At the end of this month will be a year since I lost my father. After my father’s death, many issues are left, related to (the lack of) medical care for almost fifty days of the struggle for life. What could we have done differently? What the doctors could have done otherwise? Is that the way it was meant to be? One, to me very dear, person told me: “One thing to regret for is certain.” People who have lost their loved ones will understand what I’m saying. I’m trying to rid the text of a personal feeling, not to unfairly blame on others and save the general attitude towards the health care system. That’s why I’m writing this article today, a year later, only with the desire to encourage reflection on the issues of improving the quality of the health care system in Montenegro.
During these fifty days I learnt many things and changed my point of view on many things. Views on some issues I have built during a long period of time or confirmed. A senior doctor, chief of one of the clinics at the Clinical Center, said to me at the end of last year: “Most of things we do here is done thanks to the people who work here. Otherwise, as far as what we have available, Clinical Center should be closed tomorrow.”
He was telling me about the facts related to the time when the building of the Clinical Center was designed and built for the then much smaller population of Podgorica, about the problems of mentality and attitude towards patients. Will this one or some other doctor talk about this louder and more transparent? I do not think so. Will there be a significant change? I doubt it.
Just look at the barracks in Park of Petrovic in which are some departments of the Clinical Center, in order to see the wretched work conditions and where the doctors treat the patients. It is enough to glance at the reception of CC and hear how often is the primitivism a welcome to worried people. Just as is inhumane to drive patients along the long corridors, cramped hallways and in the ancient elevators to and from the operating block.
Most people at least once in their life will end up in one of the health clinics or will find in them because of the loved ones. That’s the main reason why the matter of quality of health care services is a matter of all citizens – the matter of public policy. It is a matter of health policy– what can public institutions offer us and how much money we need to set aside for the mandatory health insurance. It is a question of policy and budget – capital budget for health facilities, the issue of higher education (for example, whether is financing the state medical university rational choice for Montenegro?).
I read the report of the Clinical Center for the period 2007-2011. It states: “A significant and very limiting restrictions of funding in 2010 and 2011, which seriously threatens the maintenance of existing levels of health care.”
Ministry of Finance and Health Fund announced a reduction in finance for healthcare facilities in the coming years. I saw people who run KC protesting. How loud? Newspapers’ headlines are producing a painful echo: “Insulin only until the end of the month”, “The Clinical tumor markers missing for months,” and so on. I remember during those bloody fifty days during the last years, we were invited from the CC to buy various drugs, relatively cheap and common, which “cen be bought in a pharmacy within the CC” or to perform analysis at a private laboratory.
Citizens have a right to know what is the actual quality of healthcare services that can be expected today in Montenegro’s health care facilities. To what extent protocols used by us comply with the latest standards, which public health services can not get here. This includes the right of patients to the risk assessment of the planned operation, data on survival statistics, the possibility that the basis of available data make a decision on life issues.
Public opinion polls show that the health system is high on the public trust. Daily conversations with people are saying the opposite. People give money to doctors without dilemma, such as many of doctors have no problem accepting it. How many times have we said or heard “there is only one who has treated”, “for all beyond the cold, go outside of Montenegro.”
Sometimes we are unjust, believing that everything is better abroad. I know that our doctors save countless lives and bring health to many patients. However, I believe that there is ample room to save many more lives and improve the health of people.
The quality and continuous public and expert discussions, the struggle against negative professional solidarity among doctors, the fight against corruption in the health sector, joining patients, a wake of Medical Association would be helpfull.
I believe, too, that it could be done even more if we organize and connect people who want to transform their dissatisfaction with the functioning of the health system into a positive energy for its changes.
Stevo Muk
President of the Managing Board
Article was originally published in the web portal of the newspapers “Vijesti”