2024-06-28 11:27:17
No companies – no cost. As a substitute, money owed are rising.
“From what has been proven, the developments are unhealthy: the establishments are in an enormous drawback,” mentioned its chairman Antanas Matulas on the Seimas Well being Affairs Committee (SRK) after the State Well being Insurance coverage Fund’s report.
Hospitals aren’t actual about income
Simona Adamkevičiūtė, director of the Financial Division of the State Sick Fund (VLK), who introduced the monetary indicators, mentioned that the ratio of prices and earnings of well being care establishments is minus 13 million. euros.
“As we all know, we pay for some extra-contractual companies later, after the primary half of the 12 months. If we estimate what we can pay in accordance with the procedures after the primary half of the 12 months, this outcome can be totally different, it might be constructive, -9.7 million. euros”, mentioned S. Adamkevičiūtė.
The place is the issue then? Firstly, not all establishments will likely be “plus”. Secondly, managers of even these sufferers who will obtain further funds complain concerning the tough each day routine.
“Medical establishments incur prices whereas offering companies, however they aren’t sure concerning the earnings they may earn,” admitted S.Adamkevičiūtė.
Healthcare establishments deal with folks, i.e. present a service, and obtain funding later, and generally they aren’t in any respect certain whether or not they are going to be left empty-handed – that is how it’s accepted within the Lithuanian medical system. Consequently, hospitals stay in perpetual poverty, their managers complain.
“Some hospitals handle higher than others beneath the identical circumstances. This, apparently, is just not one thing new”, said A. Pečkauskas.
In response to the VLK consultant, the largest affect on the rising money owed of hospitals is because of the obligations to extend the salaries of staff and the “hanging” cost from the VLK for added well being companies.
About 9 % all companies offered in medical establishments are super-contractual, that’s, these for which the state has not promised to pay prematurely.
For precedence companies, corresponding to childbirth, stroke therapy, inpatient rehabilitation, VLK pays month-to-month. Nevertheless, funds for a part of the companies are deposited into the accounts of hospitals and polyclinics solely each six months.
Reprinted with wage will increase?
The Well being Affairs Committee of the Seimas questioned whether or not hospitals which are in debt are capable of correctly handle sufferers.
“We see that each one district and regional hospitals are working at a loss, however we are going to see the true outcome after half a 12 months. However salaries make up 80-87 %. of all prices. How do establishments survive?
They’re beneath stress. Does this not mirror the standard and amount of companies offered, and subsequently the supply of well being companies? If there are not any funds, we’re working at a loss, or are the flows of sufferers not being regulated in a really humane method?”, requested Orinta Leiputė, a member of the Seimas SRK.
Nevertheless, A. Pečkauskas emphasised that extra-scheduled companies had been offered, the worth of which exceeds 33 million. euros.
“The settlement has not occurred, it is going to be in half a 12 months. In fact, if prices enhance within the first quarter, however revenues don’t embody over-quota companies, these numbers appear like they do.
However after half a 12 months, this example needs to be resolved”, assured A. Pečkauskas.
In response to him, hospitals had been capable of considerably enhance docs’ salaries by planning to obtain cost from VLK for extra-scheduled companies. Nevertheless, good works have been criticized.
“I wish to specific my opinion – started VLK consultant S.Adamkevičiūtė, – The wage enhance is the results of nationwide negotiations – phrases, percentages, quantities – are deliberate and accredited in subsequent 12 months’s finances. Establishments ought to affiliate wage will increase with a rise within the contracted quantity, not extra-scheduled companies.
In any other case it is going to be unsustainable. Elevating salaries is a long-term dedication, after which decreasing them will likely be very tough.”
Nevertheless, hospital managers say that the wage doesn’t give rise to a sense of generosity – in any other case you merely can not retain docs, as a result of everybody will flee to non-public clinics.
Hospitals are already dropping skilled docs and attempting to interchange them with youthful docs.
“Rising salaries is just not an object of free alternative, however an absolute necessity,” assured Tomas Jovaiša, basic director of VUL Santaras clinics.
There isn’t a cash and the payments are floating
He complained that guarantees of receiving cash in six months is not going to cowl in the present day’s payments.
“We’ve to pay salaries each month, we’ve got obligations to suppliers – each medicines and medical gadgets – funds should happen at intervals of 30 or 60 days. We do not have the posh of placing them off for half a 12 months, and to today Santara Clinic has a unfavourable steadiness of just below 1,000,000.
We even have simply over 2 million unpaid companies (…) the truth is that it’s onerous sufficient to steadiness the funds each month.
Sooner or later, I wish to talk about a way more frequent cost, which might permit us to not survive, whether or not we are going to obtain sufficient cash for salaries, we can settle with suppliers and we is not going to discover ourselves in a scenario the place the availability of 1 or one other service is disrupted as a result of we didn’t pay,” mentioned T. Jovaiša.
He additionally mentioned that the charges for the costly checks range relying on what number of got.
The Santaras clinic allegedly misplaced about 670 thousand because of the worth fluctuation. euros. Usually, that distinction is evened out, however hospital managers have a headache as a result of they don’t have any ensures.
“How can we plan if we do not know if we are going to get the cash?” When will we get them? It’s tough to foretell that, there’s a unfavourable impact on the functioning of the therapy facility”, complained T. Jovaiša.
Provides to pay prematurely
Parliamentarian Linas Slušnys provided to pay advances to well being care establishments and gave a depressing image of the present scenario.
“You sit within the purple on a regular basis. For the top of the hospital, it’s a nightmare while you get up within the morning and take into consideration easy methods to steadiness the finances from the purple.
We might pay a part of the advance, and when these companies are offered, we switch the remaining quantity with a brand new advance on the finish of the month. On this method, we’d permit establishments to breathe”, thought L.Slušnys.
Nevertheless, it’s written in black and white within the medical health insurance legislation that cost is made just for companies already offered up to now.
S.Adamkevičiūtė additionally observed that hospitals can use obligatory medical health insurance (PSD) premiums for working capital, as well being sector establishments don’t have to pay them.
2024-06-28 11:27:17