Field-check: are the newly opened hospitals operational?
In recent months, a new hospital has been opened by President Mikheil Saakashvili and respective Ministers of Labor, Health and Social Affairs almost every week, extensively covered by national TV. These newly built hospitals are the result of the 160-170 hospitals program, that has focused on the transition of hospital ownership from the government to private operators.
For several months, we have heard rumors about some of the new hospitals, which are all owned by insurance companies, allegedly not being fully constructed and operational. So, we wanted to find out if these rumors were substantiated.
To examine if the rumours were true, we worked with local volunteers to take a closer look at hospitals across Georgia. Our volunteers focused on examining the status of the hospitals - seeking to find out if the construction of the hospitals had been finished and if they seemed to be fully operational. In this field check, we did not evaluate the quality or affordability of services and the position of the medical staff and patients. These subjects are discussed in other blogs, which can be found here and here.
For our sample, we went through press releases issued by the Presidential Administration in 2012 that covered an opening of a new hospital or clinic by the presiden. We then visited 15 out of the 25 hospitals we found mentioned there.
We found that in most cases, the hospitals we visited were finished or about to be finished and fully equipped with what seemed to be modern medical equipment.
Four of the examined hospitals had several rooms or floors that were not fully renovated (yet), but we found that all of them were equipped well enough to provide treatment to patients.
However, our volunteers found in several instances that the hosptial’s managers sometimes told a different story than the medical staff.
Judging by their outside appearance, the hospitals all look nice and well-constructed from the outside.
|Chiatura Medical Center, Imereti (Irao)||Khoni Medical Center, Imereti (AldagiBCI)|
Our volunteers asked hospital staff if they could see the inside of the hospitals. In many cases, this was possible; in some locations, they were not granted access to all floors and had to rely on information provided by security guards, who did not always possess all the information about infrastructure of a medical center, or sometimes simply did not want to cooperate.
|Mtskheta Medical Center, Mtskheta-Mtianeti (GPIHolding)||Medical Center, Tbilisi University|
|Zestaponi Medical Center, Imereti (Irao)||Tskaltubo Medical Center, (AldagiBCI)||Shuakhevi Medical Center, Adjara (ImediL)|
What will happen in seven years?
As a result of the total privatization of the hospital sector, a large share of the newly opened hospitals are owned by the insurance companies. A worrisome clause within the contracts between the investors and the government is that the new owners are required to maintain the function of a medical institutions for only seven years.
In earlier reports, we have highlighted our concerns that after the end of this period, companies might change the profile of a hospital in order to maximize their profits, which could result in insufficient healthcare coverage for locals.
The majority of private hospital operators enterprises, pharmaceutical and insurance companies that have limited experience in the field of health care provision, and whose main goal is not to keep the hospitals affordable and operational, but to maximize their profit. Given the strong horizontal integration (meaning that an insurance company is often also controlling a hospital and the sale or import of pharmaceuticals) and the limited regulation in the healthcare sector, this is likely to affect the accessibility and the quality of treatment patients receive.
The health care sector in Georgia faces many challenges and the new policy seems to create risks and challenges in the long term. However, judging by the selected sights we visited, we can say that rumors about potemkin hospitals that were only opened for TV cameras have seen to be true and the hospitals appear to be constructed and well equipped, many problems remain with regard to sustainability, accessibility and quality.
|Keda Medical Center, Adjara (ImediL)||Chakvi Medical Center (ImediL)|