GPs: State Responsible for Disorder in GP System
On April 26, representatives of the Association of Family Doctors met with Minister of Social Affairs Hanno Pevkur to discuss, once again, the proposals for optimizing primary medical care that were made already in 2009.
The state has not kept its promise to reform the GP system during the past two years and the GPs - commonly referred to as Family Doctors in Estonia - highlighted the shortcomings of the health care system for the Minister.
For years, and with little result, GPs have been attempting to draw attention to the structural problems within the health care system that they find to be detrimental to the quality of medical care. A set of eight proposals for reforms was first presented to the Ministry by the Estonian Association of Family Doctors on December 30, 2009. Despite pledges to the contrary, only one proposal involving the reorganization of the medical certificates system has been implemented so far.
At the meeting, Pevkur presented his view of the steps to be taken and the deadlines for them, giving hope that reforms would be implemented in the near future to free GPs from offering non-medical services, such as providing disability-related medical information and double reporting on the national level.
The GPs were also promised extra funding for hiring nurses, that capitation fees would be differentiated to a greater extent based on the individual practice lists and the quality of the services provided, and that young family doctors starting out in rural areas would receive seed capital and that their diagnostic possibilities would be improved.
The representatives of GPs are particularly concerned about the decline in the quality of medical care, which has largely been caused by the system's lack of organization and resources. Due to the growing sense of disorder in health care, the GP system is no longer able to meet its goals, they find.
The Estonian Association of Family Doctors has, on its own initiative, established and enforced a set of quality standards for GPs, and has set raising awareness among decisionmakers of the issues present in the health care system as one of its main goals.
International experts from WHO and OECD have also recommended in their reports that Estonia increase attention to primary medical care in order to improve and optimize the health care system.
Sigrid Maasen
