Speech of Prime Minister Edi Rama at the launching of the project on sterilized surgical instruments at Tirana UHC:
This really is a tremendous operation in the health system, the operation that we are witnessing, to share with citizens another step of strategic importance in view of the revival of the Albanian health system, of the modernization of hospital services, and in terms of coping with decent duty standards in providing public health service.
According to the World Health Organization, surgical operations have become the largest source of disability and mortality in the world. In many poor countries, but also in many developing countries, the safety of surgical care is not recognized as a public health concern because it is a standard that requires considerable costs. The number of surgical operations in the world is estimated to be approximately 250 million per year, or 1 operation for 25 people. In Albania, approximately 50 thousand surgeries are made annually, half of which are made here in the University Hospital Centre “Mother Teresa”.
The existing inventory of surgical instruments we found would not be accepted in any hospital in Europe, and in a normal country it would be used as scrap. In addition to being very old, that inventory was not at all assorted, and it was very far away from the capacities to enable modern surgery techniques. Also, instruments inherited since many years do not provide the maximum safety of sterilization, based on the report of the Institute of Public Health, and actually they provoke the spread of hospital infections beyond the prescribed norms, in addition to being a threat to the safety and life of patients.
There is another scary datum. According to the WHO, half of the cases in the world, with verified complications or health problems due to surgery, are preventable. Therefore, one of the aspects of our program to revive the health system in Albania has been precisely to increase the quality of surgery service, and safety in terms of its provision, ranging from the supply of hospitals across the country with modern and quality surgical instruments.
Today, we had the privilege to pay a visit, accompanied by the leaders of the company that has undertaken to carry out this service on behalf of the Albanian state, and look at the newest instruments, not only in the sense of the most recently produced but also of the latest generation technology.
It will take us 18 months to extend this service across the country. We are starting in this hospital, where half of the surgeries are performed, and in a relatively short time we will meet every need for surgical instruments in this hospital, while every operation room in the Republic of Albania will be served from this base, and these instruments will be available to every surgeon and group of doctors within 18 months.
These surgical instruments are subjected to a quality sterilization process. We saw here a spectacular sterilization infrastructure, the provision of auxiliary disposable soft materials for the medical staff and the surgery bed. – I thank our hosts who managed to find a bad adapted to the not quite normal length of my leg, and the required materials to put on my shoes, so that I could be visited. – In addition, the operation room is disinfected, and at the end of the day hazardous waste is processed and turned into urban waste.
All this is a revolution within the system, which comes as a result of a procedure that has been “cursed”, “criminalized” and “indicted”, and even reported to the prosecutor’s office, the Public Private Partnership, which has been trivialized with the shameful word “concession” and transformed in an outrageous show by some ignorant people who make their ignorance an argument. In fact, it is only through the Public-Private Partnership that we can develop a modern, reliable and sustainable health system. Countries more developed than others, such as the neighbouring Italy, one of the most advanced European countries in terms of health system, or the friendly country, Turkey, known for its revolution in the field of transformation of the health service infrastructure, and many other countries have turned to the Public-Private Partnership, or to what is considered an outrageous show and called by the word “concession”, to guarantee with costs extended in time, services that are provided now. What about our country, with a modest income to meet the funding needs of a non-modest health care of European standards?
Hadn’t we funded the project with state budget money, we would not have been able to extend it in 18 months across the territory, but perhaps it would have taken us 18 years. In addition, we wouldn’t have had the human capital made available by our private partner in this revolutionary operation. It is a process that does not involve only the tools, but also people. Under the leadership of specialists, provided by the internationally renowned foreign private partner, our people are being trained, and they will become system administrators in terms of human resources in a reasonable period of time.
These models of Public Private Partnership success models stimulated at all levels, by governments, by international financial organizations, and by the necessity to give public services more and more the effectiveness of a private service. But in this case, the private provides immediate funding and knowledge, while the service remain public, and citizens don’t pay any additional penny for this service. So, these are models for the benefit of the public interest, in addition to defending the right of citizens to be provided quality services.
How is the formula of this partnership?
The private partner will make all the investment that the government cannot make, and the whole of the investment will be made within 18 months. In addition, another investment of 14 million Euros will be made in the last 3 years of the contract. If you have a look at the budget items for healthcare, you will see that it would be impossible to provide such an amount of money. Thanks to this partnership, what has come today in the largest hospital in Albania, and what will be after 18 months in the hospitals across Albania, is the German excellence in surgical instruments, and the Italian excellence in sterilization and service. What should we ask for more?
In addition to the central sterilization plant management, another 17 supporting plants of this central will be launched across the territory of the Republic of Albania. Thanks to this partnership, 555 Albanian surgeons in 153 operations room will have available for 18 months the German and Italian excellence in terms of instruments and sterilization procedures.
We saw how the whole procedure is carried out, and everything is under control, from the moment one surgery ends and instruments are handed over to the service person, until the next operation, and all this process makes available to surgeons and to the surgery staff the new sterilized package, ready for the next surgery.
