View from Estonia: Urmas Sule

Hospital Healthcare Europe and Urmas Sule

28 April 2023

Dr. Urmas Sule, HOPE president, particulars how Estonia has weathered the numerous challenges of 2022 and his hopes and expectations for 2023.

What have been your key targets and successes for 2022 in Estonia, and what have been the principle drivers for these?

In 2022, we moved from Covid-19 to an power disaster and the uncertainty of warfare. Sadly, Covid continues to be very a lot current. Managing one disaster after one other, and generally doing it concurrently, proves a problem for sustaining an affordable steadiness of healthcare companies for Covid and non-Covid sufferers. For my part, we’ve got succeeded in guarding the sufferers’ pursuits and security one of the simplest ways.

Had been there any particular facilitators that made these targets extra achievable?

Throughout these tough instances, we noticed how necessary it was to have clean cooperation between hospitals and healthcare suppliers. An efficient distribution of duties and obligations was developed to guard sufferers’ pursuits in the absolute best means.

We as hospital managers cooperate properly with the Well being Board, the Well being Insurance coverage Fund and the Authorities of Estonia. Steady negotiations with the Authorities and the Well being Insurance coverage Fund about ample financing of companies and assist for the well being sector have been mandatory and proved very fruitful.

Our partnership with the Estonian Medical Affiliation, the Medical School of the College and the Well being Care Schools has been a giant assist in involving medical and nursing college students.

Our primary focus for 2022 was, and can at all times be, to guard our healthcare employees from burnout. This isn’t a straightforward job and desires good cooperation between all companions.

What did you understand as the principle boundaries to reaching these objectives?

Much like different European nations, Estonia additionally faces the issue of a scarcity of healthcare employees. Healthcare specialists are working for a number of employers. That is good for information change, however is tough to organise in a pandemic scenario. Shortages have been an issue in Estonia for a very long time, not simply throughout Covid. The pandemic intensified the issue. Guaranteeing an affordable division of labour and obligations between hospitals and different healthcare establishments has been a problem.

However there are additionally different boundaries, too. Political priorities have shifted from fixing the healthcare disaster to an power disaster and the results of warfare. The first focus has been enhancing readiness for emergencies in all areas. Serving to Ukrainian refugees, offering them with social safety and healthcare companies is without doubt one of the necessary and ongoing challenges.

How did you anticipate overcoming any of those potential boundaries?

The Estonian Authorities created a brand new disaster employees construction throughout Covid. This construction was tailored for the healthcare sector along with the Estonian Hospitals Affiliation community. We have now collaborated with the Estonian Well being Insurance coverage Fund to ensure the absolute best availability of healthcare companies to all sufferers. This has been doable as a result of prudent and versatile planning and financing of companies.

To encourage workers, we’ve got negotiated collective agreements in two-year increments. This has been an excellent alternative to listen to the wants and expectations of healthcare employees so we are able to do our greatest to attempt to meet these expectations and enhance working situations. Negotiations for the approaching years are presently underway, and we are going to make all efforts to discover a balanced settlement and retain the efficient and trusting relationships amongst our social companions.

What measures did you employ to evaluate whether or not these targets have been achieved?

The Well being Insurance coverage Fund measures the necessity for well being companies to minimize the therapy deficit. In collaboration, we’ve got negotiated and agreed on the measures to scale back therapy deficits for non-Covid sufferers. We deliberate and launched new companies to arrange for Ukrainian refugees coming into the healthcare system. However the largest problem for hospitals is the speedy and steady rising prices of power and different companies.

We have now monitored hospitals’ workloads and cooperated to make sure finest use of all sources – particularly the healthcare workforce – to create a versatile system that’s ready for brand new challenges.

How did these result in enhancements in affected person care?

We have now seen a speedy progress of the event and use of e-services and distant companies and consultations within the healthcare sector in Estonia. There was nice growth throughout many specialities – psychiatry, for instance – through the pandemic. This has been doable as a result of collaboration between hospitals, different healthcare suppliers and the Well being Insurance coverage Fund.

Due to the well being disaster, we’ve got elevated an infection management capability and information, not solely within the healthcare sector, but additionally in society. A nationwide vaccination marketing campaign has additionally alleviated the results of Covid and the burden on the healthcare system.

What are the objectives and challenges in Estonia for 2023, and are these contingent on the 2022 targets?

We’re negotiating the 2023/24 collective settlement with the Medical Affiliation, Nurses Affiliation and different commerce unions. It’s a problem to realize a steadiness between affordable salaries and basic pricing rules that embrace all enter costs and assure ample availability of affected person companies.

On the identical time, our healthcare system has to realize the absolute best flexibility to be ready for any doable crises. This looks as if an countless and boundless job!