Ljubljana related

01 Apr 2019, 17:55 PM

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.

All our stories about healthcare in Slovenia are here

30 Mar 2019, 10:00 AM

Mladina: Who is opposed to changing the system of supplementary health insurance, and why?

STA, 29 March 2019 - The left-wing weekly Mladina looks into the reasons for the opposition to the idea to abolish supplementary health insurance in its latest commentary, noting that it is more than 15 years old, much older than the Left, which usually gets credit for the idea.

"The people who are screaming about excessive public spending are also screaming about the Left (and the coalition) wanting to take EUR 500m away from healthcare by forcing the idea," editor-in-chief Grega Repovž says in Crazy World.

"The idea to abolish supplementary health insurance is much older than the Left. It is more than 15 years old. It has been present since it was revealed that some lobbies are using it to literally cut away a part of public money they collect instead of the state."

According to Repovž, these lobbies are turning this money around on financial markets, take their 10% and then return it to the state. "This would have been abolished everywhere long ago. But not in Slovenia. Let's see why this is. Because the reasons are actually very banal, shallow and evil."

The coalition is not actually proposing abolition of supplementary health insurance, but its merging with compulsory insurance. The catch is that people with lower income would pay less, up to 20 euros a month, and those with higher income would pay more, up to 70 euros.

A majority of the decision-making MPs, officials, directors - the entire upper class, would pay more, and the thing is that they do not want to pay more. They instead let three private insurers to get their EUR 60m every year from the people.

In short, the entire upper class is pretending ignorance and does not want to shoulder its share of costs for healthcare, the share proportionate to their income. This is why they are willing to lie that the coalition (and the Left) wants to take EUR 500m away from the healthcare sector.

"Well, the question is on whose side the new health minister is. He has not been convincing so far, but he belongs to the party of the prime minister, who has committed to implementing this objective in the agreement with the Left."

It is very easy to explain the reasons for abolition of supplementary health insurance to the public, for example with the situation of general practitioners, concludes the commentary.

Demokracija: Fidesz helps EPP ahead of EU election

STA, 28 March 2019 - The right-wing weekly Demokracija says in its latest commentary that the European People's Party (EPP) members made the right decision in not expelling the party of Hungarian Prime Minister Viktor Orban and thereby diminishing EPP leader Manfred Weber's chances of becoming the next president of the European Commission.

Last week, Weber faced the serious threat of a discord in the EPP right ahead of the EU elections, and a possible break-up of the group was not excluded either, as some parties had announced they would leave the EPP if Fidesz was expelled or forcedly suspended.

At first, it seemed that a majority of the EPP members were leaning towards such a proposal from 13 members, as this was supposed to be the key to success of Christian democrats in the May elections, editor-in-chief Jože Biščak says in EPP's Training Day in Brussels.

But after the speech by Janez Janša, the head of the Slovenian Democratic Party (SDS), who seriously warned that such a decision could cause irreparable damage, the scales tipped to the other side and Orban's proposal for a six-month suspension was accepted.

A continuation of the dispute would mostly benefit the political groups on the left, as socialist Frans Timmermans would easily beat Weber, Biščak says, noting that the solution was temporary, as everybody is waiting for the election result.

The compromise between the EPP and Fidesz is the best solution for European conservatives at the moment, as they remain (at least seemingly) unified, and one can say that Orban did a favour to Weber.

As projections suggest, Orban will be a great winner of the EU elections in Hungary, and Weber's chances of becoming the next president of the European Commission would have dropped drastically had Fidesz left the EPP, as it would be followed by more parties. Actually, it would be mission impossible, concludes the commentary.

All our posts in this series can be found here

28 Mar 2019, 12:30 PM

STA, 27 March 2019 - Aleš Šabeder is taking charge of the Ministry of Health, replacing Samo Fakin, who stepped down at the beginning of March, citing health reasons. Before becoming director general of the UKC Ljubljana hospital a year ago, Šabeder had no experience in the healthcare sector.

As the new health minister Šabeder will be confronted with many challenges such as healthcare reforms and navigating through various political interests.

