Government and family doctors fail to resolve funding disagreements

Health Minister Anda Caksa, Prime Minister Maris Kucinskis and Sarmite Veide, the leader of the Latvian Association of Family Physicians, on July 12 failed to reach an agreement on ending the family physicians’ ongoing strike.

Kucinskis told journalists after the talks that the parties were still unable to agree on raising capitation, which is the government funding provided to the medics per each patient. Tomorrow, the contentious issue will be put before the health sector’s strategic council. A number of possible compromise solutions to the capitation issue were discussed at today’s talks, but the parties intend to revisit the issue also tomorrow, Kucinskis said.

Both Caksa and Kucinskis object to raising capitation. The parties, however, have succeeded in reaching agreements on all other medics’ demands, for instance, it has been decided to postpone a revision of tariffs on medical manipulations.

Kucinskis said that the medics’ pay raise, which is planned as part of the health sector’s reform, does not satisfy the family physicians, which is why they raised the issue of capitation again during the meeting.

Caksa indicated that €80m, which is a sizable amount, will be provided to ensure the pay raise already next year. “The Health Ministry proposes an equal base salary for all physicians, including family physicians, but the difference occurs because of extra pay for night shifts, which the family physicians refuse to accept,” said Caksa.

The health minister said she could not agree to raising capitation in the situation where it is necessary to decide on pay raises across the sector. I would call on the sector’s strategic council to consider whether the health sector would find it acceptable if the pay issue for one group was solved differently,” said Caksa.

The Health Minister thinks that the demand for raising capitation is an issue that has to be dealt with in the context of salaries in the whole health sector and that the Health Ministry cannot decide the issue one-sidedly. If the strategic council agrees to raise capitation for the family physicians, it will mean a revision of the existing distribution of medics’ remuneration.

As reported, over 600 family physicians in Latvia went on a strike at noon on July 3 and will not be providing any government-funded health care services to their patients until an agreement is reached with the Latvian government on the demands by the family physicians.

One of the family physicians’ demands is to raise the present capitation by 30%, while the Health Ministry has proposed to increase the wage that is included in the capitation money. Family physicians not only receive wage for their work, but they also run their practice, therefore the capitation includes administration costs.

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