Ljubljana related

11 Mar 2020, 14:03 PM

The danger of complacency over COVID-19 is that the infection spreads too quickly and hospital beds, along with healthcare workers’ schedules, get full to capacity, leaving little or nothing for patients with other conditions. This raises the possibility – as seen in Italy – of the system thus focusing attention on those most likely to recover, and letting the illness take its course among others (the older, the sicker).

All our coronavirus stories are here

In short, if you’re young and in general good health, your personal safety should not be a concern. More important is the safety of those around you – the old and sick who are more likely to die from COVID-19, as well as those, yourself included, who might need an emergency trip to the hospital in the next few months. The idea, as expressed in this widely shared image, is to spread out the epidemic and not overwhelm the healthcare system, both formal and informal.

hospital beds delay coronovirus.JPG

But how many hospital beds are there in Slovenia, and how do the numbers compare with other countries?

Using Eurostat data for 2017, there are a total of 2.6 million hospital beds in the EU28 (including the UK), counting those for curative care, long-term care and rehabilitative care, of which just 9,294 are in Slovenia, compared to 661,448 in Germany. Of course, Slovenia has a much smaller population, two million vs 82.8 million, so let’s look at the number of hospital beds per 100,000 people. Here Germany has 800 beds for every 100,000 people, or eight for every 1,000. In contrast, Slovenia has 449 beds for every 100,000 residents, or 4.49 for every 1,000, just between Malta and Switzerland.

hospital beds per 10000 people slovenia.png

The full list of countries, and beds per 100,000 people, is shown below, and note that no data was given for Albania. The Eurostat data can be explored further here.

Austria

737

Belgium

566

Bulgaria

745

Croatia

554

Cyprus

340

Czechia

663

Denmark

261

Estonia

469

Finland

328

France

598

Germany

800

Greece

421

Hungary

702

Iceland

306

Ireland

296

Italy

318

Latvia

557

Liechtenstein

240

Lithuania

656

Luxembourg

466

Malta

449

Montenegro

386

Netherlands

332

North Macedonia

428

Norway

360

Poland

662

Portugal

339

Romania

689

Serbia

561

Slovakia

582

Slovenia

450

Spain

297

Sweden

222

Switzerland

453

Turkey

281

United Kingdom

254

26 Feb 2020, 12:13 PM

STA, 26 February - The coalition government that is being formed by Janez Janša is planning to reintroduce military conscription, effectively secure the border, decentralise the country and increase local government funding, as well as introduce a general child benefit.

This follows from a 13-page draft coalition agreement obtained by the STA. The draft was initialled on Monday by Janša's Democrats (SDS), New Slovenia (NSi), Modern Centre Party (SMC) and Pensioners Party (DeSUS), but unofficial information indicates the parties have already signed the agreement.

Under the draft, the partners plan to gradually reintroduce conscription, which Slovenia abandoned in 2003, and a six-month military service. They also pledge to "tackle the situation" in the police force and consistently implement asylum procedures.

More on the conscription plans here

The parties have also committed to implement the Constitutional Court ruling mandating equal funding of private and public primary schools, and complete the system to fund science and research.

The per-capita funding of municipalities is to be raised to EUR 623.96 in 2020 and EUR 628.20 in 2021, which compares to EUR 589.11 and EUR 588.30, respectively, under the valid budget implementation act.

The coalition pledge to put in place a housing scheme for young families, build rental flats and establish a demographic and pension fund, headquartered in Maribor. Slovenia's second city will also host a government demographic fund. Pension rights are not to be changed.

The coalition also plan to reform social transfers policy and introduce free kindergarten for second or more children simultaneously enrolled in pre-school care and education. Family-friendly policies also include plans to introduce a universal child allowance.

The coalition pledge to secure extra financing from pubic and other funds in order to establish a financially sustainable and stable financing of the national health system and long-term care, and take effective measures to cut short waiting times in healthcare by engaging all staff resources.

