Etudes par pays volume 2, PDF, 346 p., 1,4 Mo - Femise

11873_2002 Study D2: Poverty, Informal Sector, Health and Labour
The new legislation made an effort for a more competitive market in health
care services and a better control of public expenditure, limiting the
responsibility of the state. This resulted in a greater share of households in
health care expenditure. The new legislation introduced, in parallel with the
‘full and exclusive’ employment of the previous regime, the practice of
‘part-time employment’ of physicians, allowing them in compensation to
have also a private practice. Every physician of the NHS had, in effect, the
option of either of the two possibilities. Due to the much lower wages of the
part-time alternative, the response of physicians to it was very small.
Furthermore, the new law allowed, under certain qualitative conditions, the
operation of private clinics and hospitals.
After the socialist government returned to power anew, legislation (L.
2194/1994) was passed to restore the NHS to its original philosophy,
abolishing, in effect, the 1992 law, but with the ambition of setting the NHS
to a new operational framework. Subsequently, with the purpose of fixing
some of the malfunctioning of the system, after consideration of the findings
of a Commission of International Experts, a new legislation (L. 2519/1997)
was voted, in 1997. This law established some Organs for the protection of
the rights of hospital patients; emphasized the preventive health care and the
need for more and better information, and it provided for the development
of facilities for the care of children’s health. Attention was also given to the
continuous training of the health personnel and the cooperation of public
health services with the welfare and social protection services. The new
legislation further provided for regional workshops of public health and a
better finance management and control of hospitals and other medical units.
In this framework, physicians of general practice were hired in clinics and
Health Centers of primary health care, while as an innovative initiative,
networks of primary health care were connected with the NHS hospitals.
Finally, the National Organization of Drugs prepared an exclusive list of
medicines that could be financed by the various health insurance funds, on
behalf of their beneficiaries.
One step further, new legislation (L. 2889/2001) followed, in 2001, with the
main objective of changing the organizational structure and management of
the NHS. Administrative managers were appointed in all public hospitals,
while health care facilities were further decentralized, by creating a
‘Regional Health System’ (PeSYs). The purpose was to create unified and
comprehensive quality regional services in all stages of health care,
including medical care at home. The PeSYs, 17 in number, have, according
to the law, extensive responsibilities for the coordination of regional
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