MINISTER GRUJIČIĆ FOR KURIR: 'I'm not afraid of saying publicly what I think! My measures not populist, POLITICS TO BE EXCLUDED'

"I live and work in accordance with what I say and advocate. If someone finds that this is populism, that's fine by me. But I have proven in my own practice that everything that I stand for is feasible. The solutions are often simple, and all it takes is a bit of goodwill and good organization. This may appear to many as populism because they aren't able to show even that little bit of goodwill. I have a great team, and I believe in the good judgment of my colleagues and their energy, which is needed to change things and get them moving," Professor Danica Grujičić, Minister of Health, says in her interview with Kurir, having announced sweeping changes and numerous measures when she took her ministerial post. She elaborates on them in detail for our newspaper.

Some measures take years, but you are starting off by abolishing booking appointments only in the first five days of the month.

"I just cannot understand that someone had allowed for such a system to be in place all this while. What happens to a person who falls ill on the sixth day of a month? They have to wait for 25 days or be looking for random personal contacts in order to reach hospitals, creating chaos in the process. Above all, citizens must have access to healthcare. The goal is to ensure that in December, or in early January at the latest, booking appointments becomes possible during the entire month."

CAMERAS KICK UP A STORM

The fact that you will use cameras to measure who works and how much has kicked up a storm. Do you stand by your decision?

"I only mentioned cameras as an example of monitoring in the context of when staff come to work and go home. Of course no one will be setting up cameras in doctor's offices and medical premises. Clocking in when arriving at work can be manipulated, but a camera at the entrance cannot."

Although you think that medical doctors should not work at both state-owned and private institutions, they are legally entitled to do so.

"Under the law, additional working hours are allowed, and of course this should be respected. But if you look at it fairly – does everyone who uses that time also utilize their working hour norms fully at state hospitals? We have noticed an absurd situation – the staff who bring certifications that they have the right to reduced working hours have no problem working at private institutions in the afternoons. This will be strictly controlled and sanctioned. I am not someone who is afraid to say publicly what they think, that's a well-known fact. I want to change things that don't work. You cannot have one year on waiting lists while at the same time patients are offered the possibility of immediate surgery, but at a private institution. I'm well aware of my colleagues' salaries, and that they want to make some extra money, but we have to find a way for them to do that. Politics should be excluded from such issues, as well as whether someone likes a person or not. We are talking about patients here – they must not suffer."

You are planning to introduce paying for services at state-owned institutions. Would that constitute a form of "legal" state corruption – the people who have spent years on waiting lists and who have regular health insurance will now be paying to the state to reach a medical doctor.

"One of the ideas for how to reduce waiting lists is being developed in collaboration with our colleagues from the State Health Insurance Fund – allowing additional work at base state-owned clinics. That said, this would again imply that they have in fact fully utilized their regular working hours. The solutions are in the development stage."

Waiting lists contain surgeries scheduled for 2031 for some people.

"The main problem is organizing healthcare, as well as the fact that the entire potential of our colleagues in the primary healthcare aren't utilized sufficiently, or the resources that the state obtained in the previous period. Good organization will make it possible to gradually reduce the waiting lists and, ideally, abolish them completely. The path a patient has to take from the first symptoms to getting the diagnosis and treatment must be much easier and simpler. I am aware that we must solve the problem of a whole pile of unnecessary procedures which force people to spend hours sitting around hallways and waiting for some basic things for as long as several weeks or even months."

'I AM RETIRING IN TWO YEARS'

You are retiring in two years. Will you stop working, and what kind of work will that be?

"Yes, I am most definitely retiring from the clinic then. I have done a lot over the course of my life, and I take the greatest pride in leaving behind a team of young people who are better than me. I think I have fulfilled the role of the lecturer in this way. I have taught them what I know, and they are slowly surpassing my knowledge. What's important is that each new generation is better than their teachers. That's what progress is, and there must be no vanity there."

The employee age structure, retirement, and specializations are important questions. It take ten years to develop a Personnel Plan, doesn't it?

"No one will be 'driven out' of their workplace. Unfortunately, at some medical institutions there is a shortage of doctors specializing in certain areas, which was what prompted us to request the age structure of the medical doctor and nurse personnel. I simply cannot understand that until now things hadn't been done according to a plan. It makes perfect sense to me to break it all down and assign specializations in a planned manner, rather than randomly. In order for someone to become an excellent neurosurgeon, cardiac surgeon, or vascular surgeon, it takes 15 years as of the start of the specialization. Because we had been going about it randomly, situations arise when a colleague cannot retire because there is no one to replace him."

Introducing family doctors takes years too, doesn’t it?

"I'm negotiating with the World Bank about starting a family doctor pilot-project. I want to visit every local healthcare centre and each village clinic in Serbia to see what the situation is, so that we could take the best decisions. The goal is for each citizen to have a fast, efficient, and available healthcare system. It takes time."

Doctors and nurses, as well as other staff, have low salaries. It won't be long before a bus driver in Belgrade will have a higher salary than a medical doctor.

"Mr. Mali, Minister of Finance, has already announced a salary increase in the healthcare system. I will endeavour to make sure that my colleagues get higher salaries because they deserve it, especially the nurses and the medical technicians. We must also raise the issue of non-medical staff – without whom we cannot operate at all – all the way down to the drivers, who often have unacceptably low salaries."

You have announced a term in office that will maintain continuity with the previous ministry. All these ideas and measures do not maintain continuity at all.

"The Government accomplished a great deal for the Serbian healthcare system in the previous period with respect to building hospitals and obtaining equipment. I support that and will try to continue doing so. However, what is also needed is the reform of the healthcare system in terms of organization, above all the primary healthcare."

THE FATE OF THE COVID HOSPITALS

When will you be converting Covid hospitals into palliative care facilities?

"If the Government supports the proposal of the Ministry of Health, Covid hospitals would become hospitals for various types of palliative care of patients. This also includes patients who need the sort of therapy and rehabilitation that would enable them to get back on their feet and go back to living normal lives."

'WE ARE LOOKING FOR REWARD MODALITIES'

You have announced rewards. When will this be implemented?

"It's unacceptable not to be able to reward excellent workers, who work overtime and take on the hardest tasks, or not to be able to penalize those who don't even perform the work they are obligated to do. We're looking for modalities for these systems, but I took the ministerial post only a month ago, and it's not possible to solve all the problems at once. That said, I am someone who has spent 40 years in the healthcare system, and I'm aware of all the problems – both those the patients face and those my colleagues face. We are taking it one step at a time."

DIGITIZATION – A SPECIAL TASK

You have announced digitization and a fibre optic cable reaching every clinic. When will this be implemented?

"Digitization is one of my special tasks, as it makes the job easier for my colleagues while shortening the time needed for patients to receive the necessary treatment. Furthermore, enormous sums are saved in the state budget, which could be redirected to a number of expensive medications or to obtaining cutting-edge equipment. The idea that we have is to bring fibre optic cables to each clinic. Of course, we first need to deal with medical centres, then the secondary institutions, and lastly the local healthcare centres and clinics. In addition, central applications need to be developed, which will make receiving all medical services maximally easy for citizens. What we are resolving through digitization is also the issue of building a system network. It is often the case that a patient repeats the same tests and examinations a number of times, or they sometimes come back several times, and run around in circles, because my colleagues don't have an overview of what the patient has already done. This is where the patient is only losing their precious time and the state is losing funds by repeating tests multiple times."

Kurir.rs/Jelena S. Spasić