Born in 1970 in the city of Ptuj, Šabeder has a degree in economics. Most of his experience stems from working in the corporate sector, including at one of the senior posts at the fuel trader Petrol (2006-08), and serving as one of the regional directors for wholesale and retail at the retailer Mercator (2008-14).

In January 2014, he took over at the seed manufacturer Semenarna Ljubljana as director general, marketing director, and exports department manager before moving on four years later to become director general of UKC Ljubljana, the country's main medical centre employing around 8,000 people.

UKC Ljubljana generated a loss of EUR 23m last year, up considerably compared to the target loss of EUR 15m. This was after the hospital made a deficit of EUR 33.5m in 2017, which was turned into a surplus of EUR 46.4m after the hospital received almost EUR 80m under the government hospital bailout plan.

On his appointment at UKC, the hospital's council cited his management experience and experience in negotiating with trade unions; however, the doctors' trade union and several political parties considered him a political appointee, supported by the then ruling Modern Centre Party (SMC).

During his presentation in parliament, Šabeder was criticised for failing to offer concrete solutions, and he admitted he would have to get briefed on the situation fast.

He pledged to endeavour for accessible and quality public health system, one that is "neither left nor right", but remains in the professional domain rather than a political one.

Šabeder is fluent in English, German, Croatian, and Serbian. He is married and has a daughter.

All our stories on healthcare in Slovenia are here

Plans to cut waiting times and bureaucracy

STASTA, 26 March 2019 - Aleš Šabeder, the nominee for health minister, was confirmed by the relevant parliamentary committee on Tuesday, with 12 MPs voting in favour and two against. He announced a systematic approach to cut waiting times and red tape, and an overhaul of the health care and health insurance act.

As the hearing started yesterday, the candidate said that the people must be provided with accessible and quality public health services, adding that he had got well acquainted with the complexity and the needs of the Slovenian healthcare system.

One of his first priorities will be to revise waiting lists on the national level and then prepare measures to cut waiting times such as setting up additional programmes and focus on the areas where the number of patients is rising.

The system of appointments needs to be revised as well, and paperwork should be reduced to relieve the burden on doctors who are already struggling with excessive workload. They need efficient IT support, he believes.

Touching on the problems on the primary level, he said that Slovenia simply did not have enough GPs, so structural changes were needed in this area to relieve the pressure on the secondary and tertiary levels.

Today, Šabeder said he was ready to cooperate with all parties and listen to their proposals. He is in talks with candidates for state secretaries at the ministry, "who will not be politically appointed, they will be experts."

Regarding the idea to abolish supplementary health insurance, he said this would require a stable and long-term source of financing. Possible solutions are a higher contribution rate, a healthcare tax, and levies on alcohol, tobacco and sugary drinks.

Quizzed by MPs, Šabeder admitted that "at this moment I don't know what the best solution is", but added that he was not connected with any healthcare insurers and not in conflict of interest.

Regarding the shortage of GPs, he reiterated that the number of specialisations should be increased and encourage students to study family medicine.

Corruption in the procurement of medical equipment should be fought by introducing national standards which would apply to all healthcare institutions, he said, adding that public procurement legislation should also be amended.

Šabeder, who has been director of the UKC Ljubljana hospital for over a year, is set to be appointed health minister by the National Assembly on Wednesday, to succeed Samo Fakin, who stepped down at the beginning of March for health reasons.

He told the STA after the vote he was happy he had managed to also convince members of the opposition, adding that he believed that he would get the required majority tomorrow.

Šabeder commented on the hearing by saying that there were a lot of open issues in healthcare. "I know that I'm sitting in a hot sea and that there are many challenges, which we can resolve with consensus and agreement."

25 Mar 2019, 16:20 PM

STA, 22 March 2019 - Threats by dozens of general practitioners around the country to quit in the face of a recent decision to increase the number of patients GPs are expected to cover have been making headlines in recent days. Matters seem to be spiralling out of control, as medical students have also been showing no interest to pursue a career in general practice.

