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The Minister of Health in the caretaker government, Firas Al-Abyad, during an interview with “Nidaa Al-Watan” newspaper, shed light on several sensitive and important health and hospital files that concern the citizen in particular… The Minister reassured that cancer medicines are insured for 3 or 4 months, after it was decided to insure them. The equivalent of 45 million dollars for these medications. As for the dialysis crisis, he pointed out that several solutions are being worked on so that the patient does not incur additional costs. He expressed good news about merging small hospitals with large hospitals. Below is the text of the interview:

Is there information about small hospitals being annexed to large hospitals after they faltered due to the crisis? Is this an indication of a decline in the hospital reality or its progress?

Merging small hospitals with large hospitals is an opportunity to develop and improve administrative performance and the level of services. Firstly, it allows savings in several areas, as hospitals grouped together can get better offers in purchasing their supplies, because in this case they buy more in bulk. Also, by absorbing some departments, hospitals relieve small hospitals of the burden of managing those departments that may not be productive. In a small country like Lebanon, this allows the citizen to obtain services, sometimes at better prices. When we communicate with these hospitals, we discover that this integration is not at the expense of the human staff, in other words, there is no dismissal from work. In my opinion, the way the merger is being done is a good indicator.

On the other hand, mergers often occur through the acquisition of private hospitals by university hospitals, which translates into bringing the expertise and high quality of services of these university hospitals to small hospitals, which in most cases are located in remote areas. This is a good thing, as the patient receives university service in his place of residence, and in this case he is no longer obligated to go to Beirut.

What about the hospital crisis with the guarantor bodies, where the citizen is the one who pays a large difference, and the Ministry of Health no longer covers the majority of operations, and sometimes this causes the death of the patient due to his inability to pay the high costs?

The main reason for the patient being forced to pay the differences is the significant reduction in the budget of the Ministry of Public Health: after it was approximately 300 to 350 million dollars, it now amounts to approximately 30 to 35 million dollars, i.e. 10% of the previous value. For this reason, the Ministry of Health is sometimes unable to provide 100% coverage as before, but on the other hand, we are working on solutions in this file to alleviate the burden of the citizen, whether through the loan project with the World Bank or by reconsidering the coverage and focusing it on the vital matters of the patient and alleviating his burden. By paying the differences.

We have taken the first step, and the second step is to re-examine the tariffs and raise them, and we expect to do so at the beginning of the year 2024 with the new budget for the Ministry of Health, which has increased about four times if approved in the House of Representatives.

The Special Drawing Rights funds have almost ended, so how will cancer medicines be covered?

Securing funding for cancer medicines is one of our priorities today. In this regard, a decision was taken in the Council of Ministers to provide the equivalent of about 45 million dollars for these medicines, which will allow them to continue to be secured for the next three to four months.

We are working with all guarantors to explore how to secure funding to continue this process. In the 2024 budget, specifically the medicines item, we can notice that funding has increased by about seven to eight times. This funding will be invested in medicines for cancer and incurable diseases, especially since we are focusing our efforts on life-saving medicines, and we believe that this is one of the means to secure the required funding. The second issue is the necessity of stopping waste, hence the importance of the “Meditrack” tracking system and the “Aman” platform, which has allowed control This waste and corruption also contributes to ensuring that international protocols for administering medicines are followed and helps reduce the medicine bill by about 40%. On the third hand, there is a lot of aid for treating cancer diseases provided to Lebanon. These three approaches that I mentioned allow for a sustainable solution to this issue.

However, it is worth noting that some of the practices that existed in Lebanon should be re-examined, which is 100% coverage for any new drug without conducting feasibility studies, as other countries such as France, Britain and others are doing. Today, several units are being established in Social Security and the Ministry of Health to study the feasibility of new medicines, which will avoid the guarantors falling into deficit and being unable to finance the medicines.

Regarding dialysis, how will the citizen bear these burdens, especially since they are expensive and he needs two or three sessions a week?

