2023-02-07
The National Audit Office identifies risks of healthcare network restructuring
The National Audit Office's overview of the healthcare network restructuring reveals the risks caused by the lack of an overall reform plan and the shortage of healthcare professionals in smaller municipalities.
In order to ensure the provision of quality and safe personal healthcare services to all Lithuanian residents, the Ministry of Health initiated amendments to the Law on Health Care Institutions and the Law on the Health System, creating the preconditions for the network reform. The fifth healthcare network restructuring is planned to be completed by 2030 and will cover the largest number of areas of the health system compared to the previous ones.
"The aim of our overview is to provide timely, early and preventive – at the start of reform – information about the risks that need to be managed, in order to leave room for improvement, make the reform run more smoothly and to enable every health professional to contribute to it. It is important to adjust the scope, objectives and phases of the reform, when necessary, however without a fixed overall picture of the reform, it is more difficult to manage the challenges that arise", says Mindaugas Macijauskas, Auditor General.
The auditors note that, in the absence of the summary document outlining the coherence of the actions envisaged, health system actors have been informed by means of evolving presentations, leading to a lack of clarity on the planned structure of the network of healthcare facilities, the scope of services to be provided etc.
A new network of services will only work effectively if we have enough health professionals. An analysis of how many and what kind of professionals will be needed, based on the assumptions of the restructuring, has not yet been carried out at the end of 2022, even though the new service delivery model is due to enter into force as early as August this year. A sufficient number of nurses is crucial for the success of the reform (and more nurses will be needed as the network is restructured), but the number of nursing graduates has been declining between 2000 and 2019, the number of enrolments between 2020 and 2022 remains very similar, and the number of state-funded places in nursing study programmes is decreasing. The nurse-physician ratio (2:1) that was to be achieved in 2020 is now planned to be reached by 2025.