While tensions over increasing red tape for GPs and their general workload have been mounting for years, the situation seems to have escalated as a result of the financing and organisational plan for public healthcare in 2019.

The plan, put forward by healthcare purse manager ZZZS and confirmed by the government, raises the permitted number of patients per GP. The increase also affects health centres that have been performing above that national average, which has been scrapped as a reference point.

More Slovenian doctors start to protest

The first to protest were 21 doctors in Kranj, who already stopped accepting new patients 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 Health Centre issued a similar threat earlier this week, while three doctors at the Nazarje Health Centre have already resigned.

Moreover, on Thursday doctors at the Ajdovščina Health Centre, which has seen a number of retirements in the recent period, announced they would no longer perform overtime work.

Doctors' organisations are demanding solutions that will allow GPs to do their job in line with professional standards. They say that the recommended patient index is 1,500, that the currently valid ceiling is 1,895, while the actual Slovenian average stands at 2,406.

However, the ZZZS argued that enforcing the ceiling would mean 325,000 people in Slovenia remaining without primary healthcare.

A threat to the constitutional right to healthcare

"Every stakeholder in the system shares some responsibility for solving this problem together. It however cannot be solved in the way proposed by some doctors, by starting to reject patients at 1,895, since this would even violate the constitutional right to healthcare," the ZZZS said.

Solutions highlighted by the ZZZS include appropriate education policy planning, meaning securing enough GPs, and a reduction of administrative burdens. It is also looking for ways to secure more funding.

"The management of health centres also have a number of tools at their disposal and can above all use reallocation to secure a more equal distribution of burdens among doctors," the ZZZS wrote.

There are currently 950 GPs in Slovenia along with 315 GP trainees and according to February data, the workload of 42% or of 595 family and children's doctors did not exceed the Slovenian average.

The Health Ministry, which is being run temporarily by Prime Minister Miro Šarec since Fakin's resignation, says it is drawing up measures that will resolve things in a systemic manner.

It announced fewer administrative tasks, a new financial model for primary healthcare that will be stimulative, and a call for applications for 80 to 90 GP speciality training spots in this year.

Healthcare in Slovenia faces growing problems

The problem however is that interest for a career in general practice has been very modest. Only 13 application were filed for 64 spots made available in a call last spring and eight in the autumn call that offered 60 spots.

What is more, health centres did not manage to find new GP staff even though additional funding had been secured for the purpose.

The head of the family doctors' trade union Praktikum, Igor Muževič proposed the impasse could be bridged with the inclusion of foreign doctors. He however added that no dialogue exists between the union and decision makers.

The situation was meant to be discussed today by the parliamentary Healthcare Committee, but the session was cancelled because it was not certain the representatives of the Health Ministry would be able to attend.

All our stories on healthcare in Slovenia can be found here

26 Feb 2019, 11:50 AM

STA, 25 February 2019 - A dentist from north-eastern Slovenia has been found guilty of discriminating against an HIV patient in what is the first such ruling in Slovenia, a decision considered a key milestone in discrimination case law.

This is the first time a healthcare employee was found guilty of discriminating against an HIV patient, the newspaper Večer says on Monday about the court case that was closed to the public.

The dentist was ordered to pay EUR 2,700 in compensation to her former patient by the Maribor Higher Court in mid-2018.

The HIV-infected man saw the dentist in March 2016 and told her during the first visit that he was being treated for HIV. The dentist sent him for a dental x-ray.

The next week, when he came back for treatment, she told him he should get a new dentist. In court, the dentist claimed that she sent him away because she had only one set of particular instruments, which she could not sterilise in one afternoon.

However, both the first and the second instance courts ruled against her. The patient was eventually admitted by another dentist working at the same health centre, Večer reports.

The man reported the incident to Patient's Rights Ombudsman Vlasta Cafnik, who turned for help to the Medical Chamber but did not receive any response despite sending several emails and letters to several people in the organisation.

The patient also turned to the healthcare inspectorate, which responded that the Medical Chamber was in charge of such issues. He wrote to the chamber as well but received no answer and ultimately opted to hire a lawyer.

