2021 state budget, its impact on economy and health system in particular 

Speech by Prime Minister Edi Rama at today’s plenary session of Parliament:

Dear (lawmaker) Myslim Murrizi, I followed you attentively. Thank you for making me laugh, because of a trivial mathematical aberration just like your former leader, as you said that2.5 + 1.2 = 3.2.  No problem though as it actually happens under the influence of the democratic virus when it comes to the arithmetic calculation. It doesn’t matter at all, as it clearly shows you still remain a sort of Democratic Party member and this is what matters most. It is for sure that anyone making silly mathematical mistakes is democratically unsuspicious, meaning you are not under Rama’s orders. This is for sur.

I don’t want to take more time from other discussions, yet I would like to take advantage of this issue on the today’s agenda of the Parliament to underline the aspects of the 2021 state budget impact on the country’s health system that holds a special place in the next year’s state budget, both in terms of further strengthening our health system as part of efforts to deliver on our vision, including new measures with their effect extending beyond next year, and in terms of direct measures designed to support most vulnerable social categories, the COVID-affected citizens and the families under the economic benefit scheme.

First of all, the growth health sector spending in 2021 represents the highest growth rate over the past 30 years, a 23.3% growth, the highest ever recorded, which, as a already noted, is related to a new set of measures that will remain in place, both in terms of strengthening the entire defensive line in order to emerge proud from this war that is challenging whole world and in the development of which – I say proudly say this – Albania lacks nothing compared to other countries.

Imagine and let everyone imagine just for a moment what would have happened should this cholera outbreak was to happen in Albania with its hospitals we inherited when we took office.

We visited Vlora regional hospital and the new intensive care unit there and the entire facility that has been made available to cope with any potential scenario should the frontline of this fight expands further, when we will be forced to involve regional hospitals in the network of the COVID-designated hospitals and the difference between what we have built in Vlora hospital and its poor state previously and this difference is absolutely like night and day.

The same goes for the University Hospital Centre and the Shefqet Ndroqi University Hospital and the regional hospitals all over the country.

Vlora hospital was equipped with obsolete devices dating from the Sino-Albanian relations era.

The oxygen lines and oxygen therapy devices for breathing support and the much needed ventilators for the COVID-19 patients in serious conditions have been installed in our entire system of anti-COVID protection.

The new sustainable measures due to enter into force on January 1 to ultimately remain there, in addition to the ongoing investments in health sector, include a measure of particular significance today and that is the 40% pay hike for all doctors and health workers all over the territory of the Republic of Albania.

In the meantime, a monthly special cash bonus for all physicians who accept to serve in hospitals located in areas other than their place of residence will remain in force. All these measures provide a decent salary to all doctors in the Republic of Albania and it is competitive to the salary they would be receiving if they choose to work abroad, where, apart from the monthly salary, they would be paying much higher taxes and face much higher living costs.

In the meantime, the new state budget guarantees the continuation of a support that is about to enter into force in the coming days and it is designed to support all COVID-patients currently being treated at their homes.

I would like to reiterate here what I happen to hear insistently; fulfil the persistent request from our experts in the Technical Committee, but also of other doctors involved in this war, to tell the citizens that they should faithfully refer to the family doctor and faithfully heed to the advice they receive from the National Emergency Service so that they do not purchase medicines and refrain from spending their household budget in buying medicines that could turn detrimental to their health.

This is a phenomenon taking place in other countries too. It is one of the common problems health authorities in developed countries with more developed health systems are facing, with people buying medicines that do not help, even they harm people who have contracted the coronavirus.

Of course, this is where speculators come into play, of course this is where the family anxiety and the COVID-patient’s insecurity come into play and therefore tend to do utmost efforts acting on the idea that the medicines on the basic prescription, based on the guidelines of our system, are not sufficient.

It is indeed the continued persistence of the experts in the Technical Committee and health authorities in many countries, where this phenomenon is evident so that the citizens do not fall prey to the anxiety, insecurity and speculators and exchange advices via whatsapp, avoiding authorized family doctors.

However, having said that, with the 2021 state budget we will continue what is about to start in a few days’ time, providing financial coverage of the basic prescription and the introducing into the reimbursement scheme all medicines for the benefit of all COVID- 19 affected people.

