Fighting corruption in healthcare is the obligation of each of us

Federal Minister of Health Rusmir Mesihović in an interview with the BH News Agency Patria talks about problems in the healthcare sector, the fight against corruption, and further activities to improve the healthcare system. Mesihović emphasized that the biggest problem is the limitation of financial resources for healthcare on one hand, and on the other, the massive prevalence of non-communicable diseases which are continuously increasing in Europe, and thus in BiH.

NAP: What are the main problems in the healthcare system in FBiH?

Mesihović: A problem specific to us is the strong decentralization of the healthcare system in FBiH, meaning divided responsibilities between FBiH and the cantons in healthcare, where cantons have broad, unique autonomy. Stronger centralization of healthcare in FBiH would lead, primarily, to greater equalization of patient rights in FBiH, equalization of healthcare worker rights, rationalization of healthcare costs, which is the basic prerequisite for system stability, but also centralization of responsibility. Precisely, the centralization of responsibility, meaning a clear system of accountability, is what I believe citizens expect, both in healthcare and in other segments of society.

I want to emphasize that despite all the problems and, frankly speaking, the limiting system in which healthcare operates, we have not, in the past period, reached a situation where we have reduced either the scope of services provided or the scope of patient rights. In some segments, they have even been expanded.

NAP: The essential drug list is a persistent problem, as is the shortage of certain drugs, etc. What is being done in this segment of the healthcare system?

Mesihović: A perception is being created in the public about numerous problems related to the essential drug list; however, I want to point out that we have made significant progress in this segment and have regulated many things. In 2011, we found an essential list that had not been changed for three years, meaning prices had not been changed for four years, although the practice is for revisions to be made annually. On two occasions in the past three years, the essential list has been expanded and its quality improved, and at the same time, we have managed to reduce drug prices on the list, thereby achieving savings. Also, in February of this year, after 16 years of waiting, the by-law on treatment abroad came into effect, we are intensively working on the development of transplant medicine, and the project of computerizing the healthcare system is progressing and beginning to yield its first results.

NAP: The Director of the Health Insurance Fund of Canton Sarajevo, Kenan Crnkić, announced a fight against corruption in healthcare. How do you view this, and do you support this fight?

Mesihović: The fight against corruption is the obligation of each of us. We within the healthcare system are a service to citizens and should work together every day to make that service more efficient and of higher quality. This certainly includes fighting corruption, but in a way that precisely emphasizes that corruption is a characteristic of an individual, not a profession.

NAP: How difficult is it to regulate the healthcare system given that we do not have a state ministry of health?

Mesihović: I have already spoken about decentralization in the Federation of BiH, which is the cause of a certain fragmentation of the system, and thus different patient rights. All of this, of course, also applies to the entire country. Personally, as a healthcare worker, a citizen, and ultimately as a federal minister, I support the establishment of a state ministry of health, because it is the basic prerequisite for the real equalization of patient rights and a more efficient and just healthcare system.