A mediation with the dentist was launched. It took a year before she wrote him an email, saying that she was aware that her treatment was demeaning and discriminatory.

The patient, who felt that the apology was not sincere, decided to take the dentist to court after her malpractice insurance company rejected his complaint.

She was found guilty at the first instance in April 2018. She appealed but the Higher Court upheld the first instance ruling in July 2018 and she ultimately paid the EUR 2,700 fine.

In response to the newspaper report about the case on Monday, the Medical Chamber said it was unacceptable to turn away a patient infected with a contagious disease.

"It needs to be taken into consideration, however, that such a case may affect organisation of work in the sense of rescheduling the appointment of the patient or other patients to ensure safe treatment of everyone present.

"All health staff has a duty to act in a way so as not to expose other patients to the risk of infection," the chamber said in a release.

The chamber said that it had received queries about the case from the patents' rights ombudsman in the previous term. In this term oversight was conducted with the dentist but "no departure from expert doctrine or work in comparable doctor's offices was established".

26 Feb 2019, 10:20 AM

STA, 25 February 2019 - A nurse from the UKC Maribor hospital is being investigated for forging more than 200 prescriptions for medicines in high demand on the black market. She and a male accomplice are suspected of defrauding the national healthcare insurer ZZZS from 3,000-5,000 euros.

The Maribor criminal police assistant chief, Andrej Kolbl, told the press on Monday that a healthcare worker and an accomplice had been temporarily detained while the police searched six houses, commercial offices and cars on Friday.

The pair is suspected of fraud, a crime that carries a three year sentence, but the investigation will also look into other potentially criminal activities such as illicit sale of medicines, and the reason for the crime.

The police will also investigate whether any other persons were involved in the scheme.

The suspect allegedly forged more than 200 prescriptions since 2017, using the green-coded prescription pads used to prescribe medicines fully or almost fully funded by the ZZZS.

The suspect had made the prescriptions out to herself and the accomplice, forging the signatures of some 20 doctors in the process.

More than 600 cartons of Sanval, Zaldiar, Lexaurin and Doreta have been issued by several pharmacies based on the prescriptions.

Kolbl said these medicines, which are mostly tranquillizers or insomnia drugs, were in high demand in particular among drug addicts.

It was a pharmacist who had suspected the signature on one prescription did not belong to the doctor who had issued it, explained Roman Košir, UKC Maribor's emergency unit head, who spoke to the press later in the day.

The pharmacist also realised the person to whom the prescription had been issued, received very large amounts of tranquillizers, and notified the doctor in question.

Košir explained UKC Maribor had been notified of the suspicious activity a week ago by the community centre for which the doctor worked.

They had checked with several doctors to establish the signature on the prescriptions were not theirs, and reported the case to the police.

The nurse had mostly forged signatures of doctors from the community centre who regularly helped at the emergency unit, according to Košir.

He also explained it was not unusual for a nurse to have access to prescription pads or stamps.

"This is how we do things. Doctors, nurses, prescriptions, stamps are available at any moment due to the very nature of the work process."

Košir said the nurse had worked for the emergency unit for more than two years and the procedure to dismiss her had already been launched.

He said UKC Maribor was not harmed financially by the wrongdoing, as prescription drugs are paid by the national health care insurer.

It is yet to be established how much the two suspects have gained from the illegal activity.

22 Feb 2019, 11:50 AM

STA, 21 February 2019 - The government confirmed on Thursday the financing plan for public healthcare in 2019, which includes additional funding and incentives for reducing waiting lines and an extra EUR 104m to cover the recent pay rise for healthcare staff.

The government confirmed what is termed "the general agreement for healthcare" and the financial plan of the healthcare purse ZZZS which envisages revenue and expenditure to level out at EUR 3.054bn. The figure is EUR 172m higher than in 2018.

A total of EUR 55m has been earmarked - coming on top of EUR 35m left from last year - to address waiting lines, which have been the main and persistent issue of the public healthcare system.

The funding framework adopted today was presented as giving the green light to some of the measures meant to cut the waiting times, one novelty being bonuses for hospitals and health centres for every medical examination beyond the number set down by standards.