The Ministry and the guaranteeing bodies are in full communication in this field, and dialysis patients are a priority. We are working on several solutions so that the patient does not incur additional costs. The first step was to pay the fees of hospitals and doctors. The good thing is that the Ministry of Finance and the Bank of Lebanon have begun transferring these funds. As we promised the Hospital Syndicate, there will be a re-examination of the tariff to ensure that it reflects reality, and we expect that a session will be held with the Hospital Syndicate and the guarantor bodies in the next two weeks to discuss this file.

What is the reason for the continuous rise in drug prices? What about pricing fluctuations from one pharmacy to another? Since citizens resorted to Syrian and Iranian medicine as an alternative?

The prices of medicines reflect that most of them are imported in hard currency, which makes their price in the Lebanese market appear high in pounds. But if we compare its price in dollars, the opposite becomes clear. The price of some medicines in Lebanon has decreased due to the Ministry of Health’s policy of opening and accelerating the drug registration process, especially generic medicines, whose prices have decreased compared to other medicines. The local pharmaceutical industry also contributed to reducing these prices by manufacturing medicines at prices competitive with imported ones. But on the other hand, the economic and financial crisis has weakened citizens’ purchasing power, making medicine prices high for them. We mention here the application launched by the Ministry of Health, “Med Leb,” which allows any citizen to scan the barcode in the pharmacy and know its price according to the official price list set by the Ministry. In the event of fraud, the citizen can contact the Ministry. We are closely following these issues and taking the necessary measures against the violating pharmacy.

As for the issue of medicines being smuggled into Lebanon by some merchants, the Ministry of Health has warned citizens and called for attention. These medicines enter Lebanon without ensuring their quality, and they may be contaminated or counterfeit and do not even contain the medicine. The matter is not limited to Syrian or Iranian medicines, as we also see Turkish medicines. Citizens are “tempted” by their appearance due to their low price, but I remember that in most cases they may not even contain medicine.

In this regard, the Ministry of Health, through its tracking program, which has achieved excellent results with regard to cancer and chronic disease medicines, will allow the citizen to confirm whether the medicine was entered in a legal and secure manner. This contributes to ensuring the safety of the medicine being consumed.

A percentage of doctors and nurses immigrated from Lebanon. Is there a shortage now? To what extent does this affect the hospital reality?

The economic crisis undoubtedly caused the migration of large numbers of doctors and nurses from Lebanon. But according to what the Doctors Syndicate and other unions informed us, there is no longer a large wave of migration, but on the contrary. According to the head of the Beirut Doctors Syndicate, we have begun to see the return of a number of doctors to Lebanon. But solutions must be found quickly so that we can reduce this migration or even encourage people to return.

How do you evaluate the reality of the government hospital?

There is no doubt that government hospitals proved during the crisis that they were a refuge for the difficult things we went through. During the Corona crisis, the government hospital was the one that received the largest number of patients, and also during the cholera period. Today we see that these government hospitals are the first resort for the most vulnerable classes.

In exchange for the burdens borne by government hospitals, we must provide full support, especially to their workers, who, like those working in the public sector, have not yet seen adequate compensation for their salaries. As a ministry, we are trying to provide assistance to them. This sector deserves greater support from the Lebanese state so that these hospitals can continue to serve citizens.

What is your future outlook on health in general? Are there plans to protect the sector from further collapse?

The health sector in Lebanon has shown a high capacity for resilience after going through major challenges, whether during the Corona crisis, the economic crisis, the port explosion, and other successive crises. However, we see that hospitals are still steadfast and providing services to citizens. Last week, we opened seven medical conferences in Lebanon in various specializations. We see that the medical services provided in Lebanon are still among the best in the region, which drives medical tourism to continue, and we are all hopeful that this sector will continue to find solutions in order to remain steadfast.

The main problem facing the citizen does not lie in the collapse of the health sector, but in the cost of services due to the economic and financial crisis. Coverage is no longer always provided by guarantors. Hence, we find that there is inequality in access to health services between the classes of society, and I believe that this issue is essential to work on to ensure that citizens, regardless of their financial capabilities, have access to medical services, and this is the greatest challenge. The solution to this problem is fundamentally linked to solving problems in the economic and financial sectors alike.

2023-10-11 03:10:28

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