Dr. Stevanović SDP candidate: My goal is to stop political strongmen's pressure on healthcare

Prim.dr. Dragan Stevanović, a respected internist and long-time employee of the General Hospital „Prim.dr. Abdulah Nakaš“ in Sarajevo, who was among the first to raise his voice to stop the closure of the General Hospital, reveals his motives for running for councilor in the Centar Municipality in the upcoming local elections in an interview with the Patria news agency.

Dr. Stevanović is on the SDP list, and the sole and exclusive motive for this act is „to try to help advance medicine and protect healthcare workers“.

PATRIA: You are one of the few professional individuals who first raised their voice and mobilized the public to prevent the closure of the General Hospital „Abdulah Nakaš“, which was the plan of Dr. Sebija Izetbegović, director of UKCS and former director of the General Hospital. Now, from this perspective, has it really been stopped and what is happening now at the General Hospital?

STEVANOVIĆ: According to statements by the highest officials in the Sarajevo Canton, the General Hospital „Prim.dr Abdulah Nakaš“ as a public healthcare institution of cantonal importance has its clearly defined place in the healthcare system of the Sarajevo Canton and as such is not planned for abolition or merger with other healthcare institutions. This is the official stance. However, I must remind you that all activities related to the closure of the General Hospital in January this year took place in alienated centers of political power, quietly and without public insight, and I believe that in those centers of power this idea has not been abandoned.

Only thanks to fortunate circumstances that we came into possession of documents by which the closure of the General Hospital had practically already been completed, which was supposed to be formally formalized through government institutions (I still have those documents in a safe place) and that we mobilized the professional and other public, as well as the media, this process was stopped.

Due to the lack of clear, disclosed, and well-thought-out positions on the so-called „Reform of the healthcare system in the Sarajevo Canton and beyond“, informal pressure is still being exerted on the General Hospital in various ways, making its work and daily operations difficult.

Regarding the conditions under which the General Hospital currently operates, I ask you to discuss more broadly with the current management, as they are responsible for providing you with the most concrete information.

I can only assess that in the coming period, depending of course on the results of the local elections in the Sarajevo Canton, pressure on the General Hospital's work and efforts to shut it down will continue to a greater or lesser extent, and the final outcome will primarily depend on the influence of the general public.

PATRIA: How do you comment on the fact that Dr. Izetbegović boasted about reducing the number of employees, and looking at the figure of 146 who are no longer at UKCS, a large number are healthcare workers. Is there really a surplus of doctors and medical staff in healthcare?

STEVANOVIĆ: Unfortunately, daily politics has widely entered everyday life in public healthcare institutions, and many activities are used for daily political promotion. In a situation where there are no clear and disclosed visions and plans for the reconstruction of the healthcare system in the Sarajevo Canton, depending on daily political needs and political marketing, such announcements also occur.

In the Sarajevo Canton, there is certainly a shortage of doctors, especially highly skilled narrow specialists; in my assessment, the quality and scope of healthcare we provide to citizens of the Canton is decreasing, and the outflow of the most skilled is evident, both into private practice and abroad.

In part, the departure of doctors from UKC Sarajevo is also a result of the strict application of the existing Rulebook on supplementary work of doctors, which is absolutely fine because it is obvious that this Rulebook has not been applied at UKCS until now. I would not comment on other reasons at this moment.

This trend will certainly continue, especially if in the coming period the already poor standard of healthcare workers in public healthcare institutions is further degraded, for which there are intentions in society. It is a matter for the professional bodies of UKC in Sarajevo, but it is also in the interest of the wider public in the Canton to clearly disclose the plan for reconstruction and reorganization of UKC Sarajevo, the directions of its future development, and only in that context is it possible to comment on your question.

For now, from the sidelines, I see that the only goal is to save as much money as possible, whereby it seems to me that the volume and number of services at UKC in Sarajevo are significantly decreasing, and part of them is being transferred to other healthcare institutions without substantive agreements and adequate staffing and material strengthening of those institutions. This is obviously short-term political marketing that may bring short-term benefits to its authors, but in the long term it will devastate the healthcare system in the Canton.

PATRIA: The departure of healthcare workers from BiH is evident. Is it possible to stop this trend?

STEVANOVIĆ: The trend of healthcare workers leaving BiH is unstoppable. It is partly a reflection of the migration of skilled workers from poorer to richer countries, which is a global trend. The World Health Organization has warned about this problem and that there will generally be a shortage of healthcare workers in the world, especially doctors, which will most affect developing and poorer countries.

A major problem in our country is the poor financial position of healthcare workers, excessive incompetent political interference in the healthcare system, as well as the lack of clear development visions.

I expect that after the acceptance of our application for EU membership, within further activities, exceptional importance will be given to this segment, which implies a better financial position for healthcare workers and a more thoughtful development of the healthcare system.

Some say, let doctors leave, we have young forces. I must say that the education of a top doctor is extremely expensive and time-consuming; it involves enormous effort by the doctor himself and his knowledge, daily learning, but also growing and maturing as a specialist doctor alongside experienced and proven doctors, thereby gaining personal experience and the ability to make difficult decisions in critical moments, which not every doctor can do if they only apply established procedures and protocols.

If I am a good doctor, it is not only due to my persistent work and learning, but also the fact that I worked and grew up for many years alongside such greats as prim.dr. Jaroslav Suđi, prim.dr. Hajro Bašić and prof.dr. Mirko Grujić and many others.

PATRIA: You are on the SDP list for councilor of the Centar Municipality. Is your entry into politics a form of struggle for your profession - medicine?

STEVANOVIĆ: Yes! Politics is not my commitment nor will it ever be; it is only medicine, and I hope that even when I retire, I will continue to practice medicine in an appropriate manner. Unfortunately, politics deals with medicine, rarely successfully and often without respecting even the minimum professional opinions of professional bodies from the medical profession and other medical professions, sometimes even abusing those professional bodies for daily political purposes.

Now we are aware of such pressures on the Medical Chamber of the Sarajevo Canton, which at one point tried, based on available resources, fully aware of all its organizational and other weaknesses, to be a partner to the current political authorities in finding the best solutions for organizing the healthcare system.

Pressures and marginalization of professional medical organizations and doctors in general in making major decisions in the healthcare system have been almost always present in the last 20 years, regardless of which political option was in power at the time. Now they are most pronounced because political power is concentrated in the hands of a very narrow circle of people. My only goal is to stop this process.

Modifying the healthcare system according to EU standards

PATRIA: What is the state of healthcare in the Sarajevo Canton and BiH? What can be done and what are the necessary steps to improve the situation?

STEVANOVIĆ: I think I have already partly answered this question, but I must emphasize that the healthcare system in BiH is absolutely fragmented, burdened by all the problems that the entire country faces, developing anachronically and depending on the balance of political power. Without thoughtful and clear analyses of the current situation (which must take into account demographic data, data on staff structure, data on morbidity and mortality of the population in BiH, as well as some geographical parameters), development directions cannot be projected.

I reiterate that the only salvation in this agony that has lasted about 20 years is probably the acceptance of our application for EU membership and the modification of the healthcare system according to EU standards. This cannot be done by various informal political groups, but by highly professional institutions dealing with this work in healthcare, with the participation of the widest professional public.