"These examinations will be paid separately. They can start with them immediately, they just need to increase the number of doctor's offices ... I know that the system is rigid and that things will take time. But progress can be reached within a year," Health Minister Samo Fakin told the press.

He added that the results will be most obvious if the waiting lines are tackled at the country's largest hospitals, in Ljubljana, Maribor and Celje. If the response is slow, private providers will show interest, Fakin warned.

The ZZZS budget for 2019 envisages EUR 2.14bn going for healthcare services, 5.6% more than this year.

The financial plan entails an expansion of the primary healthcare network, providing funds for more GPs and paediatric surgeries since access varies greatly across the country.

The plan earmarks EUR 366.6m for sick pay (+7.5% over 2018), while EUR 54.2m is to be spent for healthcare provided abroad (+2.4% y/y).

Moreover, the insurer wants to preserve the same level of accessibility to innovative drugs. In total, EUR 444.5m will be available for drugs, medical aids and vaccines next year, 7% more than in 2018.

The government was also briefed on a report on the year-long project aimed at cutting waiting times that was adopted by the previous government as part of a strike deal with doctors and concluded on 31 March 2018.

The report found that out of EUR 18m earmarked for the purpose only EUR 8.15m was actually spent. The money went for performance bonuses for doctors and other healthcare staff putting in extra work to reduce waiting times and provide better care to patients.

All our stories on healthcare in Slovenia can be found here

07 Feb 2019, 11:50 AM

STA, 6 February 2019 - A debate on problems in primary healthcare is heating up. Overburdened and understaffed, health community centres are looking for solutions but the one most recently proposed by the health minister has upset trade unions as well as nurses.

The problem of GPs being overburdened and underpaid has escalated to the point that in one health community centre, in Kranj, primary healthcare can no longer be provided to all residents.

Last week, the community centre notified citizens that GPs cannot accept new patients there and advised them to find their GP outside their city.

Responding to the situation there, Health Minister Samo Fakin proposed yesterday that GPs be paid according to the number of patients they have. "We already have this model in private healthcare and it's working," he said.

Although Fakin said trade unions had informally agreed with the proposal, the FIDES trade union of doctors and the Praktikum trade union of GPs rejected this.

Moreover, the minister upset nurses, who felt the minister ignored their problems completely, as well as the Association of Private Doctors and Dentists, who said that more patients always meant poorer quality of treatment.

Praktikum said that a new system of rewarding had been mentioned as a possible solution at one of the meetings with Fakin but "we told the minister this could be seen as an initiative to conduct work less professionally".

"No pay will reduce the burden on GPs. We will also propose to the minister to restrict the financing of work that exceeds professional standards," Praktikum said in a press release.

The trade union also proposes changes to the system of financing, cutting the red tape, and flexible hiring, especially in rural areas.

"We understand the minister is in a tough spot, being restricted by the political will in parliament and being unable to offer systemic solutions by himself. We need systemic measures to increase interest in family medicine and improve the chances of GPs staying in an area."

FIDES too called for honouring standards and norms with vice president Janusz Klim saying that the ministry, the ZZZS public health fund and health institutes had failed to take the necessary steps to implement the standards and norms from the 2017 strike-averting agreement.

Commenting on the situation at the Kranj community health centre, Fakin said that 51 students would finish their GP specialisation this year, just as many next year and another 31 in 2021. Half as many GPs will retire so that the gap should gradually close, he said.

The last resort will be to follow the example of other European countries and open the door to doctors from EU and third countries, he said. According to Fakin, the ministry is also working on changes to the management of public health institutions act.

But FIDES and Pratikum believe that the situation will further deteriorate with the natural retirement of doctors. "With every specialist that leaves, we have 1,500 patients left without quality care."

This causes burnout among doctors in primary healthcare, which prompts doctors to leave their job and discourages young doctors from becoming GPs.

The trade unions therefore expect decisive measures from the government.

The opposition New Slovenia (NSi) has already called for an urgent session of the parliamentary Health Committee, where it also expects concrete solutions.

