Hospital autonomy is a new funding and human resources management style aimed at taking delivery of quality and real-time care to a whole new level. The new health care bill has cleared the way to a long-awaited transformation of the public and private health care service, primarily providing public hospitals with the opportunity to build all the required legal and regulating mechanisms of financial and human resources management.
The Managerial Autonomy was for the first time launched as a pilot program at the Fier Memorial Hospital last March and the hospital’s performance has significantly improved in all its indicators since then.
Prime Minister Edi Rama attended a ceremony where the managerial autonomy certificates were awarded to the Mother Teresa University Hospital Centre and four regional hospitals. Health personnel, hospital executives and health care experts also attended the event.
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Hello everyone! We have come together several times for various reasons related to development stages on the path and progress of this effort launched amid conditions that now seem to have never existed before, amid conditions that sound unimaginable now, but which have been part of the life of health personnel members, health care service and our citizens.
All the background images here are actually images of today’s reality of hospitals and these pictures would have been merely a dream seven, eight, nine or ten years ago, a totally impossible dream to come true within a relatively short time, but we have now ushered in a completely different stage.
We have ushered in a new stage and I can truly confirm it also how as a University Hospital Centre patient – namely the Foreign Minister, if I am not mistaken – underwent a surgery procedure at the newly-built internal medicine hospital and he texted me saying: “I can’t still believe this is our hospital in Tirana.” This is because he was appointed as Minister after serving as part of the country’s diplomatic service abroad.
It has been one of the strategic objectives for the doctors and health workers at the country’s public health care service to be provided more power than that of just a employee and grant hospitals the freedom to manage their funds through the managerial autonomy and provide doctors with the opportunity to receive a horizontal state wage, but also an additional payment that will be awarded to all doctors who work harder, perform more surgery procedures and deserve a lot more.
I think there is no reason whatsoever for the public health system to be the first choice of the Albanian citizens who can afford receiving care services from the private health care system. There is no reason for that.
Yes, some of the private hospital facilities actually offered much better conditions when we embarked on this path. But, this is no longer the case. The conditions at the internal medicine hospital or at other public health facilities are beyond compare, while the same doctors serve at both private and public systems. How come then that one should choose private hospitals and pay a lot for care service at private facilities if you can receive equally quality even better care from precisely the same doctors at public hospitals? The reason is just one; the still prevailing perception that public health care fails to offer decent conditions and where no care is delivered and stuff like this.
We initiate a new chapter thanks also to the fact that the Fier Memorial Hospital served as a model to pilot the managerial autonomy and, within a year we plan to launch the dual practice, so that the best-performing and most-in demand doctors working at public hospitals can offer and deliver care beyond regular work hours, can make use of the hospital facilities, equipment and conditions to deliver extra care in exchange of a payment, with 70% of it to be paid to doctors and 30% to be paid for the hospital and in this way we finally join Europe in terms of how we design and build the public system, with doctors being not merely health employees and being forced to look for ways to leave work at public hospitals and take up jobs at private sector to add something to their salary, but with all doctors receiving a decent salary instead. This way, every doctor can work more beyond regular work hours and be paid directly by this practice. This is one side of the process.
The other side – and I would like to emphasize it – as soon as we complete the entire needed process of estimating all cost, protocols and processes required to deliver on the financial autonomy through the managerial autonomy, the hospitals will be granted full autonomy, not only managerial, but also financial autonomy, and due funding will be allocated to hospitals and, acting as independent entity, they will decide how to spend funds, which medicaments they will procure and, at the same time, doctors will receive extra payment from the hospital revenue according to a clearly defined protocol.
So, not only the dual practice, but the increased merit-based remuneration internally will make physicians and health specialists show greater interest in working at public hospitals, while competition will become increasingly stronger. Therefore we will have no reason to worry about those doctors who leave the country to work in Germany. I can make such a statement confidently, because I am personally convinced that the coming years will mark a turning point in this aspect too.
On the other hand, I am very confident that based on the current knowhow, the experience we have amassed and the investment plans on the country’s health system, we will succeed in providing more opportunities for the health care system to also become part of our tourism industry. All these have been part of our vision since the very beginning, things we have dreamed about since the onset, but everyone has thought we are kidding or we are lying or as if we were doing what every politician randomly does when seeking to trump up support and more votes. But, our history is completely different, our path is different.
Many thanks and have a great year ahead!
