Romania's health minister says sector needs 11.5 billion lei and orders CNAS audit

An 11.5 billion lei shortfall

Alexandru Rogobete, Romania's health minister, told Antena 3 CNN on Wednesday, 21 October, that the whole health sector needs about 11.5 billion lei to pay overdue invoices, with bills to suppliers unpaid since July. The ministry itself needs 1.2 billion lei of that sum, 800 million of it for emergency medicine, while the remainder is needed by CNAS. Speaking at his first press conference since returning to the post, he traced the crisis back to the budget drafting stage. A document he presented, sent to the Finance Ministry at the start of the year, shows the ministry asked for 31.91 billion lei, while the ceiling set by the Finance Ministry was 22.25 billion lei. That left a gap of 9.65 billion lei (-30.26%), and the approved budget was cut by 4.78 billion lei compared with the previous year.

An audit at CNAS and the Moldovan resignation

Rogobete announced an in-depth audit of CNAS, covering each programme separately, including pharmacies, medicines and compensated drugs. He called the resignation of the institution's president, Horațiu Moldovan, the best thing to happen in the sector in the past week, and blamed Moldovan's incompetence for pushing the system into a crisis. The minister said the crisis affects oncology, diabetes and cardiovascular programmes managed by CNAS, and that he could not recall a comparable crisis in the past 10 years. He also accused former prime minister Ilie Bolojan of making cuts without regard for the specifics of each field and of not understanding the figures, citing the Floreasca hospital example Bolojan had given. The resignation came as the Liberal party (PNL) decided to move into opposition and withdrew officials it had backed.

Emergency units and the budget rectification

Rogobete hopes the budget rectification can be completed next week. If it is delayed by one or two weeks, he said he will ask for money from the government's reserve fund for emergency units. Emergency units (UPU) need 391 million lei for local hospitals and ministry hospitals until year-end, plus another 156 million lei for priority critical care in intensive care, stroke, heart attack, neonatology and severe burns. He argued that these components cannot be cut evenly, saying:

Emergency components cannot be cut evenly with an axe from top to bottom, because we will reach a point of financial collapse.

Rising fuel and energy prices have also pushed up the cost of medicines and medical supplies, reducing budgets faster, particularly for ambulance services and emergency units. On Wednesday evening he requested an urgent supply of medicines and critical materials from all emergency units in Romania.

Private practice and on-call rules

Rogobete also targeted doctors who leave public hospitals at 10:00 for private clinics. He said he would seek a legal route allowing hospital managers to terminate contracts at the third such offence. Doctors who move patients to their own practice using public resources also face controls, he warned:

Those who move patients to their own practice, along with the medicines from the public system's cabinet, will get a surprise!

The minister also said the rules on on-call exemptions would change 'by 180 degrees', so that an exemption applies in both public and private settings. Mandatory infection-control courses every two years for staff in intensive care and anaesthesia wards were also announced.