KS Government Must Stand By General Hospital and Hundreds of Patients Who Depend On It

By: A. Vrabac

On the same day that the acting director of the General Hospital “Prim.dr. Abdulah Nakaš” Ismet Gavrankapetanović sent a letter, or rather an appeal for help, to the KS Government, KS Assembly, Health Insurance Fund, KS Crisis Staff, Management and Supervisory Board, the corridors in front of the doctor's offices were full of patients. 

This has been the situation for almost two months now, since the General Hospital was designated to provide all secondary-level healthcare services in the “patient pathway” seven days a week. This is a scope of services far greater than the hospital has ever provided, and for which no additional financial resources have been allocated, leading the hospital to financial collapse in the midst of the coronavirus pandemic, and on the eve of the flu season and the expected increase in the number of infected people.

“Since 17.07.2020, in accordance with the binding document of the KS Ministry of Health, the General Hospital has engaged its maximum capacity and significantly increased the number of services it regularly provided. Additional premises, materials, medicines, medical and non-medical staff have been engaged due to the increased number of healthcare services. In such conditions, the financial resources and medicines that were planned for one month of operation under normal conditions were consumed within 7 days. Many more doctors have been engaged in on-call duties and standby, which has necessitated additional funding,” the letter states.  

The cantonal authorities have been asked to provide financial support to the General Hospital no later than September 30, as the hospital management has no right nor is prepared to assume obligations towards employees and suppliers without available financial resources.

There has been no response yet to Director Gavrankapetanović's letter. Gavrankapetanović also warns that the hospital has debts to suppliers incurred before the appointment of the new management. As early as mid-July (he took office on July 1), he requested an audit of the hospital's financial plan, but this has not happened.

“It is necessary to determine the actual financial situation as of 30.06.2020, which appears to be alarming according to current estimates. It is essential to ensure a comprehensive audit of operations – financial, legal, IT – in order to establish a baseline and ensure a “clean start” from 01.07.2020. We believe there is no greater priority for the citizens of Sarajevo at this moment,” the letter states, calling for concrete measures to stabilize the financial situation.

According to information available to Patria, the General Hospital's financial deficit is around 4 million KM. Considering the new operating regime that requires maximum engagement of both employees and material resources, and without adequate support, it is certain that the General Hospital could collapse.

Although the Crisis Staff of the Federal Ministry of Health has constantly emphasized that no medical service has been suspended, patients have most acutely felt how the healthcare system has closed down. Surgeries were canceled, appointments and check-ups postponed, and it was impossible to get an examination for months, with chronic patients and those needing surgery suffering the most. Many patients did not live to see the reopening of hospitals, especially those who were not emergencies. The KCUS (Clinical Center University of Sarajevo) declared itself a tertiary-level healthcare institution in the midst of the pandemic, only to resume secondary-level surgeries from August 17. Although the General Hospital has been admitting all patients who would normally be divided between these two hospitals, KCUS's funds were not reduced, while the General Hospital's were not increased.

Despite the workload that has increased manifold for the General Hospital, the KS Government had the idea for this hospital to also take over the management of the temporary isolation facility at Bjelave, where coronavirus-infected patients would be treated. Only thanks to the voice of expertise, which prevailed in this case, was the disastrous idea of treating coronavirus patients in non-hospital settings abandoned. The reconstruction of the former Garrison clinic next to the General Hospital building has begun, where an isolation facility will be established and managed by the General Hospital.

Director Gavrankapetanović has warned all responsible parties in the chain of command about the alarming situation and the consequences that could arise if additional material resources are not provided.

The numbers being published are relentless. Patients have been without adequate healthcare for months and are now trying to make up for lost time. Dr. Gavrankapetanović's statement that in his 32 years of surgical practice he has never seen such a number of neglected cases, even among young people, should have been an alarm for all responsible parties. However, it seems to have gone completely unnoticed by those who should be caring for the citizens of KS. In the shaky government, where two ministerial resignations (health and labor and social policy) are still hanging in the air, it seems they are more concerned with themselves than with solving problems.

A hospital with only a few hundred beds has become a 24/7 service for the entire Sarajevo Canton, and this should be enough for those in charge during this crisis to make all necessary resources available to the General Hospital. No one yet wants to openly admit the fear that the General Hospital could face both financial and medical collapse, which would irreversibly destroy a hospital that was opened 154 years ago and bears the name of the honorable surgeon Abdulah Nakaš.