Economy on Focus – Progress in health system as solid basis to further deepen reform

Prime Minister Edi Rama, the Minister of Health and Social Protection Ogerta Manastiriliu, at weekly news conference “Economy on Focus”: 


Prime Minister Edi Rama: This is the day when the weekly open forum takes place. The today’s conference will focus on health system. I would like to dwell upon three main issues, starting with very good news on detention of four more rogue people as part of a further investigation that was launched following a public denouncement by a citizen via the TV investigative show “Stop”.

It is very good news, as it is a clear message to the citizens, who should not hesitate to report any case in any way they see it appropriate and effective, including the investigative media, and I avail myself of the opportunity to again thank them for their work, namely in revealing such a scandalous and meaningful case.

This is a clear message to that part of the army of health workers which fortunately is a small minority, but enough to tarnish the image, to tarnish the purity of the ‘white coats”, and tarnish the ongoing transformation, not only in terms of conditions, but also in terms of their performance. It is a clear message for the future, as I am convinced that the long-lasting and successful cure to treat the cancerous wound of bribery in the health system is a more profound reform. A reform that we have already launched and a solid basis has been established to take the major step towards the hospital autonomy, further motivate doctors and health professionals in accordance to their performance, performance-based diversification and bonus for physicians. Of course, the reform will also focus on moving into a whole new phase, where, based on the best models and international practices, we can and we will make sure that public hospitals work with a logic that blends free care for citizens and the performance-based bonuses for doctors.

Of course, this is an ambition, which is certainly easier said than done, but which could not be a top priority earlier without laying first the basis of the entire health infrastructure and the new health system.

A lot remain to be done in the health system too, albeit a lot has been done and what has been already done is a testimony to the unparalleled transformation compared to what our health system used to be, compared to the state of our hospitals and the health care services, not 70, nor 17, but just seven years ago. Their state was unprecedentedly scandalous right at the heart of Europe.

Today we have a completely different picture in every aspect, and based on that picture we can now afford taking the next huge step. The new Fier regional hospital project is part of this ambition, a facility which will feature not only contemporary infrastructure and state-of-the-art technology and equipment, and highest quality care standards, as we have already built and established such structures and it won’t be the first one, yet Fier hospital will become a centre of know-how transfer and it would serve as a pilot project to transform whole management system within the network of our public hospitals. The know how transfer will take place according to the renowned successful model of Turkey’s health system, where there is a clear division between asset management and logistics with human resource management, where the evaluation of doctors’ performance defines their reward, where the long-time story about doctors working both in private and public hospitals ends for good, not only because it is a forbidden practice, but it is also unnecessary  given that doctors can receive much higher salaries than those they receive today while working at a public hospital, based on the care they deliver and their performance.

This pilot project will be an important source of information and knowledge, which would help us to extend such a management model to all hospitals throughout the country.

The University Hospital Centre is definitely incomparably better than it used to be, but we will launch the next reform phase starting with the University Hospital Centre, designed to  grant autonomy and create opportunities for doctors to be not only servants to the public in the hospital, but also feel like they are in their own property in the greatest sense of the word and not like being in someone else’s property, namely the state-owned property, where the state would actually maintain a anonymous presence. They should feel in their own property so that the assets and equipment are best preserved and maintained and perfect care is delivered in order to increase income and their earnings by work, certainly by providing care to citizens for free at every public hospital.

Fier regional hospital will be a public hospital. Citizens will not pay for the care they receive at that hospital, but the hospital’s management model will be completely different from the current management model at our hospitals.

Of course we would have been very happy if we were to take the step towards hospital autonomy earlier, but how the hospital autonomy could be possibly established when the hospitals used to lack medicines, logistics, heating systems, and even blankets and food, with an unmotivated and badly paid personnel? Impossible!

Today’s health system is like the reconstruction sites we have launched in the wake of the earthquake. We have removed the ruins, the foundations have been laid, the basic infrastructure has been built, the structure has been constructed and we need to complement it with its all elements, so that the structure becomes fit to live in. And we will definitely do and accomplish that, because we are on the right path and everything is running as planned.

The great change we have the ambition to bring about takes time and the path towards change is paved step by step.

The next issue I would like to touch upon is an overall panorama and overview about everything we have done to date in the fight against the COVID-19.

