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Chapter 6 | The impact of the crisis on the health system and health in Latvia
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Appendix 6.1
Major crisis related events and changes in the health system in
Latvia, 2009–2012
Date
Event/action
2009 Discontinuation of the “Development Programme of Out-patient and In-patient
Health Care Providers” because of the economic crisis
Consolidation of state functions into fewer institutions: closing down of the
Public Health Agency, the State Centre of Medical Professional Education
and the State Agency of Health Statistics and Medical Technologies; creation
of the Centre of Health Economics to replace the State Medicines Pricing
and Reimbursement Agency; closing down of the State Compulsory Health
Insurance Agency and assigning its functions to three institutions: the Health
Payment Centre, Centre of Health Economics and the Health Inspectorate
Reduction in the number of staff at the Ministry of Health and its agencies
Rapid reduction in the number of hospitals providing statutory services from
72 to 43 (some of the hospital closures had been planned for a long time)
Creation of the state Emergency Medical Service, incorporating the State
Centre of Emergency and Disaster Medicine, thus centralizing and rationalizing
the provision of emergency medical assistance in the country
Approval of the Safety Net Strategy by the Cabinet of Ministers (funding
provided by the World Bank)
2010 Law “On the Rights of Patients”
2011 Cabinet approval of the Public Health Strategy 2011–2017
Cabinet approval of the “Regulation of the National Health Service”: creation of
the NHS as the result of merging the Health Promotion Centre with the Centre
of Health Economics
2011/2012 Reform of the pharmaceutical reference pricing system
2012 Creation of the Centre for Disease Prevention and Control as the new national
institute of public health
Political decision to introduce the Nord-DRG system for payment of hospitals:
preparatory work for implementation (piloting started in 2013)
Reform of Regulations No. 899 (“On the Reimbursement of Expenditures for
Medicinal Products and Medicinal Devices”), introducing 50% reimbursement
for all prescription medicines (beyond those listed in the positive list) for children
up to 24 months and 25% for all pregnant women (including up to 42 days
after childbirth)
Note: Nord-DRG: Nordic Diagnosis-related Group scheme.