This project will be completed in the hospital “Mother Teresa” in the first 6 months, in the second 6 months in hospitals in Tirana, and in the third 6 remaining months in all other hospitals.
If you want a side impact, there will be 100 new employees who will be trained and become specialists provided with the European certificate for service capacity.
In addition to this project, following a 1.3 million Euro funding by the Bank of the Council of Europe, the plant with steam sterilization of surgical instruments will be operative. It was inaugurated in 2011 but to date it has been obsolete, inoperative. Actually, how could such a system be operative, built as a kiosk that is not connected to any road, without water, power or anything else? This also will be included within the system and will become operative.
I want to underline very honestly another fact. We know very well, and I am aware that there are still many shortcomings in healthcare. We know very well, and I am aware how much there is still to be done for every single person who enters a hospital, ranging from the hospital “Mother Teresa” to the most remote hospital. We know very well that what remains to be done is much more than what has been done.
Everyone should know that changes in healthcare are difficult changes. Changes come at a price, require time and above all, as all the reforms in healthcare have shown and all the efforts to further reform in the health system either in Italy or in France have shown, they encounter resistance. But one thing is for sure, what we have done in terms of healthcare in these 32 months was not done in more than 20 years.
Not only wasn’t it done in more than 20 years, but more importantly in these 32 months we were able to make available to the reform additional resources, additional funding, thanks to the public-private partnerships, and above all we didn’t waste any citizens’ penny and didn’t use the money of the budget to pave roads incessantly, calling for tenders.
What remains is still a lot and it is difficult. If you ask me how pleased I am with the current situation, you will get a very honest answer. I am the most dissatisfied person among those who are dissatisfied, but not because what we’ve done is not worthy of praise, but because what we have to do is still much more.
For this reason we will continue determined on this path, we will take all the mud that is thrown to us every day, we will hear all the charges against us every day, we will coexist with the daily criminalization of every idea, project, public-private partnership, or of the reforming operation. Ultimately, what matters to us is what citizens will get in exchange for all this great strain on the health system, and what will get in return for all this effort – also in terms of human costs, in the simplest sense of the word for all of us who have to endure every sort of slander and accusations, – every person who comes here as a patient deserving to be served as a human being with rights equal to everyone living in the European space.
I am very grateful to the Italian Ambassador for his presence here. I know that this is not a very positive day, not because of him and of the Italian government, but because of our state who doesn’t have yet serious state institutions. His presence here, for an investment made by an Italian private enterprise, is a clear expression of the determination to advance an excellent relationship from which we have much to benefit, and a lot to learn from our dearest and closest Italian friends. I am grateful to the directors of the company and to the previous speakers. There cannot be a better combination than this, Germans and Italians, and among them Albanians. It is something that happens very rarely, but I am sure that it is destined to yield success.
Many thanks!
***
The service for the supply of new surgical instruments and for the innovative management of their sterilization was presented today at University Hospital Centre “Mother Teresa”. It marks a new era in surgery service in Albania, by providing the highest standards of methods and best international practices.
This important project, the result of a public-private partnership aimed at managing the risk of infections in the operating rooms, enables the radical improvement of sterility at the surgery premises, and as a consequence it will expand the range of surgical interventions in our public hospitals.
This new program, which in the nearest perspective will be extended to every city across the country, will replace older autoclaves that were amortized and to date could not ensure the maximum sterilization standards, thus becoming a threat for the life of patients, in addition to spreading hospital infections beyond allowed norms. But thanks to this partnership, in 18 months only, 555 surgeries in 153 operating rooms will provide the same quality and higher performance.
Prime Minister Edi Rama, accompanied by Health Minister Ilir Beqaj, the Italian ambassador Alberto Cutillo, and leaders of this new service, visited today the premises of the hospital centre “Mother Teresa” where the central plant for sterilization has been placed, and met with surgeons of different services, who are carrying out their mission in brand new conditions.
As a whole, the project provides for the supply of hospitals across the country with modern, new, quality and assorted surgical instruments, and their quality sterilization; the provision of auxiliary disposable soft materials for the medical staff and the surgery bed; the disinfection of the operating room at the end of the day; the processing of hazardous waste and its transformation into urban waste; the provision of a personalized set according to the type of surgery to be performed. These instruments are grouped according 13 surgical sub-specialities and 71 different sets.
Hospitals will also be supplied with approximately 96 thousand instruments of approximately 6 thousand types. Approximately 3 thousand sets will be ready at any given moment in every hospital across the country. 17 other sterilization plants in the whole country will be complementary to the central sterilization plant.
Directors of surgery services at TUHC, such as the chief of Neurosurgery, dr. Mentor Petrela, the rector of the university of medicine, Arben Gjata, the chief of cardiology, Edvin Prifti, the chief of general surgery, Arvin Dibra, and the chief of Paediatrics, Dritan Alushani noted that this system constitutes a very important innovation for the Albanian medicine, since it enhances the quality of interventions and increases safety for the life of patients.