In the meantime, we will double the economic benefit for the vulnerable social categories during entire time we will need to fight together the pandemic, not to the benefit of COVID-affected people in this case, but to the benefit of all families eligible to the social and economic benefit programme. This includes the society’s most vulnerable part and if we rightly ask them to limit their activity but it is indispensable that we provide doubled economic assistance the family heads, who mostly work in the informal employment sector.

On the other hand, the Albanian government today paid the deposit for COVAX within the deadline that expires at midnight, joining a network of states that have financially commissioned access to the vaccine that is set to become widely available in the coming months. In the meantime, we maintain daily communication with the European Union. Last Friday, I had a long conversation with the European Commission President, as well as with some Prime Ministers of the EU member states, and the Austrian Chancellor prior to coming here, in a bid to ensure access to the population vaccination, taking notice of the fact that a vaccine will become available soon, but the quantity of doses due to become available won’t immediately meet the needs for vaccination of the entire population in Europe and in any other country and each country has developed a strategy.

We have the same strategy to start with free vaccination of all the most vulnerable categories and then extend free vaccination to entire population. What matters most is that today we are ready to have access and meanwhile we are working as well as others to build the right alliances, because this is actually happening with other countries so that we do not lag behind others.

This is what every country is actually doing and this is what we are doing too, and I am very optimistic that the European Union will pursue an all-inclusive approach as part of its strategy to ensure vaccination of the population and our region, Albania too, will be part of this comprehensive process.

All these said, I want to conclude by reiterating that it is very important for everyone to receive as much fact-based information as possible, as much information as possible from our health authorities, as much information as possible from the entire defence system, in the very foundations of which stands the family doctor, and use the brain mask to protect the brain from toxins intensively spread through misinformation, fake news, fabrications, slander, because, unfortunately, Albania has a specific in this war that you hardly encounter in any other country, at least as far as I am concerned, I have not seen it in any other country; there is an opposition, one of the oppositions, the non-parliamentary one, which unfortunately once again in 100 years, just like a pandemic is a cycle that repeats every 100 years in the whole world and affects the Albanian people too, still fails to find a reason and moral strength to join forces with the majority, not with the government, but with the majority and play a human and constructive role, not by giving up criticism, not by giving up their duty to encourage government to act in the right direction, but by refraining from committing the crime of disinformation and fabrication of a reality, which is fortunately not the today’s reality of our hospitals and our system of defence in the face of this invisible enemy.

It is really criminal to tell citizens that hospitals are collapsing, even though this could have well been the case, but they are not, even though this could have been the case just like in many areas right within the borders of the world’s most powerful countries, but they are not. It is not true that the COVID patients lie on the floor of the hospitals. This is not true.

It could well have happened, as it has already happened in the Lombardy hospitals, one of the excellence hubs in the Italian and European health system, where the COVID patients really lie in beds along hallways, but this hasn’t happened in Albania and fortunately this is not going to happen; It is not true that our hospitals face shortages of medicines. The COVID-19 treatment guidelines applied in our COVID-designated hospitals are the same with the ones being observed in France, Italy, Turkey, and Germany. We also happen to come across absurdities like the suggestions that patients in Albania hospitals are jumping from windows as “they can’t stand the unbearable noise generated by the oxygen therapy devices.

Today again they suggested that the noise generated by the oxygen therapy devices is equal to the noise produced by an aircraft when taking off. The typical noise generated by these devices is the same all over the world because it is the same devices being used.

All these cause anxiety, insecurity, as well as a completely deformed idea because of the propaganda suggesting that the suicide incident committed by the COVID patients have happened in Albania only. This is not true! Such incidents have been recorded in many other countries too, but in no other country the opposition has blamed the government for these tragic events. In the meantime, it was just few days ago when the health personnel in Liege hospital in Belgium were ordered to continue their work in the COVID-designated hospital although they had tested positive for the coronavirus and this happened because of the shortage in human resources, because of the shortage in physicians and nurses.

And it is not me saying this, but this news was rapidly disseminated everywhere. And this is the case in many other countries all over the world.

We don’t differ from others. We don’t face fewer troubles because of this cholera, but we don’t lag behind other countries in tackling the COVID-19 pandemic.