The commitments include adopting legislation on long-term care and reforming the healthcare and health insurance act to change the management and functioning of the Health Insurance Institute and transform top-up health insurance.

Under the plans, employees will be able to take three days of sick leave without seeing a doctor, but only up to nine days a year. Measures are also planned to increase the vaccination rate and to set up an agency for quality of medical services.

The coalition have also committed to reduce taxes on performance bonuses and to reform the public sector wage system by pegging part of pay to performance.

Plans in the judiciary include making court rulings fully public and giving judges the option to pass dissenting opinions. Legislative changes are to affect the Judicial Council, state prosecution service, insolvency law and penal procedure.

The foreign policy agenda includes a pledge to support Western Balkan countries in their integration in the EU and NATO.

Other concrete projects include introducing e-motorway toll stickers and considering the option to transfer the Koper-Divača railway project and its manager 2TDK to the national railways operator.

The coalition would also like to reform land policies and the Farmland Fund, amend the co-operatives act and regulate production and use of cannabis in medicine and industry.

The coalition agreement sets out that the partners are taking the responsibility to manage the state according to voters' will, constitutional values, and rights and obligations as set forth in the agreement, based on the principles of equality and partnership.

The coalition pledges to focus on what connects and unites people in the country, and to advocate cooperation based on the willingness to work for the common good.

Under the draft, the SDS will be responsible for the departments of home and foreign affairs, finance, culture, which includes media, as well as the environment, diaspora and cohesion. The SMC was allocated the briefs of education, economy, public administration and justice, the NSi labour, infrastructure and defence, and DeSUS health, agriculture and the demographic fund.

This is the first in a series on the new government’s plans, to be posted in the next few days, with the whole set here

24 Feb 2020, 12:38 PM

STA, 23 February 2020 - As the novel coronavirus is spreading fast in neighbouring Italy, Slovenian health minister assured the public on Sunday that there was no reason for alarm. However, a medical official, speaking at the same press conference, said there was little doubt that the virus would appear in Slovenia as well.

Slovenia has not confirmed any case of infection with the novel virus as yet, Health Minister Aleš Šabeder noted at the press conference in Ljubljana.

How safe is Slovenia from coronavirus?

So far the only Slovenian to test positive for the virus that originated in China was a couple who contracted the virus, named Covid-19, on board the Diamond Princess cruise liner docked in Japan's Yokohama for over a fortnight. The couple have been admitted to a hospital in Japan.

Šabeder said that the government would call a session of the National Security Council secretariat for Monday to discuss the situation and take potential additional measures.

The minister does not want the virus to become a political issue. "This is a serious situation, unfolding not only in Europe, but also elsewhere round the globe," he said.

Is traveling to Italy from Slovenia safe?

He said that official data from Italian authorities showed that 124 had so far contracted the virus in Italy. Meanwhile, Italian media have reported the number has risen to over 150 with three fatalities.

Should Italian authorities establish that a Slovenian citizen has been in contact with those infected, Slovenia will be alerted right away, the minister said.

Health Ministry State Secretary Simona Repar Bornšek noted that part of Slovenia had just finished winter school break and that many would have spent it abroad.

With north of Italy being a popular skiing destination for Slovenians, the official advised all travellers who had returned from north Italian regions to monitor their condition and to contact their GP or duty service in case of a fever, cough or shortness of breath.

Hospitals prepare for coronavirus in Slovenia

All primary and secondary healthcare providers have been notified of the measures they need to take and the hospitals that could admit potential coronavirus patients have been urged to re-examine their contingency plans.

The state secretary said there was no confirmed coronavirus case in Slovenia, but that additional measures would be taken depending on the developments such as expanding testing.

She urged the public to follow information the website of the National Public Health Institute (NIJZ), which is being updated 24 hours a day, and not to fall for provocations.

Tatjana Lejko Zupanc, the head of the UKC Ljubljana Department of Infectious Diseases, said that there was almost no doubt anymore that the novel coronavirus would appear in Slovenia as well.

