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Privatization of public hospital management to become reality

Trans. by E.Khishigjargal

The health sector has seen a decline in the last twenty years. Under the central government, health policy and the medical services of public hospitals have hit an all-time low, while doctors fail to fulfill their oaths for the sake of money.
The way out of this situation is privatization. Sixteen years ago the State Department Store was privatized. When the subject was first brought up, everyone, including the parliament, discussed it, deeming it impossible. Now, the store is flourishing in front of our eyes, whereas state funded organizations are still “shabby” because of deficient funds. This applies to state owned hospitals.
Two years ago the government cut back on funds for the health sector, because of so-called economic hardships. In 2014 the government pruned 100 million to 180 million MNT from the sector’s budget, while this year the second and third level hospitals saw a hefty 10 percent cut from their budgets. A sector that was barely making ends meet is now forced to crawl on its knees thanks to the decisions of the government. Everyone in the health sector is complaining about the current budget, with funds sufficient for only six months of operation.
Quality free service from state hospitals no longer exists. For example, when a patient with high blood pressure and food poisoning turned to state hospitals for treatment, the doctors replied, “Bring your medicine yourself. We don’t have spare medicine lying around”. A friend of mine, who underwent gallstone removal surgery, said that he had to buy medications for the procedure that cost more than 100,000MNT. Cases like these make it clear for the need to change the status of state hospitals. When doing so, it is best to hand over the management of the hospital to a reliable body, instead of allowing for 100 percent privatization.
The Health Center of Bayanzurkh District was privatized 10 years ago, and citizens claim the quality of the hospital is superior to others. Recently, the Sukhbaatar District Polyclinic was privatized under a management contract and was renamed Sukhbaatar Polyclinic. Director of the City Health Department Sh.Enkhbat stated, “It doesn’t matter whether the ownership of hospitals is state or private. If things don’t work out, the state can simply take it back. The ownership of Sukhbaatar Polyclinic will be private. Apart from the Bayanzurkh and Sukhbaatar district hospitals, the polyclinics of other districts will not be privatized in the next decade. District hospitals are public property and must offer the closest, cheapest health services to citizens. Family clinics are a different matter. The Health Law states that family clinics are private institutions operating under a government organization, but currently the line is unclear. Next year, family clinics will start being privatized, according to international examples.”
Some hospital administrators are supporting the privatization, which they believe will “freshen up” the health sector. Recently, officials are discussing the separation of hospitals from the government into an organization with individual status. Minister of Health G.Shiilegdamba spent his entire first advisors’ meeting discussing this issue. His advisors also supported privatization, especially the privatization of management at third level hospitals: the three State Hospitals, the National Center for Communicable Diseases, and the National Cancer Center.
Citizens are concerned that privatization of the biggest hospitals will turn the health industry into nothing more than a for-profit company. Yet the government is required to care for its citizens according to the Constitution. The answer to this dilemma is that there are many types of privatization. The currently discussed plan is considered to be the best. The hospitals will not be fully privatized and would remain the property of the state. The role of the government is that of providing legal freedom to the hospitals. The Board of Directors, made up of external sources instead of ministers, should have the power to choose the hospital’s directors and doctors. Sector officials agree that in order to efficiently use the budget and make doctors work creatively, management privatization is the best way. If we don’t turn our hospitals into for-profit organizations, we should at least let them be run like a business, since the private sector makes up 80 percent of Mongolia’s GDP.
Rome wasn’t built in a day. Likewise, this process is expected to take a long time. In order to privatize the large public hospitals, changes must be made to the Health Law, as well as other laws; starting with the Budget Law, which states,“All organizations funded from the state budget shall be under state authority. Thus, they shall be nonprofit.” Changing every relevant law would be time consuming, thus the draft for a health care and services law has been proposed to Parliament by MP S.Odontuya and her team, while consultations for the proposal were held nationwide on March 17. The proposal takes into account the legal framework of budget expenditure, transparency, a hospital’s board (which should include scientists and members of the general public), and who will appoint the director of a hospital. Financing for hospitals should be acquired through a contract between the directors of the hospital and the Health Insurance Agency.
The proposal, consisting of six acts and 65 articles, will oversee health services concerning organization, administration, and funding, while also including proposals to make changes to existing laws. If the proposed draft is accepted, international standard health service and treatment will be available locally to anyone who has health insurance, regardless of registration. An information pool will be made available to healthcare providers through individually customized cards.
The proposal could help reduce health issues caused by poverty, while making a significant contribution to economic growth. If reform in the health sector is to be expected, the current structure, status, and administration of hospitals should be changed, transitioning to a client-centered, professional industry.
Source: Unuudur

Short URL: http://ubpost.mongolnews.mn/?p=13889

Posted by on Mar 26 2015. Filed under Opinion. You can follow any responses to this entry through the RSS 2.0. You can skip to the end and leave a response. Pinging is currently not allowed.

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