Deputy Health Minister Valeri Kvaratskhelia talks about the details of Bernard Kouchner’s visit to Georgia and meeting with the board members.
On November 19-22, the Georgian Health Ministry hosted Bernard Kouchner, the chairperson of Global Alliance supervisory board. As part of the meeting, the board members and the Health Ministry officials held a meeting behind closed doors, where Georgian officials received recommendations around the ongoing reforms and future plans.
– The Georgian Health Ministry concluded an agreement with Global Alliance international consulting company several months ago. The company had to fulfill certain obligations, including they were to submit intermediary documents in late October in the directions we have jointly worked on. They introduced two bills for universal healthcare system and DRG payment system that mainly refers to the pharmacy segment. We were given a 8-day period for exploring the documents and approving this interim document. As to Bernard Kouchner’s visit, it was successful and useful. Mr. Bernard Kouchner is a famous and influential person in the world politics and the world health system. He has led the Health Ministry of France three times under the ruling of various political forces and this is a genuinely unprecedented case. Moreover, Mr. Kouchner has founded the Doctors without Borders organization and its members are first to enter all hot spots worldwide. Amid the Ebola virus spread, the organization was the first to enter the region and only after that, the
World Health Organization and other influential organizations appeared in the region, to provide active job in Georgia, especially in the field of tuberculosis. They have rendered huge assistance to us and plan to continue cooperation with us in the future too.
– Bernard Kouchner has transmitted many advises and recommendations to the Georgian Health Ministry. What is the most important message?
– Bernard Kouchner has left very good and clear messages and we have marked them as a certain action plan.
One of the main messages says that even a world-level consultant cannot help us if we do not start doing real affairs in our country.
Recommendations that are given by experts are not of obligatory character for us, because this group is a consulting body and we should only take into account these recommendations and advises. They have given weighty recommendations on the pharmacy law, but I cannot talk about it, as the law should be revised and refined after a long job. We will forward these recommendations to pharmaceutical associations, nongovernmental organizations and all interested bodies and groups. We will accept their consideration and then we will hold a big meeting regarding this issue. When we started working, we were meeting everybody and asking to join the process. We are ready to receive considerations, remarks and so on.
– The Health Ministry is actively carrying out the primary healthcare system reformation project. What recommendations have you received in this direction from the Alliance representatives? Does the Georgian Health System follow the correct way?
We always repeat that the universal healthcare program is a unique one, but we also realize and we have received recommendations that we should make this program cost-effective.
The job performed by the Global Alliance group of advisors will enable us to make our universal healthcare system cost-effective. This is of crucial importance for our country.
Our opponents stage criticism that all citizens should not have an equal access to the same services and we should introduce the concept of differentiated groups, but our program is called a universal one and this signifies it is to serve all citizens of Georgia. At the same time, this program does not restrict anybody to enjoy services of a private insurance company. For example, before my appointment as a Deputy Health Minister, I was insured at a private insurance company and I have continued this insurance policy. I have saved a small amount in the state budget. It is difficult to set borderlines here. There is a category of our citizens who are not included in the category of socially vulnerable people, but they cannot afford taking cardio surgical operation costs anyway, because this operation costs about 15 000 GEL.
Only 1% of Georgian citizen can afford taking similar costs. This is a direct investment. We grow salaries to doctors and they pay taxes. We have constructed many clinics, purchased urgent medical assistance vehicles – all these steps make direct investments in the economy.
We spend 2.1% of GDP on healthcare programs, while all civilized countries spend 6-7%.
– The primary health system reformation is considered an important project of the Health Ministry. What innovations are planned in this direction?
– We are working on the primary health system reformation very seriously. In about 15 days we will have determined specific places for arranging primary health assistance facilities. The advancement of this chain will enable us to further cut the expenditures. Today, our citizens have to visit inpatient clinics for even taking blood analysis, where service tariffs are quite high. The primary health assistance facilities will set far lower tariffs. For example, in England the health system is mainly focused on the primary healthcare system, as a cornerstone of the whole healthcare system.
We will also set accents on the primary healthcare chain.Our objective is to arrange second-level inpatient clinics in regions.
We are constructing a similar clinic in Zugdidi. Another one will be constructed in Kutaisi. In the near future, we will determine the winner in the tender for rehabilitating three major hospitals in Tbilisi – infectious, oncology and Republican Hospitals. Tbilisi-based healthcare facilities will mainly serve heavy patients, while all other categories will be treated on regional level. This project will enable us to considerably cut the expenditures. All these plans represent the part of our efforts and job. Naturally, Mr. Bernard Kouchner assists us in implementing all these plans. He provides intense consultations and gives recommendations. We keep permanent contact with him and he is ready to provide competent answers to our questions.