2025-08-19
National Audit Office: queues for doctors are against the interests of the people – more effort is needed
The assessment carried out by the National Audit Office, Reducing waiting queues for personal healthcare services, shows that the accessibility of personal healthcare services is not improving, even though measures have been taken to reduce waiting queues for doctors. According to the Auditor General Irena Segalovičienė, the measures taken to address this problem are insufficient, so it is necessary to look for more effective solutions.
"Accessibility of healthcare services is not a statistical indicator, but a matter of human dignity. When people have to wait months to see a doctor, and people in rural areas cannot get help close to home, a fundamental principle of equal access to healthcare for all is violated. Long queues and regional disparities are neither inevitable nor justifiable. This is not a new problem, but efforts to solve it have so far been insufficient and ineffective. Today, it is clear that isolated measures are not enough; much greater, focused, and intensive action is needed to ensure that the system serves the health of the people," says the Auditor General.
In a population survey commissioned by the National Audit Office, as many as 73% of residents most often cited long waiting queues to see doctors as the main problem with the healthcare system (in 2018, 55% held this opinion). There are also significant disparities between large cities and regions. Rural residents are more likely to experience difficulties registering for services and find it harder to access doctors closer to home.
Territorial disparities are also revealed by preliminary patient registration data. They show that in 13 municipalities, more than half of the population waited longer than 7 calendar days for family doctor services. The largest proportion of residents in Radviliškis, Jonava, Ignalina, and Vilnius waited more than 30 calendar days for a visit to a specialist doctor, such as a dermatovenerologist (waiting time for a doctor's appointment by municipality in the interactive chart). The specialists whose services are waited for the longest remain essentially unchanged. These are haematologists, cardiologists, dermatologists, gynaecologists, orthodontists, etc.
An increasing number of healthcare institutions are using the Advance Patient Registration Information System (https://ipr.esveikata.lt/), which is designed to help patients choose the fastest or most convenient time for a doctor's appointment and to distribute patients more evenly among healthcare institutions. Unfortunately, only about 7-8% of patients use the system (according to the Ministry of Health (MoH) calculations, based on the times visible to patients in the system, 13-16%). Appointments with doctors are still most often made by telephone (42% of respondents). In addition, this system only shows residents about half of the available appointment times.
More than half of the healthcare institutions surveyed consider the workload of their specialists to be high or very high. There were cases (41) where the workload of doctors exceeded the 1.5 full-time equivalent allowed by the Labor Code. There are specialists who work 2.75 full-time equivalents. According to the assessment data, some specialists work in 6–12 healthcare institutions, most often oral surgeons, obstetricians-gynecologists, pediatric cardiologists, etc.
"When doctors have too heavy workloads, there is a risk to the quality of services, which can harm people's health. A tired doctor cannot give as much attention as is needed. This means not only longer queues, but also the risk of mistakes and burnout. This situation is dangerous for both patients and doctors themselves, so doctors' workloads must be properly regulated," emphasizes Ms. Segalovičienė.
In implementing the recommendation of the National Audit Office's previous audit The Accessibility of Health Care Services and the Orientation Towards the Patient, the Ministry of Health approved the Plan of Measures for Reducing Waiting Queues for Personal Healthcare Services for 2023–2024. The aim was to eliminate the causes of queues, improve the accessibility of services, and make more efficient use of available resources. The assessment shows that, as the ministry does not have information on the extent of implementation of the measures in all public healthcare institutions, in the absence of established indicators for the implementation of the measures and without assessing the impact achieved, it is not possible to effectively eliminate the causes of queues and achieve the objectives of improving the accessibility of services.