STA, 1 April 2019 - GPs around the country are stepping up pressure in the face of the increasing workload and red tape. As announced, 23 doctors of the Kranj community health centre tendered their resignations on Monday, according to the head of the primary healthcare of Gorenjska, Jože Veternik.
The resignations come after the doctors threatened to quit their job as of 1 April unless the conditions are created enabling them to carry out their work safely and in line with medical standards.
Under the law, doctors have a 60-day notice period. If the situation is not resolved within the next 60 days, the GPs will have to be let go at the end of May, which means Kranj's primary healthcare would collapse, Veternik said.
According to the head of the Kranj Community Health Centre, Lilijana Gantar Žura, 23 of the 34 doctors tendered their resignation, which means 40,000 people would be left without their GP at the end of May.
"This is a serious alarm to which all stakeholders need to respond quickly," Gantar Žura said, calling for talks between the Health Ministry, government and the healthcare purse manager ZZZS.
"Doctors no longer believe promises and will withdraw their resignations only if things are agreed on, written down and signed," she said.
Veternik said they were counting on solving the situation this month. "The [health] minister paid a visit on Friday and we exchanged views. Our suggestion was for the minister to try to meet at least part of the doctors' demands in April," he said.
Health Minister Aleš Šabeder met the head of the Praktikum trade union of GPs, Igor Muževič, in Ljubljana today. No concrete measures were agreed, but both labelled the meeting constructive. A task force will meet again on Wednesday.
The meeting also seemed to have cleared out Friday's misunderstanding when doctors refused to meet the minister after being denied having their representatives present at the meetings between the minister and the leaderships of the community health centres.
"The minister has indeed been open for talks with trade unions all along, which we could see today," Muževič said after meeting Šabader.
The minister said he was aware solutions would need to be found quickly. "We have a month, two at the most to settle the matter and reach an agreement," he said.
Among the solutions discussed today is importing doctors from abroad, which Šabeder warned would take time because of the necessary legislative changes. "Quick calculations show that we would need approximately 50 doctors in the short-term at this point," the minister said.
The trade union also proposed an emergency bill to prevent patients who cannot be admitted by a GP in their community health centre to be sent off to another centre. In turn, the understaffed centre would be given an option to hire a doctor from abroad, a retired doctor or a freelancer to ensure primary care to all patients.
Vetrnik thinks it is crucial to change the ceiling for accepting new patients. Last year the ceiling was at 1,995 patients per GP, while this year's ceiling is the average of a particular community health centre.
Currently, the average patient index for Slovenia is some 2,400 or 1,850 patients per a team of doctors, but in Kranj a team of doctors deals with some 2,000 patents, which is 10% more than an average Slovenian doctor and 25% above the 2017 agreement.
"This must have been the last straw that caused the doctors' resignations in Kranj, and the announcements of resignation in Celje and Maribor," Veternik said.
Doctors want the ministry and the ZZZS to endorse the standards and norms from the 2017 strike-averting agreement.
Later in the day, GPs from the Ptuj Community Health Centre joined the calls for change in primary healthcare, or else 16 GPs would collectively resign on 1 June, the Ptuj health centre said in a release.
The Ptuj GPs demand that once a doctor has 1,895 patients, they no longer accept new patients, and the figure should be gradually cut, by 5% annually, to eventually drop to 1,500.
The doctors in Kranj were the first to protest against the plan to increase the patient index, and stopped accepting new patients already in February. They also addressed a letter to Samo Fakin, who in the meantime resigned as health minister due to ill health, in which they threatened to quit by the end of March.
All of the 15 GPs at the Celje Community Health Centre issued a similar threat last month, while three doctors at the Nazarje Community Health Centre have already resigned.
GPs in Ajdovščina announced they would do no more overtime and GPs in Grosuplje announced they would stop accepting new patients. The GPs of the Maribor Community Health Centre threatened to quit their job on 1 June unless the situation is resolved.
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