The Slovakian parliament voted to delay a reform that would cap waiting times for hundreds of medical procedures, as the state did not prepare the necessary mechanisms – making the planned January 1 2024 start date unfeasible.

Waiting periods for appointments with specialised doctors or surgical procedures in Slovakia can exceed a year, with months required for an appointment for necessary examinations. However, a lack of data has impeded the pilot program’s implementation, making the launch of the new system impossible, according to the Slovakian health minister.

Establishing waiting time ceilings

The law guarantees maximum waiting times for patients ranging from 7 to 365 days for almost 700 procedures carried out in hospitals. For example, pancreatic surgeries would have to be performed under 30 days, kidney biopsy within 60 days, hernia intervention in less than 120 days, or knee and hip endoprosthesis within 365 days.

The waiting times serve as ceilings; patients can receive the necessary care sooner.

If the established waiting time is not met, the health insurance companies will be required to ensure and cover the healthcare service with a non-contracted provider. In case it cannot be provided in Slovakia in a timely manner, the health insurance companies will have to cover the costs of the patient’s care abroad.

The main issue lies in the absence of data upon which the waiting times could be accurately documented and ensured.

Slovakia’s Health Minister Zuzana Dolinková proposed to move the January 1, 2024, start date by a year.

“The health insurance companies have assured me that we do not have the needed data,” Dolinková said in a political debate on the television programme “O päť minút dvanásť”.

Dôvera health insurance company PR specialist Matej Štepianský told Euractiv: “Originally, the waiting list system was supposed to be piloted and data collected in 2023. The pilot programme was not implemented this year, so the waiting list system is unprepared, and the January 1, 2024, start is unfeasible.”

The majority deemed deferral necessary

The parliament approved Dolinková’s proposal to put off the law with the support of many politicians from the opposition.

“In Bratislava, you will get an appointment with a rheumatologist for the year 2025. A woman with a lump in her breast will get a mammogram in five months,” said MP and doctor Tomáš Szalay during his parliamentary address.

Despite the inaccessibility of many healthcare procedures, Szalay supported Dolinková’s postponement proposal, blaming the law’s current unrealizability on the previous health ministers from Movement Slovakia (formerly Ordinary People and Independent Personalities).

Aside from the health insurance companies and many MPs, the Association for the Protection of Patients’ Rights supports the deferral in their statement: “Clear criteria are missing, e.g., who will manage the waiting time registry, who will collect and evaluate data, or whether there will be a pilot project that would identify the shortcomings. The delay is necessary to set up the system and give the health insurance companies and healthcare providers time to prepare.”

Ex-minister Krajčí opposed the proposal in minority

The strongest opposer of the deferral was Marek Krajčí, former health minister from Movement Slovakia. As health minister, he was the one who incorporated guaranteed maximum waiting times into legislation.

“We find the argument that the system is unprepared to implement this fundamental patient right to be superficial,” ex-minister Krajčí told Euractiv. “The law was approved in 2021 with a pre-agreed deferment of its validity to January 1, 2024, to allow time for necessary measures.”

In his response, the ex-minister did not address the non-existent pilot programme or the absence of data but rather focused on what could have been approved: “State cardiology institutes maintain legally prescribed waiting lists and oncology institutes routinely schedule patients for their surgeries,” Krajčí continued.

“Our cardiology institutes have sufficient capacities to increase the necessary number of procedures. The Minister could have introduced the maximum waiting times at least for selected cardiac and oncological surgeries.”

Krajčí concluded: “With this proposal, the government will cause many preventable deaths next year that could have been avoided if the law had been in effect since the beginning of the year.”

The President signed the deferral into effect

Movement Slovakia appealed to President Čaputová to not sign the amendment into practice.

The President considers the delay justified and signed it into effect since the Health ministry, hospitals, health insurance companies, and many experts deem the January start unfeasible.

Currently, in some cases, due to the backlog of surgeries caused by the pandemic, patients may experience delays for certain surgical interventions that exceed 12 months. This postponement should provide additional time to catch up, while simultaneously alleviating some pressure on the healthcare providers and health insurance companies to prepare the maximum waiting times system for 2025.

[By Filip Áč, Edited by Vasiliki Angouridi | Euractiv.com]

Read more with Euractiv