State’s Debt to the Pharmacies Should Not Lead to Reductions in Patients’ Rights
The right to health protection, including access to medication, is one of the rights guaranteed by the Constitution.
In the recent days Croatia has been witnessing problems regarding the delivery of medications to hospitals, leading many seriously ill patients to wonder whether they will be able to access the medications necessary for their treatment. The situation was caused by the public health system’s failure to cover its debts to the pharmacies, which is only one of the manifestations of the wider problem with public policies that do not guarantee the appropriate provision of medications.
The current situation could have especially harmful effects for patients with chronic illnesses and cancer patients, who can be considered high risk groups and for whom a pause in the provision of therapy, compounded with the issues with the access to COVID-19 vaccines, could be life threatening.
Treatment Must Be Accessible to Everyone, Regardless of the Health System’s Financial Difficulties
The lives and health of the patients must not be negatively impacted by the health systems’ financial difficulties. It is the responsibility of the public policy holders to act in line with their role and work responsibly to ensure the continuous accessibility of health care services and the sustainability of the health care system itself, including securing the conditions for the availability of accessible and efficient treatment of good quality to every citizen at any time, regardless of the circumstances the country is currently in.
On the occasion of the World Health Day, marked on 7 April, the World Health Organisation has called on the states to provide living and work conditions that are conducive to protecting their citizens’ health. Unfortunately, one’s ability to live a healthy life often depends on the geographical location where one was born, grew up, lives, works and grows old.
Health Protection One of the Most Common Reason for Complaints
Out of all of the complaints submitted to us by the citizens in 2020, the largest number was related to the issues they encountered in the health care system, such as difficulties in the access to medications and medical procedures, especially pronounced at the beginning of the pandemic, as well as those related to accessing their physicians, having to wait outside in unfavourable weather conditions before being able to enter a health care institution and others.
The waiting lists for medical procedures are not getting shorter in the recent years and for some of them they are now even longer. The emergence of the pandemic and the resulting mobilisation of the health care sector in March and April of 2020 lead to a situation in which only COVID and emergency patients had access to the physicians and health care institutions, and a large number of appointments, diagnostic procedures and surgeries were either cancelled or postponed until further notice. This caused new disturbances in the health care system, as, according to the data by the Croatian Health Insurance Fund, the number of first appointments with a specialist was significantly reduced (55.007 as opposed to 129.356 in 2019), as well as the number of follow-ups (280.599 in 2020, compared to 515.590 the year before). In spite of that, waiting periods have remained the same, which points to the conclusion that the waiting lists have grown significantly and the citizens are unable to access health care services within reasonable time periods.
The pandemic has worsened the existing issues in accessibility of the health care services in the rural and remote areas. An example of this is the case of our complainant residing on one of Croatian islands, who, along with the rest of the island’s residents, was unable to access the service of physical therapy provided at the patient’s home, which, on the other hand, is available to the patients living on the mainland. An even distribution of health care services throughout the country’s territory, especially in smaller and more isolated towns and villages and on the islands, is a necessary precondition for all citizens to be able to exercise their right to health protection.
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