Etudes par pays volume 2, PDF, 346 p., 1,4 Mo - Femise
Etudes par pays volume 2, PDF, 346 p., 1,4 Mo - Femise 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 FONDAZIONE CENSIS 141
11873_2002 Study D2: Poverty, Informal Sector, Health and Labour activities and the effective organization and management of all health care units within their jurisdiction. All health care units operate as decentralized and independent units of the PeSYs they belong to (Ministry of Health and Welfare Report). Specific actions in this context include the ‘’Asterias Programme’’, which promotes networking between local authorities in order to strengthen services to citizens and the ‘’Hippocrates Programme’’ that improves the access of small islands to health care services (EC, 2002, p. 66). Another important innovation of this legislation is the instituted possibility of physicians to receive patients in hospitals after regular hours in the afternoon, charging a predetermined fee that is allocated to the hospital and those involved in the after hours practice. At no other circumstances may the physicians of the NHS exercise private practice in or out of the hospital. According to a recent statement of the undersecretary of the Ministry of Health and Welfare, the main policy objective for 2003 is prevention, subscribing to the philosophy that it is better to have fewer patients in hospitals rather than more hospital beds. A ‘’smoke free environment everywhere’’ and a warning to people, especially the young generation, about the harmful effects of modern dietic habits and alcohol, as well as the benefits of more exercise are the primary concern. Building new hospitals in various parts of the country and staffing them with the appropriate medical and nursing personnel are also in the agenda of this year’s activities. FONDAZIONE CENSIS 142
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11873_2002 Study D2: Poverty, Informal Sector, Health and Labour<br />
activities and the effective organization and management of all health care<br />
units within their jurisdiction. All health care units operate as decentralized<br />
and independent units of the PeSYs they belong to (Ministry of Health and<br />
Welfare Report). Specific actions in this context include the ‘’Asterias<br />
Programme’’, which promotes networking between local authorities in order<br />
to strengthen services to citizens and the ‘’Hippocrates Programme’’ that<br />
improves the access of small islands to health care services (EC, 2002, p.<br />
66). Another important innovation of this legislation is the instituted<br />
possibility of physicians to receive patients in hospitals after regular hours<br />
in the afternoon, charging a predetermined fee that is allocated to the<br />
hospital and those involved in the after hours practice. At no other<br />
circumstances may the physicians of the NHS exercise private practice in or<br />
out of the hospital.<br />
According to a recent statement of the undersecretary of the Ministry of<br />
Health and Welfare, the main policy objective for 2003 is prevention,<br />
subscribing to the philosophy that it is better to have fewer patients in<br />
hospitals rather than more hospital beds. A ‘’smoke free environment<br />
everywhere’’ and a warning to people, especially the young generation,<br />
about the harmful effects of modern dietic habits and alcohol, as well as the<br />
benefits of more exercise are the primary concern. Building new hospitals in<br />
various <strong>par</strong>ts of the country and staffing them with the appropriate medical<br />
and nursing personnel are also in the agenda of this year’s activities.<br />
FONDAZIONE CENSIS<br />
142