A total of 3656 doctors and nurses currently receive an additional bonus pay of 1000 euros on top of their monthly wage and they will continue receiving this additional pay until this war is over.

A total of 1212 support staff members who are provided an additional pay of 500 euros plus their monthly salary and they will continue receiving this pay until end of this war.

Some 464 young physicians and nurses have joined the health personnel in the COVID defence system to cope with this war, ensuring increased capacities according to the needs. The COVID-designated hospitals have been equipped with best state-of-the-art technology and devices found in every hospital all over Europe. Our hospitals lack nothing.

The capacity of breathing aid devices has been trebled.

Work is underway on daily basis to build up capacities in every direction, human and logistic capacities in all links along entire chain of our health care system.

The treatment therapies and the medicines, according to the hospital service guidelines,  have been unified with the therapies currently applied in other countries. Home treatment for COVID-19 patients Treatment of COVID-19 symptoms at home has been 100% reimbursed through a fund of 1,2 billion lek under the two reimbursement schemes. I avail myself of the opportunity to renew my appeal, not on my behalf, but on the behalf of the experts who consistently call on everyone not to binge yourselves and your relatives on medicines and don’t fall prey to 20.000 suggestions and recommendations coming from 20.000 directions with a totally contradictory approach, but instead just refer to the two basis treatment protocols, because a cure to treat COVID all over the world has yet to become available. Whole world clearly advises not to take excessive medicines, say no to advice and recommendations coming from all four directions, but refer to the two simple schemes, which at first glance resemble to common flu treatment protocols, but which are in fact the only schemes that are globally unified and do no harm. The influx of drugs can damage finances; can cause irreparable damage to health, when it would be too late to go to the hospital.

The ambulance fleet has been expanded with 36 brand new ambulances.

As many as 100 new ambulances are specifically operating on the ground to respond to emergency calls for the COVID cases. Most important aspect of this entire process is the epochal transformation of the Health Emergency Service. Today we have a National Health Emergency Service with a proven, computer-registered capacity in a number of services, while this was totally unimaginable just a few years ago.

The laboratory capacities have quadrupled since day one of this war and the number of tests has increased tenfold compared to last June. Rapid coronavirus tests are now available at some 53 community-based testing sites and over 80.000 rapid tests have been performed.

The number of epidemiologists employed in COVID-19 tracing on the ground has increased by 30%, making sure that 90% of the cases suspected to have contracted the virus be identified and isolated within 48 hours.

This is a difficult challenging process. This is a process in which we can succeed if we stay together and everyone does his duty and part, and in which we can fail all together if a single link along the chain of solidarity is broken.

Before commenting on the vaccines, I would like to go back to the year 2013, when no common flu vaccines were to be found in Albania. While we have provided common flue doses for over 350.000 citizens, or four times higher than in 2019, for all high risk groups. On the other hand, we have also succeeded in securing the COVD-19 vaccine in absolutely unfavourable conditions for our country for the reasons you all know. We have launched the vaccination drive, while facing, just like every other country, with delays caused by the extraordinary pressure due to the global demand on Pfizer and the company’s decision to halt vaccine production for a while and quickly invest in increasing manufacturing capacities. However, we have secured 1.6 million vaccine doses to date for 800.000 citizens under a direct contract with the pharmaceutical company Pfizer and under the COVAX mechanism. We are negotiating with other vaccine producers and other states.

–My first question will go to Health Minister. An investigation by TV show “Stop” at University Hospital Shefqet Ndroqi, besides corruption practices, revealed another problem such as lack of food, as patient’s messages show. If there is no problem, as the Prime Minister says, why food should be brought in from home to the hospitalized patients, if there is a contract with a company?

Second question for the Prime Minister; Since Thursday, when Mr. Fatos Nano showed up at Opinion political talk show at Klan TV, I would like to say that a large part of the public opinion credits you with somehow you can order even the former Socialist Party leader to line up. Bearing in mind that all politicians, not only in Albania, become available at a price, is the President’s office, he has long eyed, the price you would pay to Fatos Nano? Would you fulfil this early wish and does this attitude of his have anything to do with it?

And, if I may, another short question, given that Democratic Party leader Lulzim Basha has been showing himself as a good family man cooking for his family, will you also demonstrate such a skill?

