bolnica rebro - kbc - hitna.jpg
Photograph: HINA/ Dario GRZELJ /ds

The exit of the Croatian Health Insurance Agency (HZZO) from the state treasury, an attempt to adopt a new law on health protection and schemes to shorten lists of patients waiting for medical examinations in hospitals have marked the 2015 year in Croatia's public healthcare system.

At the beginning of 2015, the HZZO exited from the state treasury which, according to the statements of the Health Ministry and the agency itself, brought in an additional 2.2 billion kuna in the public healthcare budget. 

According to the ministry, new models of payment have also helped health institutions to stop accumulating new debts.

Throughout 2015, the administration in  the public healthcare system has claimed that these new measures have yielded positive results, however the final account to be made in early 2016 will show whether all this has ensured a stable and financially sustainable system.

In mid-2015, Minister Sinisa Varga had to give up from attempts to introduce new healthcare legislation, following the mounting pressure from professionals, trade unions, patients' associations and the public that feared that the new laws on healthcare protection and compulsory insurance would pave the way for the privatisation of the the public healthcare system.

The minister dismissed criticism as groundless and as an example of petty-politicking, nevertheless, he did not push further with the proposed legislation.

In 2015, the Health Ministry has launched several schemes to shorten waiting lists for examinations and treatment in hospitals following the rising discontent of patients. The data show that in the first ten months of 2015, the number of services offered in hospitals rose by one million compared to 2014.

The 2015 year has been also marked by discussions about doctors' "brain drain" with the Croatian Medical Chamber (HUBOL) presenting statistics in July about 220 doctors having left the country and more than 900 having requested documents necessary to start working abroad. HUBOL representatives called on the health administration to take measures to motivate doctors to stay in the country.

This prompted the Health Ministry to issue a a statement saying that in the period from Croatia's accession to the EU to the end of the first quarter of 2015, 336 medical workers had left the country, which accounts for 0.7% of all employees in the health sector. The ministry noted that over the past year it had adopted and started implementing a number of measures to ensure the best possible working conditions for doctors.

"One should underline that the emigration is a result of Croatia's accession to the EU and the possibility for doctors to work in other countries, and this is not unique to Croatia," the ministry said in a comment on HUBOL criticism.

According to the ministry's data, between 1 July 2013 and the end of the first quarter of 2015, 234 doctors, 98 nurses, two medical biochemists, one midwife and one health worker had left the country. In the same period 839 medical workers requested documents enabling them to look for work abroad, less than 2% of the total number of medical workers.

The ministry insisted that its human resources management strategy contained eight concrete measures, that rules on bonuses for doctors were being defined, that it was using EU funds to financially stimulate doctors to go and work in rural areas where there is a shortage of doctors and that it planned to enable young doctors to take subsidised housing loans with very low interest rates.

Also in October 2015, the use of Indian hemp for medicinal purposes was allowed in Croatia when the Health Ministry's rules governing its use by patients suffering from multiple sclerosis, cancer, epilepsy and AIDS entered into force.

The rules set a legal framework for the import of hemp-based medicines into Croatia, requiring that medicines containing tetrahydrocannabinol (THC), dronabinol and nabilone may only be dispensed by pharmacies on prescription.

Such drugs will be prescribed by selected general practitioners on the recommendation of medical specialists in neurology, oncology, radiotherapy, infectology and neuropediatrics.

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