Of the approximately 5,16 million euros donated by citizens and the economy to combat the consequences of the covid-19 pandemic, almost half is intended for the purchase of two angio rooms in Berane and Kotor, while certain hospitals, such as the one in Pljevlja, did not receive a single cent.
Almost a quarter of the money intended for Kotor is still trapped in the institution's account because the tender for the purchase of the angio room was cancelled, while the newly established Beran clinical and hospital center only recently signed contracts and began the construction process, which will last until the end of this year at best. "Vijesti" interlocutors claim that the entire process of distributing the money paid by the citizens and the economy is irrational, and that the decision about who will receive and how much money is characterized by ignorance and local patriotism, and that it was not preceded by a quality analysis.
Directors of hospitals, from the ranks of the ruling parties, on the other hand, see nothing controversial in the minister's decision to allocate much less money to them, even though in the previous period they were without basic equipment for work. Part of them, through amendments in the Parliament, and through a political party, tried to get money for medical equipment or replacement of worn-out medical vehicles through the budget.
"Every distribution of such significant funds should be preceded by a serious managerial analysis of the situation in the system, and not be done in a lump sum and according to the type of 'I have one wish'. That analysis, called the Hospital Safety Index, would show the true state of our hospitals and finally let the minister and other managers know that our hospitals are in a state of construction chaos and that they do not meet basic human criteria, not to mention medical standards," he believes. doctor Vladimir Dobričanin, until recently a member of the Parliamentary Committee for Health, Labor and Social Welfare.
The distribution started after the findings of the SAI
In October of last year, the Ministry of Health informed the State Audit Institution (DRI) that according to the Government's decision, four general hospitals, one special one, the Clinical Center (KC) and one, the Cetinje Health Center, will receive EUR 5,16 million. This was done after the DRI audit determined that there is 5,16 million in the account of the Crnogorsk commercial bank, which citizens and business persons paid as a donation for the fight against covid, but that the purpose and who manages that money are unknown. The audit report showed that from March to September 2020, 8,23 million euros in donations were paid to that account of the former National Coordination Body (NKT), and that three were paid for the implementation of measures to suppress and mitigate the consequences of the pandemic, of which 1,2 ,XNUMX transferred to the account of three general hospitals.
The collegium of the SAI ordered the Ministry of Health to submit an Action Plan for the implementation of the recommendations by April 1, 2023, and a report on the actions undertaken by September 1 of this year... The Ministry of Health did not answer how much money has been spent so far and for what purposes. nor did any working group, commission or body decide how the donated money would be distributed.
The previous government, whose majority was the Democratic Party of Socialists (DPS), intended to allocate 5,16 million euros for the construction of two new clinics for dermatovenerology and mental health. After the European Union provided all the money for the Infectious Diseases Clinic and the Dermatovenerology Clinic, it was decided that the money donated during the pandemic would be used for the construction of the Mental Health Clinic and the Hematology Center with a PET scanner, considering that Montenegro is the only country in region that does not have this type of diagnostics.
However, according to the decision of the 43rd Government and Minister Dragoslav Šćekić 2,2 million euros were allocated for angio rooms in Kotor and Berane, whose general hospitals received an additional 387.200 euros for the purchase of two digital mammograms. In October of last year, the minister claimed that the money was invested where it is most urgent and needed - "exactly where thirty years of negligence made those funds unavailable".
The largest health institution, the Clinical Center, received 463.000 euros for a chamber for cytostatics, 121.000 for newborn screening and 50.000 for a video endoscopy column with a 4K monitor.
The Risan special hospital is allocated money for an X-ray machine and a reanomobile, while the Bar hospital received around one million euros - 758.809 euros for magnetic resonance imaging, 252.000 for a laparoscopic column, operating tables, and equipment for the anesthesiology department. The Government's decision was that at the level of primary health care, only the Cetinje Health Center would receive money from donations, 330.000 euros.