But she said that health institutions were getting ready for such a possibility. Their department sped up activities to be able to admit the first patient.

"All the paths have been agreed, which tests would be conducted. A few beds are ready, including at the intensive care unit. We'll have extra beds ready during the week," said Lejko Zupanc.

The department could admit 10 to 20 coronavirus patients at one of its units, theoretically even more. It is also capable of providing 10 intensive care beds, which "should suffice for a smaller outbreak".

In case of a massive outbreak, procedures would be quite different, involving the civil protection, among other mechanisms, said Lejko Zupanc.

She said everyone on the staff was willing to be involved in the effort in case of a potential outbreak, and if necessary military health staff could be engaged in case of staff shortages.

She said there were currently no suspected cases in Slovenia according to her information. She also said that Slovenia was well equipped for tests which were being conducted at three labs.

She said there was no need for panic or fear; if people "have been to what are epidemic hotspots at the moment", they should monitor themselves and seek advice from health services.

As prevention against potential infection NIJZ official Maja Sočan advised regular washing of hands, regular surface cleaning and measures generally taken to prevent an infection spread.

Sočan said the four Slovenian passengers from the Diamond Princess, who have already returned to Slovenia, were feeling fine, as were the couple hospitalised in Japan.

There were a total of six Slovenians on the ship, three couples.

NIJZ has not advised against travel.

Matija Cevc from the Slovenian Medical Association noted that posters appeared in parts of the country calling for citizens on behalf of the association to take preventive tests.

He said the association had not issued such a poster, denouncing the campaign as "utterly abject". He supposes it was aimed at making money at a time when people are in distress.

All our stories on coronavirus and Slovenia can be found here

19 Feb 2020, 09:21 AM

STA, 18 February 2020 - Slovenia is well prepared for early diagnosis in the case of an outbreak of the novel coronavirus COVID-19, but its hospitals could not handle a great number of patients, experts told the parliamentary Health Committee on Tuesday. Slovenia's hospitals have been neglected for too long and are ill-equipped for a big epidemic, the body heard.

The committee convened to discuss the country's preparedness for COVID-19 on the demand of the Democratic Party (SDS), with its MPs Jelka Godec saying today that the government and health institutions had failed to provide concrete information.

Health Ministry state secretary Simona Repar Bornšek said that instructions to passengers entering the country have been put up on all entry points, as well as hospitals and health centres.

"Health care personnel have been given concrete information. All institutions have their own pandemic plans in place," she said, adding that there is a very clear course of procedure for COVID-19 and that there is currently no need for additional measures in schools and kindergartens.

Tatjana Lejko Zupanc, the head of the UKC Ljubljana infectious disease clinic told the committee that the hospital had performed an extensive training for its health care staff, while UKC Maribor has also included its cleaning staff in the training.

Lejko Zupanc, as well as Aleš Rozman, the head of the Golnik hospital, both expressed concern about hospitals being outdated and too small to handle a great number of patients.

"In Slovenia, we must work on hospital infrastructure. Improvisation cannot be our default work mode," Rozman stated.

30 Jan 2020, 09:35 AM

STA, 29 January 2020 - The National Assembly failed to pass on Wednesday amendments that would abolish supplementary health insurance, a motion which had split the coalition and was one of the reasons why Prime Minister Marjan Šarec stepped down on Monday. They were rejected as 51 deputies voted against and 32 in favour.

Voting against the amendments to the health insurance act were the opposition Democrats (SDS), New Slovenia (NSi) and National Party (SNS), as well as the coalition Pensioners' Party (DeSUS) and Modern Centre Party (SMC).

Two deputies of the coalition Alenka Bratušek Party (SAB) voted against and two abstained, despite the deputy group presenting arguments in favour of the changes prior to the vote.

The amendments were meanwhile endorsed by the coalition Marjan Šarec List (LMŠ) and Social Democrats (SD) and the opposition Left.

