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Financial Crisis Threatens Healthcare in Montenegro

April 12, 201608:47
The Montenegrin healthcare system is facing its worst-ever financial crisis because the state cannot afford to buy basic supplies and equipment to ensure public hospitals work properly.
Patients queue for hours to schedule a doctor’s appointment | Photo: BIRN.

For patients in Montenegro, a routine medical examination is becoming difficult to schedule because public hospitals are faced with severe financial crisis and a lack of important drugs, basic medical supplies and equipment.

Hundreds of Montenegrins have to wait in line for hours each day at the main public health clinic, the Clinical Centre in the capital Podgorica, and appointments are often put back two or three months due to overbooking and the lack of enough medical staff to perform basic tests and examinations. 

Pensioner Miluna Vucetic told BIRN that she travelled nearly 200 kilometres to Podgorica on Monday for routine specialist procedures but was told that they had been postponed for three months because the equipment needed to do them was broken and “no one knows when there will be enough money for its repair”.

“What’s worse, this is not the first time that the same thing happened. Last time it was a lack of medicines, before it was about the reagents for some laboratory analysis,” Vucetic said.

Forty-five-year-old Zoran Markovic from Podgorica said had to come to the Clinical Centre four times to do a simple test that was needed before he could get further treatment. 

“It’s unbelievable that I was once re-scheduled because there were no needles for a blood test,” Markovic told BIRN. 

Under growing pressure from the media and patients’ rights’ organisations, the state Health Insurance Fund admitted last week that it cannot launch a tender for the procurement of basic medical supplies because the state has allocated only five million euro for all public hospitals for 2016 – almost three times less than what is needed this year.

The Fund, the state institution in charge of the procurement of drugs and medical equipment for public healthcare facilities, said that “the health system could soon find it has collapsed”.

It warned that it would not be able to solve the problem without assistance from state institutions, as there is a discrepancy between the planned purchases of medical supplies and the money available to buy them in 2016.

“The functioning of the healthcare system is unsustainable with five million euros, bearing in mind that for the Podgorica Clinical Center alone, we must provide around 11.4 million in 2016,” the fund said in a statement.

The most recent data from the State Audit Administration, published in March, showed that the debts owed by the Fund and public health institutions were over 50 million euros in 2015.

However, Prime Minister Milo Djukanovic said last week that most of that has been settled and that current debt amounts to about 10 million euros.

According to the latest Euro Consumer index, published by Swedish NGO Health Consumer Powerhouse in January, Montenegro has “the most backward health system in Europe” and allocates only five per cent of its budget to healthcare, while the European average is eight to 12 per cent. 

The Euro Consumer index ranks healthcare systems in Europe according to 48 indicators, including patients’ rights, accessibility, prevention and outcomes. It put Montenegro at the bottom of the rankings for 2016.  

Research has shown that Montenegro has the lowest number of doctors per capita in Europe, the lowest doctors’ salaries in relation to the GDP and the worst medical education in Europe, as well as poor working conditions.

An inspection of public healthcare institutions across Montenegro in February 2015 also uncovered major problems with hygiene.

A searing indictment of the state of cleanliness in all 15 Montenegrin hospitals showed the presence of dangerous bacteria and poor standards of hygiene. 

The health authorities have said they are aware of the problem, explaining that inefficiencies, the excessive prescription of drugs, the large number of referrals of patients to treatment outside Montenegro and the huge costs caused by people going on sick leave further burden the public healthcare system.