Professor Gencho Nachev, Executive Director of the University Hospital St. Ekaterina: There are clinical pathways that lack final funding at a 100%

Sonya Stamboliyska


- Currently, many hospitals are in a severe situation because they lack funds to pay for consumables. How can this problem be solved?
- It is very simple. First, the healthcare system should become a priority for the Bulgarian state. This is a political decision which has not been taken so far. The second thing which must be done is for the number of hospitals to be reduced. Hospital aid must also be structured. This is very important. Fourthly, changes to the funding system must be made. We must switch to diagnostically related groups because, obviously, clinical pathways are not a funding mechanism. However, it is high time to say that the National Health Insurance Fund (NHIF) cannot cover a 100% of hospitalisations because this is not real. Finally, there must be transparency in hospital activities and quality control. To that end, the rules of good medical practice must be introduced so that a periodic analysis is implemented with follow-up sanctions based on strict rules. Besides, we must set up a medical chamber.

- The Health Minister Anna-Maria Borissova stated that an audit of clinical pathways will be carried out, as well as that a new pricing method of medical services will be introduced ...
- There is no clinical pathway which has final funding. Some lack less final funding, others – much more. If an audit of the pathways is carried out, this should lead to an increase of these clinical pathways which lack final funding at a greater percentage.

- Do you believe that if the additional amount of BGN 200 mln is transferred to hospitals, these funds will be enough until the end of this year?
- This amount should be enough, provided that limits are imposed on the NHIF. When talking about funding for hospitals this year, we must say that it is much less compared to that in 2009 because the funds allocated in 2010 covered the expenses for hospital activities in November and December last year. I sincerely hope that Prime Minister Boyko Borissov has been properly informed about the truth on financing in 2008, 2009 and 2010.

Doctors are preparing to stage protests if, by September 17, they fail to receive a response whether the funds intended for hospitals will be obtained. Is this the way to resolve the situation?
- I am totally convinced that this is not the way to solve the problems but meanwhile protests are the last resort which will make the public pay attention to something that is important to it. I am optimistic in this respect and I think that no protests will be staged because no one is interested in this. I do not want to think about protests but about ways to solve the crisis in the healthcare sector.