DeSUS MP Branko Simonovič said the legislative proposal did not go about abolishing the current system of compulsory and top-up health insurance in the right way. He expressed concern regarding its effects on the health purse and the state budget.

Similarly, Jani Möderndorfer of the SMC said his party supported the idea to abolish the top-up health insurance but opposed the motion on the table because it does not actually abolish supplementary insurance but merely transfers it to another address while demanding that the budget door is wide open.

The SDS and NSi were also critical of the motion, saying it introduced a uniform contribution which would be collected by the ZZZS public health fund rather than commercial insurers, which collect supplementary insurance contributions now.

Meanwhile, the LMŠ, the SD and the Left presented arguments in favour of the changes, noting that many attempts to change the current health insurance scheme had failed in the past.

Luka Mesec of he Left expressed support to the proposal initially tabled by his party but then heavily modified by the coalition, noting that after 2021, when the bill was to be implemented, there would still be time to find a fairer system of financing.

LMŠ MP Robert Pavšič said the LMŠ had further amended the proposal to raise the monthly contribution for healthcare from the initially proposed EUR 29 to EUR 32 and reintroduce the provision saying that any shortcomings would be covered by the budget.

The SD proposed its own amendment which introduces monthly contributions based on individual's income that would range from EUR 10 to EUR 150, but the proposal was rejected, as were all amendments attached to the act during the course of parliamentary procedure.

After the vote, Mesec announced a new attempt to abolish top-up health insurance during the current term of the National Assembly. "We are not giving up. The battle has been lost, but the war is only beginning."

"Today it became clear who is who, who stands where, who defends the public interest, and who defends insurers. Unfortunately, the abolition has not, even after 17 years of attempts, succeeded," he said in a statement to the press.

According to Mesec, the rejection means that health insurance will keep getting more expensive and that insurers will continue to make tens of millions in profit, while poor people will continue to pay the same monthly contribution as people who are well off.

He presented the statistics showing that some 120,000 people in Slovenia cannot afford top-up health insurance, which means that "we don't have as universal coverage as someone might think."

LMŠ deputy group head Brane Golubović said that in the end, lobbies and insurers had played their role, and regretted the missed opportunity to get rid of intermediaries and transfer extra funds to the public health fund.

"We came far, but in the end, capital defeated people," he said, adding that the LMŠ would continue with the efforts and that this was only one stage in the process.

28 Jan 2020, 08:41 AM

STA, 27 January 2020 - The coordination group for monitoring and managing contagious diseases discussing the coronavirus outbreak announced in Ljubljana on Monday that Slovenia was braced for a potential outbreak. It is monitoring the situation carefully and cooperating with all WHO member states in efforts to prevent the spreading of the virus.

Mojca Gobec from the Health Ministry asserted that the country was prepared for a potential outbreak. "It is very important that we are ready because we can expect imported cases," said Gobec, the head of the public health directorate at the ministry.

It is essential that the system contains the infection and reduces the risk of the spreading of the virus to a minimum, she pointed out a press conference after today's meeting.

Medical staff has been acquainted with the procedure to prevent further contamination in case the virus occurs in Slovenia, said the head of the Ljubljana clinic for infectious disease, Tatjana Lejko Zupanc.

Maja Sočan from the National Institute of Public Health urged against travelling to China, noting that the country had run out of protective masks and that transport had been hindered because of the virus.

She noted that measures introduced at airports to prevent the spreading of the virus from China such as the measurement of body temperature were not efficient, because the disease can be spread before the symptoms occur.

"Thermal cameras seem to be a very agreeable measure at first glance, but we must be aware that most passengers arrive by land," she said.

Lejko Zupanc said that such infections were nothing new, noting that primarily at risk were the people with chronic diseases and those who are fragile.

The pneumonia-like illnesses from the newly identified coronavirus, which appeared in December in Wuhan, central China, has so far claimed at least 80 lives. More than 2,700 people have been infected.

Cases of infections have been recorded in several other countries as well, including the US and France.