They claim that the government officials go to Turkey for medical treatment. This is not true. We can’t stop anyone wishing to travel abroad for medical treatment and believing they can receive better treatment if they go to Turkey, but no government officials have travelled to Turkey and there are several cabinet members who have recovered and are recovering from COVID. None of them has gone to Turkey. I am not going to provide even family examples to show that we don’t go to Turkey and this for a very simple good reason. This is not because that other hospitals across Europe can’t deliver more specialized services and this is the case even within Europe itself when it comes to such a very rare and unknown disease, but because in this case Albania provides full treatment just like in any other country. Albania applies today the same treatment guidelines, possesses every medical device and equipment currently in use in every European hospital; Albania has dedicated team of doctors, nurses and health professionals.

Again, I would comment on the issue of the number of tests that has somehow become ridiculous. This is issue is as important when considering what it is all about, as ridiculous when considering the fact that it has become a sort of a ping-pong ball being played by all kinds of paddles in this country that are granted the opportunity to sit in a table in front of the TV cameras.

The today’s debate on the number of tests has become a broad debate, be it in the countries that have already conducted the highest number of tests, or in the countries with a lower number of tests, the infections chain has not been broken and the consequences seem to be not different at all. Quite the contrary, the number of infections and the effects turn out to be higher and even worse in the countries with the highest number of tests compared to the countries with a lower number of tests. And this certainly doesn’t mean that the countries with more tests are all the same, just like it doesn’t mean that the countries with lower number of tests are also all the same, but the essence of it all, as already explained by our experts in the Technical Committee from the very beginning, is the existing  one since day one. The testing strategy is closely connected with the identification of the fresh cases and tracing of the close contacts. Tests are not conducted for the sake of testing. I tell many people the same what our experts frequently reiterate and perhaps, also because of my position, they pay more attention to what I say rather than what the experts say. I also reiterate as soon as you feel suspicious but not worrying symptoms to the point where one would need to be hospitalized, you should observe self-quarantine rules and heed to the family doctor’s recommendations and behave as if you have contracted COVID-19.

Health authorities in Lombardy, Italy’s wealthiest region with the most excellent system, deny people the opportunity to conduct the COVID test if they do not show signs of a certain rate, and instead they advice them to stay at home, receive treatment and closely follow the dynamics of the disease. Rushing to undergo the COVID test at private labs and hospitals and spend money all in vain can help you to relax, yet it has nothing to do with the way of treatment of the enemy in this war. No country as of today in this second wave of the pandemic does what they did in the first wave and the countries that did testing, testing and only testing have slowed down this testing process trying instead to focus where Albania and a number of other countries like Albania and not only Albania have been focused from the very beginning of the pandemic. There is no other reason and this is not because we are better, or that we cannot afford, but because this has been the strategy chosen by our experts. If the Technical Committee would say we need a lot more tests then we would certainly have purchased more test kits. Could we possibly refuse purchasing them?

We would have purchased them, just like we created the opportunities to pay the salaries of the oil workers under the current conditions, even though it is about a problem caused by others, just like we have created the opportunity to double the economic assistance for the vulnerable social categories starting on January 1 next year, just like we have created the opportunity to do a lot more other things concerning this ongoing war. We would have absolutely created the opportunity to increase the number of test kits available to the health authorities, but, at the end of the day, there is only a way to assess the situation; what is the number of the infections? What is the fatality rate and what is the number of beds available to the COVID patients? If you have all these three, you are then doing things right. Based on these three indicators, Albania is not ranked among the countries on top list for the number of the infections per million population, the death rate and the hospital bed capacities, but it is on par with every other country considered normal in these abnormal times. It could have well happened, and it can still happen along this process, we don’t know it for sure, and that’s why we have been prepared even for the worst that can happen, and that’s why we have still free unoccupied bed capacities also in the COVID 3 hospital or in the new hospital facility that has yet to become operational if things get worse, as well as in the regional hospitals that will join the frontline fight should the infections and hospitalization rate increase above our capacities. However, this has yet to happen.

Our region today holds a comfortable position also in psychological terms. Bothering people with the constant tam-tams echoing the monstrous dream of those who abandoned Parliament thinking that by resorting to unknown undemocratic means they would seize power, and who now dream that COVID will do what they failed to do by sowing extreme despair among Albanians and turn this sense of despair into a generator of a war against the government. This actually only shows chronic mental laziness of those who think they can seize power by allying with the COVID.

This won’t happen and it can no way happen!

We will do everything, all together, that until the end, – the balance of this war is done at the end – to have a balance for which in the end we are all relieved with ourselves and with the people, who did everything we could and Albania came out of this war with all the consequences that every war brings, but with no consequences more than all the others.