For many years, the management of the Pilsen Region has been striving for higher payments from health insurance companies for regional hospitals. However, there has never been a significant increase. Hospital losses have always been covered by the region. On average, it was around 250 million crowns a year. Why is that so?
This is due, among other things, to the fact that there is no hospital in Pilsen that would belong to the network of hospitals in the Pilsen region. FN Plzeň is a state-run hospital that provides a substantial amount of health care within the region, but also provides care that could be provided by smaller hospitals in the region.

When we look at the neighboring South Bohemian region, the České Budějovice hospital is part of the regional healthcare system and there is a system of division of care. Thanks to this, even small hospitals in the region can be economically self-sufficient. Hospitals have different rates set by insurance companies, which can lead to economic losses. The aim is therefore to ensure a higher volume of care, and thus streamline operations. The good news, however, is that the loss of hospitals, or SGEIs, has now decreased because payments for covid patients were high.

After boarding Václav Šimánek to head the University Hospital in Pilsen in 2014, there was talk of cooperation with regional hospitals, which was not entirely successful. University hospitals are still growing financially and regional hospitals are stagnating in budget.
Cooperation between hospitals should work, but this is difficult to achieve when routine care is centralized in a teaching hospital. We cannot blame the director, because he is simply defending his interest, but it is not ideal for other hospitals in the region. It is also complicated by the fact that the university hospital is paid much more by the health insurance companies for the same performance, which leads to market distortions. If all hospitals in the region had rates like the University Hospital Pilsen, they would be better off economically. But we must work with the situation we have, and even in this unfair market, regional hospitals must be competitive. We need to download more services, so we get more money for care.

How much will the region pay the hospitals in 2021?
The planned amount in 2021 was 200 million crowns and due to the covid situation it decreased by 50 million. This year’s plan is 160 million crowns and the goal is to get more care to hospitals, which we are doing with outpatient care. You just need to work on returning the clinics to the hospitals.

What will it mean for the patient to return the clinics to the hospitals?
Due to the fact that doctors in specialist outpatient clinics are aging and there is a risk of worsening the availability of this care, it is necessary to provide it within hospitals, as was the case during the former OÚNZ, ie district institutes of national health.

But you need a doctor for that.
Yes, you are right. For example, a young specialist doctor does not have the money to buy his outpatient clinic from a senior specialist, and we want to provide these doctors with conditions and perspective within hospitals. We will therefore focus on the offices of retired doctors who cannot find a successor, move ambulances to hospitals and try to provide this care.

Does this also apply to practitioners?
Yes. A general practitioner must return to the hospitals, who will ensure the personnel agenda of the hospital and at the same time will also work for the organizations of the Pilsen Region. It is about linking health and social care. In the middle of May, general practitioner’s offices and a cardiology outpatient clinic will open at the Domažlice Hospital. Further tenders are being prepared, thanks to which we will strive for new outpatient clinics in other regional hospitals as well.

There has also been talk for a long time about whether the region will take over the Sušice hospital. It was in town for the fall referendum. Are you planning to take it over?
The city of Sušice is bound by a referendum to provide active support to provide acute care in the Sušice Hospital. On April 20, the representatives of Sušice approved the concept of the hospital, which in my opinion is in conflict with this referendum. It follows from the concept that the ideal variant of the hospital’s operation is to take over the region, which has to correct all the ills of the Sušice Hospital. Even as a councilor of the town of Sušice, I am not sufficiently informed about the condition of the hospital and I am denied access to information by the hospital.

I see the advantage of the city hospital in the fact that there is another alternative within the region. When I was together with Václav Rada in the position of managing director of the Sušice Hospital, we got doctors there who did not want to work in regional hospitals. Thanks to the existence of a city-owned facility, we had a different option. Thanks to that, she is an intern at the Sušice Hospital. Doctors are very professional.

Isn’t it a conflict of interest when you are the Deputy Governor for Health and at the same time a councilor for Sušice?
No, I don’t see it that way, on the contrary, I see it as an advantage, because it gives me an overview of the need for care in the region. Previously, I was closely focused and only cared about the interest of the Sušice Hospital. As Deputy Minister for Health, I am taking steps towards financial support for the Sušice Hospital. I have already informed the mayor of Sušice. However, this is not to say that it is not possible to take over the hospital in the future. However, the new management of the region must get acquainted with how the Sušice Hospital is doing, especially in the area of ​​personnel. But now we intend to help financially. We have proposed ten million for this year, which has not succeeded in the entire history of cooperation between the hospital and the region. The money is to be used so that acute branches can be operated here, and thus the result of the local referendum can be fulfilled.

Ten million crowns? Is not it too little?
This amount is sufficient for the fact that inpatient care in the field of surgery is suspended at the Sušice Hospital. LDNka itself should have enough leeway to generate profit and help ensure other traffic.

So the municipal elections in the autumn have to decide on the future of the Sušice hospital?
Certainly, only choices. Most representatives in Sušice today think that it is easiest to get rid of the hospital. A close minority, which also includes former councilors for healthcare in the Pilsen region, Milena Stárková from the CSSD or Pirates, including me, says that the hospital can survive on its own, that it does not have to be unprofitable and that the unexpected appeal of me and Václav Rada from the position of executives September 14, 2020 was a step that damaged the hospital.

However, the question is whether the device can still be revived.
When Václav Rada and I took over the hospital from Penta, there was no internship or ICU, in short, no acute care. At that time, we had four months from insurance companies to open it, otherwise the hospital would have ended then. The only chance is probably after the election, and it will either work out or not.

There is talk of health care reform. Is there a chance that the current government will embark on it?
If health care reform is not done quickly, as experts point out, the whole system will collapse.