"Unless the government and the health minister tackle the situation soon, the whole system of primary healthcare could collapse in a few years," the NSi said, noting this would be the biggest problem in Slovenia's history.

11 Jan 2019, 20:00 PM

STA, 11 January 2019 – Gynaecologists (ginekologi)  in Slovenia have too many women enlisted as their patients, which leads to lower-quality examinations and longer waiting times. They thus urge authorities to reduce the number of women per gynaecologist to preserve the achieved high level of gynaecological care.

Medical Chamber representatives told the press in Ljubljana on Friday that a shortage of gynaecologists and ever new generations of women entering the system had affected access to gynaecologists.

They believe at least 30 new gynaecology teams would be needed to cope with the shortage and take the pressure off overburdened gynaecologists.

In 2018, a gynaecologist had an average of 4,800 women enlisted as their patients, while the college of gynaecologists and obstetricians maintains 4,000 would still be an acceptable figure.

However, some gynaecologists had even more than 7,000 women enlisted, explained Domžale Medical Centre gynaecologist Petra Meglič, who treats some 6,200 women.

All women, including girls aged at least 13, are entitled to choose their personal gynaecologist in Slovenia.

Since some 700,000 women have their personal gynaecologist, gynaecologists carry out more than 1.5 million medical examinations a year.

Another burden is a number of administrative tasks gynaecologists are obliged to carry out, which further shortens the time they have for their patients.

An aging and shrinking profession

Gynaecologists are, moreover, getting older; in 2017, out of a total of 361 active gynaecologists, 160 were older than 50 and 82 older than 60.

Some 300,000 women could remain without their personal gynaecologist due to retirements in the coming years.

"Young specialists prefer to work at hospitals, as working in a gynaecology office is extremely specific, with constant high pressure to process a mass of women," said Meglič.

She also said her office rejects 10 to 20 women who have not yet chosen their personal gynaecologist a day.

According to gynaecologist Renata Završnik Mihič, young doctors are eager to specialise in gynaecology, yet not enough residencies had been opened over the past years to make up for the shortage that would stem from retirements.

The system is working only because gynaecologists assume ever more work, which leads to burn-out.

They thus called on authorities to overhaul the standards governing the number of women patients per gynaecologist, which were adopted in 1994, taking into account population ageing and new discoveries in medicine.

In this way, the country will preserve its quality gynaecological care, few unwanted and teenage pregnancies, relatively few abortions and a low rate for cervix cancer.

09 Jan 2019, 10:19 AM

STA, 7 January 2019 - The URI Soča rehabilitation centre in Ljubljana launched on Monday a new device for gait rehabilitation for severely impaired neurological patients. The Lokomat device provides supported, automated and computer-guided training for persons with impairments of the central and peripheral nervous system who are not able to stand or walk independently.

"The robot connected with virtual reality enables gait training for patients who would otherwise not be able to start it so early into rehabilitation," URI Soča medical director Helena Burger told the STA at the ceremony.

The device will make rehabilitation and its effects faster, as it ensured highly intensive learning with numerous repetitions of a steady and symmetric gait.

URI Soča director general Robert Cugelj added that they wanted to establish a centre of modern technologies by 2020, which would provide patients with services in line with the European rehabilitation guidelines.

The centre would provide rehabilitation with robotised equipment and virtual reality equipment at one place.

A patient using the Lokomat praised the device he uses three times a week for 30 minutes. He said the exercise was exhausting, but beneficial, as it helped him get closer to walking independently, which had seemed impossible at the start of the rehabilitation.

The purchase of the EUR 400,000 device was financed by the Health Ministry. Minister Samo Fakin said that the introduction of new medical technologies and therapeutic methods was important if patients in Slovenia were to be provided with best treatment.

Cugelj meanwhile noted that the biggest problem for URI Soča at the moment was development of neurological rehabilitation, as they needed a new facility. Waiting lines are manageable, but they are long when it comes to treatment of chronic pain.

The public healthcare fund ZZZS has already approved a new programme and Cugelj expects that the waiting times in this field will be completely eliminated in a few years.

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