-bed intensive care unit, featuring state-of-the-art equipment and optimum conditions.
