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Timur Kulibaev: Growth of private investments in health care and high quality of medical services are mutual tasks of Atameken & Ministry of Health

12 April 2019
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This opinion was expressed by chairman of the Atameken Presidium Timur Kulibayev at a meeting of the Committee of the pharmaceutical, medical industry and services. Prior to this, head of the National Chamber Timur Kulibayev and minister of Health Elzhan Birtanov had a working meeting.

In global practice health care is a large industry, that has many sectors involving both public and private investments.

The pharmaceutical industry, the manufacture of medical devices are private areas, the dentistry and plastic surgery have the lion's share in it. Business is actively involved in laboratory diagnostics and the provision of consultative and diagnostic services.

The head of the Committee Jambulat Sarsenov noted that with the effective use of the potential of domestic producers, it is possible to significantly reduce the volume of imports of medicines and medical devices by more than 200 billion tenge. This will reduce the cost and increase the availability of drugs. Statistics show a stable annual growth of domestic pharmaceutical production (over the past five years, growth of more than 50 per cent) and a gradual decline in imports. In 2018, entrepreneurs invested almost 44 billion tenge in healthcare. The total investment amounted to 90 billion tenge. In this way, private investment in the health sector has almost reached par with government. During 2018-2019, the number of private providers of medical services and the amount of payment for the state order increased by 2 times.

The state-guaranteed list of free medical services will remain. It is enshrined in the constitution. The state still performs the function of regulator of the system of health and health care, using such tools as standardization, accreditation, licensing, requirements for sanitary standards, quality control, etc.

Starting from 2020, the Compulsory social health insurance (hereinafter CSHI) will be implemented - this is a completely new form of payment for medical services. An important direction is the pricing policy. The head of the NCE RK approved the ongoing work with the Ministry of Health on the harmonization of tariffs for medical services.

 “Services and tariffs should be standardized in the new system. There should not be a big difference in the availability, quality and cost of medical services provided by public and private clinics. It is necessary to develop jointly with the ministry the methods for covering the costs of private medical institutions, including services via CSHI. This will create favorable conditions for increasing the participation of private medical institutions. You should also detail the lists of services in the framework of the guaranteed package of free medical care and CSHI. For the attractiveness of the tariff it is necessary to include the cost of updating fixed assets and increasing the salaries of medical personnel. In addition, to expand the list of medical services in the CSHI system by increasing the volume of rehabilitation, palliative care, which are necessary to improve the quality of life of citizens, especially for the elderly people. We should enable the check-up service and additional innovative technologies. When introducing CSHI, everything should be aimed at strengthening the health of citizens, strengthening the preventive direction,” Timur Kulibayev said.  

According to the Minister of Health, the ministry is preparing for the introduction of a new system: standardization of procedures, protocols, introduction of an electronic patient passport for effective evaluation of the medical organization's work.

Paperless workflow is introduced. The integration Healthcare Platform is being developed, on the basis of which an electronic health passport will be formed. Patients will be given access to information, electronic services that facilitate access to medical care, and the ability to evaluate the activities of medical organizations. The introduction of Artificial intelligence will also provide proactive services, that is, to predict possible pathologies, genetic diseases, and outbreaks of morbidity.

The ministry will receive the necessary data for statistics, analytics and industry management: planning the volumes and costs of medicines, medical devices and medical equipment including labeling and tracking.

The Social Health Insurance Fund (SHIF) focuses on the amount of treatment provided. There are no clear indicators of the quality of services and assistance. It is very important to create a modern independent examination of the quality of assistance and services. It should be carried out by independent experts who will monitor the provision of treatment, the course of treatment and the result. The goal should be either a complete recovery of the citizen, or long-term remission for chronic patients without repeated similar treatment.

The above measures will enable medical organizations to improve the quality of services provided, to optimize government spending on the provision of medical care. There is a successful example: registration in the information system of free drugs allowed the ministry to save 14.5 billion tenge, which was redistributed to financing of primary health care (PHC) and ambulance.

In order to preserve and increase the trend of private investment in health, the Ministry of Health and the Chamber of Entrepreneurs developed a Roadmap, including a single prospective plan for the development of the health system in the context of the 17 regions until 2025. The plan was developed taking into account statistical data, forecast of demographic growth and increase in life expectancy, the number of new hospitals, the need for reconstruction and modernization of existing ones, transfer to trust management, public-private partnership projects (PPP).

In addition, 23 sanitary rules of sanitary and epidemiological requirements were optimized and 12 control and supervisory functions of the Ministry of Health were excluded, Unified system of inspections was introduced in all regions.

According to Yelzhan Birtanov, to improve the quality of medical education in each state university, the first vice-rectors are representatives of leading medical schools from the USA, Sweden, Italy, Turkey, Lithuania and Poland. Their task is to change the curriculum, management in universities, attract foreign teachers, and strengthen scientific educational activities, student exchanges. University clinics are being created, seven research institutes and NCs are integrated with universities, the academic and managerial independence of universities has been expanded.

The experts noted the importance of improving the digital literacy of all medical workers at the meeting. Existing educational programs and qualification requirements should be consistent with the progress in modern medicine. Practitioners should also possess the skills of digital medicine. There is a significant potential for private business here - to create training and retraining centers on the basis of universities and colleges.

In conclusion, Timur Kulibayev instructed the Committee to strengthen the work in the regions, unite and strengthen the potential of regional business associations, which are well aware of their capabilities, features and needs of the local market. He added that, taking into account transformations and health care reform, it is necessary to analyze the infrastructure and specialization of the regions for certain types of medical services and, based on the results, invite businesses to occupy existing competitive niches.

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