22 Jan 2020, 11:53 AM

STA, 21 January 2020 - Slovenia is one of the most effective EU countries in fighting cervical cancer, mostly due to its successful ZORA screening programme. Moreover, prevention efficiency has been boosted by a steady increase in the human papilloma virus (HPV) vaccination rate among girls.

The vaccination rate for eleven-year-old girls has increased by 10 percentage points to nearly 60% last year, health officials said on the occasion of the European Cervical Cancer Prevention Week.

The lowest rate was recorded in the Ljubljana region, bellow 50%, and the highest in the Koroška region, at 87%.

Experts are pushing for the vaccination to be free of charge also for boys. The proposal has been drawn up by the National Public Health Institute, pending approval by health and public health fund authorities.

Some municipalities, especially in Koroška, are funding vaccination for boys themselves.

According to Leon Meglič of the gynaecology unit of the UKC Ljubljana hospital, at least 90% vaccination rate is required to eradicate the disease not only among girls but in the entire population.

HPV infection, one of the most common sexually transmitted diseases, causes more than 99% of cervical cancers but also the cancers of the throat, anus, and penis.

Ideally, girls should get the vaccine before becoming sexually active, but as of last year, girls born after 1998 who were not vaccinated when they were 12, can still get the vaccine free of charge in Slovenia.

Last year, 420 girls and 38 boys were vaccinated in a four-day campaign, said Mojca Miholič from the Ljubljana Student Health Centre. Some 60% of the girls received the shots free of charge.

Meanwhile, women, including those over 50, are urged to get screened regularly, as cervical cancer discovered in its early stages is often easily curable. Cervical cancer incidence has halved since the launch of the ZORA prevention programme in 2003.

Some 120 women in Slovenia are diagnosed with the disease every year, one of the lowest rates in Europe, which is quite an achievement given the country used to have one of the worst statistics in Europe on cervical cancer incidence, according to Urška Ivanuš from the Ljubljana Oncology Institute, who heads ZORA.

According to Meglič, no other country has made such progress in such a short time.

28 Nov 2019, 12:00 PM

STA, 27 November 2019 - The parliamentary Health Committee has surprisingly endorsed legislation that would effectively end the current system of compulsory and supplementary health insurance as of 2021 in favour of a fully-fledged single-payer system.

The committee was discussing Wednesday amendments to the health insurance act tabled by the opposition Left that would fold the supplementary insurance contribution, which is paid as a lump sum regardless of income, into higher employer and employee payments.

It was widely expected the amendments would simply be voted down since the government said the bill was not appropriate. Its reluctance to back it was also the main reason why the Left terminated its cooperation agreement with the minority government.

Instead, the original proposal was transformed with coalition amendments into a bill that folds the lump sum, roughly EUR 29 per month, into the existing compulsory payments.

This means that supplementary health insurance contributions of individuals would increase by the same amount regardless of income, in what the government says is "the first step" of a more comprehensive solution.

Even the Left in the end backed the government solution, with party leader Luka Mesec arguing that this would "keep the bill open" and provide an avenue to find better solutions in the coming days and months.

Despite the surprise endorsement today, the legislation faces obstacles down the line.

For one, the parliament's own legal department voiced apprehension about the bill being changed so thoroughly with amendments. It also has qualms about how clear the provisions are.

Marjan Sušelj, the head of public health insurer ZZZS, which would manage all health insurance payments under the new system, said the solutions were not defined clearly enough.

He also noted that the government had recently agreed with social partners to steer all legislation through the Economic and Social Council prior to adoption.

And even if these issues are resolved, the three companies that provide supplementary health insurance, two private firms and a mutual insurer, have indicated they will put up a fight against legislation that would effectively kill their business.

These insurers currently collect roughly half a billion euro in health insurance premiums, money that would be handled by the ZZZS if the legislation is passed.

20 Nov 2019, 11:15 AM

STA, 19 November 2019 - Overworked and underpaid, Slovenian nurses have been quitting their jobs in droves, leaving hospitals struggling to find replacements, in particular for vacancies at intensive care units.

