Family doctors refuse to sign framework contract with NHIS

Family doctors said that with the new contractual arrangements, the incomes of a cabinet would decrease on average by 20-25 percent. The deadline for signing the new contract framework is 1 June.

A contract between family doctors and the National Health Insurance House (NHIS) in Romania has not been yet signed because of the complaints coming from doctors regarding the implementing rules that are to regulate health care payments.

The last round of negotiations failed and family doctors threatened with not signing the contract if the document remained in its current form.

Doctors submitted to the Ministry a set of proposals for the legislation on their activity, and the deadline to sign the new framework agreement is 1 June.

Last year, the relationship between family doctors and the National Health Insurance turned into a tense one.

Doctors claimed that there were major problems not only regarding the new form of framework contract and its implementing rules, but also regarding many of the government decisions, which can not be applied in their present form.

Family doctors did not agree that the 50 percent financing to be made depending on the number of patients registered to a certain family doctor and the other 50 percent depending on the number of that family doctor's medical services, nor the doctor to have a career drop.

‘So far, apart from some Health Minister promises that they would try to solve these things together, we have not worked anything out.

‘Concerning the National Health Insurance House, I could only say that I have been there for many times in the past eight months and each time was a wasted of time, that they never looked for solutions, but for checking the consultations with the representatives of family doctors, but no solutions have been found so far’, President of the National Society of Family Medicine, Rodica Tănăsescu said.

Funding, ‘same as last year'

Doctors argued that in the new contractual arrangements, the income of a cabinet would decrease on average by 20-25 percent, which would inevitably lead cabinets to bankruptcy.

The President of the National Health Insurance, Lucian Duţă, stated that the funding for family doctors is at the same level as last year, whereas in hospitals it has declined by 10 percent, and through this new form of framework agreement, Romania lines up with other EU countries in terms of cost control.

‘We,unfortunately, have to do with a management that, in my opinion, does not represent their interests most of the many times, but represents its own interests. Until last year, the funding of family doctors was made through a very convenient mechanism for them. 90 percent of the money that they took, was taken for the fact that they had lists of patients and only 10 percent for the actual work done’, Lucian Duţă said.

The President of the National Health Insurance House, Lucian Duţă, said that in coming days there would be held discussions with the Ministry of Health so that new solutions can be found.

Translated by: Iulia Florescu
MA Student, MTTLC, Bucharest University