Court of Audit blames faulty system for lack of doctors

Ljubljana – While Slovenia is grappling with a shortage of doctors and long wait times for medical procedures, the Court of Audit has found the Health Ministry and the Medical Chamber of Slovenia do not know how many additional specialist doctors are needed, which ones, and how to provide them, describing the system as ineffective.

In a report released on Monday, the Court of Audit found that between the beginning of 2008 and the end of September 2019, the Health Ministry and the Medical Chamber had failed to identify the actual need for additional doctors and the reasons for shortages by specialty.

Despite public warnings about alarming work overloads, especially among general practitioners, the Health Ministry has failed to plan and implement any much-needed activities in this regard over the past 12 years, the Court of Audit said.

“It is therefore not known why doctors are overworked, given the almost 32% increase in the total number of doctors in the public health service and the increase in the annual numbers of specialists over that period, with the population numbers virtually unchanged,” they added.

According to the Court of Audit, the main reason for the inefficiencies when doctors enter into the labour market is that it is not possible to identify existing medical capacities, nor to correctly assess the need for additional doctors.

Nobody knows how many effective hours of medical work per month are carried out by each doctor within different forms of medical service with different healthcare providers.

In addition, there is no proper system in place to assess the need for specific doctors, the Court of Audit said, listing the absence of a comprehensive public health service network, a lack of a precise methodology for identifying the need for doctors and the insufficient analyses of doctors’ workloads.

Due to the lack of a system, the Health Ministry and the Medical Chamber have been assessing the need for doctors on an annual basis within calls for applications.

The Court of Audit noted that the two organisations had drawn up their own methodologies for each call for applications, which caused them to be largely non-transparent and arbitrary.

Thus, the Health Ministry has failed to develop realistic medical standards over the 12-year period. Instead, it left this task to the Medical Chamber and the health sector trade unions.

The current standards were drawn up in 2011 and approved by the ministry in the face of doctors’ strikes, even though they were poorly drafted, the Court of Audit said.

Moreover, the court gave no confirmation that these work standards provide an adequate basis for identifying the need for additional doctors and for addressing the alleged work overload of some doctors.

The Health Ministry did implement several activities and measures, but it did so without first analysing their expected impact.

None of these measures was effective in terms of providing additional medical capacities and relieving the burden on doctors, the Court of Audit concluded.

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