Let’s start the conversation with this year’s biggest topic – Covid-19. The medical institution you run seems to have done the most work in this regard.
Yes. The Eastern Hospital is the largest hospital in Latvia with more than 4,500 employees, and I think it is safe to say that the most important Latvian hospital, which was also shown by the events of the last six months. Spring turned out to be a very difficult period for Covid-19 Oriental Hospital due to the crisis. As the main Latvian medical institution in controlling the pandemic, our staff, especially medical staff, had to bear the brunt of the crisis.
What are the consequences? However, the operation had to be reorganized very significantly.
Of course, until we realized that the virus was present, we re-profiled the Latvian Infectious Diseases Center Covid-19 as soon as possible. The situation was further complicated by the fact that the Gaiļezers Hospital, which had two wards for the treatment of Covid-19 patients with severe chronic diseases, continued to be renovated during this period. no foci of infection would occur. However, even during the crisis, the main goal was not forgotten for a moment – accessible and high-quality top-level healthcare for every patient who urgently needed it.
There were about 6,000 patients for whom we canceled records for outpatient services, of course, after that we had to call all these patients and offer other times.
Did you call yourself? People didn’t have to re-apply?
We have a Customer Service Center that dealt with it. We all called, rescheduled. Of course, there were those who had meanwhile found the opportunity to receive the service elsewhere or whose need for it was no longer relevant. At present, of course, due to Covid-19, the queues for outpatient services have remained longer. Also because the service delivery time is longer, taking into account the need to disinfect equipment, premises, thus our (but it is also everyone else’s) throughput capacity has decreased and the service waiting time has unfortunately become longer in many cases.
What about the financial side? There were new costs for Covid-19, but did you save anything by not working at full time for a while?
Given the decrease in the number of services and the number of patients, there was also less revenue – the state pays us for each activity performed. However, the state, for its part, also provided a kind of downtime payment through the National Health Service (NSS) – it is not a full service, but so much so that we do not have to lay off staff and we are prepared to take on even more patients than necessary. It was. This is also called preparedness funding. For our part, thanks to this standby payment, we were also able to provide downtime payments to staff whose salaries had fallen, as this is also largely linked to the specific work done. The basic setting was not to dismiss anyone as much as possible, because it is not the case that a doctor or nurse who has been dismissed today can be taken back tomorrow – they will quickly find work elsewhere.
There isn’t much to go if you’re the biggest.
Private medical institutions are very happy to accept our employees.
Once upon a time, various private practices were also set up on the hospital’s premises, with the same staff working for some hours as public officials and some as private employees, including through public resources. Isn’t it now?
It is no more. But, of course, we are interested in providing paid services ourselves in cases where the state does not pay for it or if the amount of services paid for by the state is less than demand – a large number of people are also willing to pay just to have the necessary services. Of course, we are interested in providing these paid services to improve our financial situation, but the total amount of paid services for us is no more than 5% of the total turnover. Basically, we fulfill a public order.
Isn’t it like saying to a person: wait in line for three months or pay and see a specialist today?
We try not to do that. But, of course, there are differences between the line for state-paid services and paid services. If, for example, public funding is allocated to a certain number of, say, computed tomography or magnetic resonance imaging examinations, then we distribute it evenly over the months of the year, and if our capacity is greater, in addition to providing government-funded examinations, we also provide small number of paid services.
Once upon a time at the end of the year, there was usually a big brawl that large hospitals, which had done more than expected, accordingly expected additional funding from the state. It turned out that the hospitals were almost accused of not rejecting any patients.
We currently have cases when the state does not pay for a service either … We have to be very careful not to exceed the amount set by the state.
How can you regulate if patients are admitted to the emergency room as much as they are admitted?
The urgent, of course, must be accepted by all. But if there are any planned investigations, then we have to take into account that the state may not pay if we have done more than budgeted for – it only shows that we do not know how to plan our activities.
Of course, if the state had an immeasurable amount of financial resources in the person of the Ministry of Health, the allocators would probably act differently, but they also have a strictly limited budget, and therefore we cannot pay more than its money.
What does this year look like from a budgetary perspective?
Despite the Covid-19 crisis, the situation will be even better financially than last year (at least for now, there are forecasts, not knowing what will happen in the remaining months of the year). As a result, financial results could improve by about 20%.
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