So far, the Institute for Tumors and the Children’s Hospital in Klaićeva Street have ended the year with negligible losses. Experts say that after the merger, costs in these hospitals will rise by about 30 percent.
writes Ivica Grčar
[email protected]
A reader contacted me warning about the misguided decisions regarding administrative rather than functional merging of hospitals. He states that in Zagreb, for example, the Institute for Tumors and the Children’s Hospital in Klaićeva Street, as so-called small hospitals, have been merged into the much larger Sisters of Mercy Hospital in Vinogradska Street. Until now, these two so-called small hospitals have reported negligible losses or ‘operated at a positive zero’, but after this merger, the reader argues, costs in these hospitals will rise by at least 30 percent by the end of the year.
A trick with the calculation In so-called small hospitals, regular meetings of departmental doctors would discuss how to keep costs under control. After department meetings, there would be meetings of department heads with the director. Will department heads from small hospitals now leave their departments for meetings at the large hospital? Can a director from Vinogradska know what exactly cannot be done without, and what might be possible to reduce costs in all smaller merged hospitals, as the dismissed directors of those small hospitals used to know? How will the director from Vinogradska decide what can be done without, for example, in the Children’s Hospital in Klaićeva Street, and what cannot be done in the treatment of sick children? The Ministry of Health claimed that this administrative merger of hospitals would save 300 million kuna per year, mostly on directors’ salaries. The reader asks who misled the Ministry of Health with that calculation. I inquired and found out that this calculation came from HZZO. HZZO simply calculated how many hospital directors and associates would be fewer after the merger and summed their annual gross salaries. However, it turned out that this calculation was completely wrong. Directors in all smaller hospitals did not sit in the directors’ offices, but continued to work as departmental doctors in the departments where they were heads before being appointed directors. This means that after they are no longer directors, only the amount of the so-called director’s allowance should be deducted from their gross salaries, while the salaries of department heads remain. Thus, instead of the expected savings, by the end of this year, we should expect a cost increase of up to 30 percent. And no one will be held accountable for this – just as no one has been held accountable for any failed health reform so far.