The situation is worst at UKC Ljubljana, Slovenia's largest hospital, which has been forced to limit admission of patients at about 40 out of 2,150 beds.

"Part of the daily working programme is maintained by going the extra mile to stretch the timetables," UKC Ljubljana said, adding that it lacked the leverage to pay nurses at clinical departments properly.

"Those are the hardest workstations, and younger generations are avoiding them," said UKC Ljubljana director-general Janez Poklukar.

Nurses have been leaving hospitals, where they often work three shifts, for better paid and less demanding jobs either abroad, in primary care or for non-nursing jobs in the corporate sector.

Hospitals in the north and north-east of the country have been hit particularly hard by staff leaving abroad, mainly to Austria. UKC Maribor is facing a shortage of 25% of nursing staff.

Marjan Pintar, the head of the Slovenian Health Institutes' Association, says that staffing problems first occurred with the establishment of nurse-led consultancies at community health centres in 2011.

Some 500 graduate nurses left hospitals for those consultancies at the time, and a further 200 have left to be employed at the call centres established recently, Pintar said.

This is why the shortfall of graduate nurses is the most acute, even though their per capita number in Slovenia is within the OECD average.

"Since 2000 the number of nursing staff increased by 45%, the shortfall mainly due to the gap between the increasing expectations of the profession and the available staff," said Pintar.

"If new work standards are adopted and community health centres need to hire extra graduate nurses, the most demanding units at Slovenian hospitals will be drained empty, which may seriously jeopardise our health system."

Based on the standards that are being drawn up, it is estimated public health institutions will need an additional 3,543 graduate nurses, 145 graduate midwives and 45 nurses with secondary education, at the cost of EUR 100 million.

The nursing and social care trade union estimates shortages at between 20% and 25% at the moment, which means roughly 2,100 nurses, mainly at hospitals. There are also shortages at nursing homes.

What is more, 8,200 nurses are aged above 50. "Over the next few years a large and highly experienced generation of nurses will retire, and it will be impossible to replace," the union's head Dragica Kekec has warned.

"Nursing work is hard ... it involves sacrifice from individuals and families, night-time work ... work at Sundays, holidays, no time to rest, those absent are not being replaced," says Kekec.

Even though 1,000 nurses were registered as unemployed in September, the Employment Service says that less than half had nursing experience and only 580 were looking for a nursing job.

Another problem is that the job seekers do not have the level of education required by the employer, while some of the unemployed have limiting factors such as heath or other issues.

The trade union believes that higher pay and better working conditions would do much to curb the high turnover. It opposes ideas to look for nurses abroad.

Despite shortages, few hospitals have opted for such a solution, the main obstacle being the required language skills and demanding procedures to recognise foreign qualifications.

UKC Ljubljana officials have taken part in a career fair in Belgrade, detecting considerable demand for work in Slovenia. But they note the obstacle of the high language proficiency requirements.

As a stop-gap measures they are hiring staff through student work agencies and alleviating nursing staff of administrative work.

All our stories on healthcare in Slovenia are here

24 Oct 2019, 17:12 PM

For those wondering how Slovenia plans to deal with an aging society and a shortage of medical staff and care workers, a recent story in The Philippine Star may provide an answer.

The Filipino Department of Labour and Employment has announced that Slovenia is looking for from 2,000 to 5,000 skilled and semi-skilled workers to move to Europe and address labour shortages in the country. The positions that would be open to Filipinos in the deal, which has yet to be signed, are expected to include healthcare workers, nurses, engineers, truck drivers, heavy machine and equipment operators, household service and staff in other industries.

Filipino Labour Secretary Silvestre Bello III said that a technical working group still needs to negotiate the terms of the agreement and ensure the protection and safety of the workers, which would take around three months. The exact jobs and qualifications will then be announced, but the latter will certainly include proficiency in the English language.

More details can be found here.

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