Health Minister Ogerta Manastirliu: Before answering your question, I would like to briefly comment on the case that was aired by the investigative TV show “Stop” and reported by a citizen, who, unfortunately, lost her mother. First of all, I would like to reiterate my appreciation for journalists and the daughter of the late woman, who took the initiative to report the case and renew my appeal to the citizens: report any suspected corruption case to the media, the hospitals directorate, or the Ministry of Health. Report them and help us to remove any malignant boils from our health system. We live in a country, where we have seen countless examples of impunity in its history over the past 30 years, while the suspect and her accomplices have now already ended up in prison. I would like to reiterate that if we want to really eradicate corruption from the country’s health system, we should cooperate together, the media, the citizens, while the government demonstrates its commitment to press ahead with its efforts to uproot any boils from our health system as a malignant disease that, unfortunately, has yet to be removed.

All hospitals across the country provide food to hospitalized patients. Certain hospitals provide food to patients through catering service under a contract with a certain company, just like it is the case with the “Shefqet Ndroqi” hospital, whereas other hospitals have employed a hospital kitchen staff to cook food for patients. We have yet to sign contract with third parties for these hospitals. As far as “Shefqet Ndroqi” hospital and COVID-3 hospital are concerned, the hospital officials have decided to allow a channel of communication with the family members of the patients to bring in food and clothes. The overall rule approved prior to the pandemic, as well as the rule regulating activity of the non-COVID hospitals, stipulate that no food should be brought in for hospital patients, because we need to understand something. Patients at hospitals are treated with specific diets that contain certain amount of calories and it is forbidden that a patient, who could be treated for diabetes, just like it was the case of the patient in question, should not take more calories that could trigger other health issues. Such a concession to allow family members bring food in for hospital patients has been offered by the doctors themselves, given that the COVID patients also develop emotional and mental problems as they don’t see their family and relatives, and this has been a way to stay close to the sick family members by providing them food from home, but this is not because the state is unable to provide food to patients. This has been demanded by the families of the patients and it has been approved by the health personnel and hospital officials. Of course, what actually happened has made us to reflect more and take some additional further measures to establish a segment control system of all links of the whole chain of nursery and medical care. Of course, correctness of our staffs cannot be questioned, as such cases can in no way negate the excellent work of our health personnel to save thousands of lives in these hospitals.

Prime Minister Edi Rama: I would like to strongly emphasize the indispensability to distinguish between hard work, dedication and sacrifice of the overwhelming majority of doctors and nurses and elements or individuals like the ones, who were revealed thanks to the investigation and who are an unprecedented disgrace not only to the health system, but also to our society and who fortunately are now imprisoned and I wish they will be never released, because that barbaric form of abuse of a sick woman and her desperate daughter goes beyond corruption. It is inhuman torture. I am nobody to judge a man how the daughter of the deceased who, finding herself in that situation of anxiety and need to save her mother, was stuck in the vicious circle of the trap set by a cleaning woman, who would be fit for the negative role in a film about the scheme of the fraud she has developed, but I want to take this opportunity to tell those who may encounter such monsters not to fall into their trap and immediately report and challenge hospital officials by informing them about what is going on. Thousands of people use my phone number, often to send useless sms texts that are normally a waste of time, and energies, but everyone can use it to report such cases. You can also use the Health Minister’s phone number, that of the police directorate to report such cases. If they have no confidence in any of us, then let them address to the investigative media, without waiting to fall prey to such traps, with people abusing whether hospitals provide food or nor to patients.

As far as the question about the hospital food is concerned, I would say that I am sorry that you Elia, a highly-experienced reporter make such a question. You can’t make such a question, because it is something easily verifiable as you can investigate to find out whether food is provided or not to the hospital patients. The hospitals are there and you can verify it in person and I don’t think they would mobilize a whole structure to serve food just like to show it for your camera.

The problematic side of all is going to extreme and identify the colossal work that has been done in health system, the colossal sacrifices being made on daily basis and the colossal transformation that has taken place with a handful of ordinary rogues and villains, who have been sent to prison. I hope and believe and I beg everyone to join me in this hope, confidence and contribution to send to prison everyone else like these individuals. We can’t turn down everything else. Thousands of people have escaped from the COVID claws thanks to this health system, thanks to these doctors and nurses.