How hospitals spent money
Director of the Kotor Clinical Hospital Center Davor Kumburović he said that 1.294.700 euros were paid to them through the account of the Health Insurance Fund from covid donations, of which 1.101.100 was for the purchase of an angio room, while the rest was intended for the purchase of a digital mammogram.
"The tender for the angio room has been canceled and the funds are in the account, and the digital mammogram should be delivered in September," he claims.
Director of the Special Hospital "Vaso Ćuković" in Risno Vlado Popovic he replied that the Government allocated them a total of 325.246,20 euros from the money donated during the covid-19 pandemic. He explained that they bought hospital beds in the amount of 105.028 euros, a digital X-ray machine with a C port for 160.228,20 euros, and a resuscitation car for 59.990 euros. He pointed out that the hospital beds are already in use, while the delivery of the medical vehicle for which the contract was signed is expected at the end of August, while they are preparing the tender documentation for the X-ray machine, and delivery and installation are expected by the end of the year.
In the answers of KC, it is written that on their account on 6.12.2022. transferred a total of 644.937,91 euros, while they have spent 630.368 so far.
"For the purchase of medical consumables and screening equipment for newborns, 116.299,70 euros, then a video endoscopy column with a 4K monitor for the needs of gastroenterology, 60.318,42 euros, and the purchase of chambers for cytostatics with software, 453.750,00. The remaining 14.569,79 euros will be part of the necessary funds for the preparation of the room for the apparatus for the central preparation of cytostatics", the answer states.
From the Health Center in Cetinje, which received 330.000 euros, they said that 236.825 euros have been spent so far for the renovation of the roof and facade. They explained that they will use the remaining funds for the purchase of equipment for the needs of the institution, after the approval of the Government.
Bjelopolska General Hospital received EUR 259.640,00 from the Government, which was used to buy a digital X-ray machine and an ambulance with medical equipment, while the Beran Clinical and Hospital Center and the Bar Hospital did not answer questions regarding the use of the donated money.
Through the party to the basic devices for work
The Pljeval hospital did not receive a single euro from covid donations, although it acquired a scanner only last year, considering that the existing one produced in 2005 had been broken for years, while all the medical vehicles of the institution are old and have traveled over half a million kilometers.
Asked how he comments on the fact that certain hospitals received millions, and that institution got nothing, the hospital director Saša Grbović he said that they were not familiar with the criteria that applied when distributing money from donations.
"The assumption is that care was taken to distribute the funds to the health institutions that needed help the most at that moment," answered Grbović.
He said that they have regular communication with the Ministry of Health and the Health Insurance Fund and that they are informed in a timely manner about the needs of the hospital through capital and "regular" budget plans.
"For this year, through the capital budget, OB Pljevlja requested three vehicles due to the age and high mileage of the existing vehicle fleet, which is understandable given that this hospital is the furthest from KC. In communication with the employees of the Ministry, we received assurances that we can count on the purchase of two vehicles this year. Also, this year, through the Fund's capital budget, money was provided for the purchase of a mobile X-ray machine (the so-called C look) for the orthopedic room", he explained.
The hospital in Pljevlja reminded that for the project of the building of the new hospital, funds were allocated for the competition for the conceptual architectural solution, as well as for the main project of the hospital.
"Also, through the amendment of the SNP group of deputies, 300.000 euros are planned in the budget for the procurement of the missing equipment, for which the documentation has been completed and we are in communication with the Ministry of Finance on how to use those funds and withdraw the money. The management of the hospital has already sent the appropriate letters and we hope that the tender procedures for the procurement of this equipment will start soon", said the director of the hospital, otherwise the president of the Municipal Committee of SNP Pljevlja, the party whose vice-president is the Minister of Health.
Of the 5,16 million, the Nikšić hospital did not receive the money either. At the beginning of the pandemic, that institution was a covid center, so then, like the hospitals in Beran and Bar, it received 400.000 euros, which it later used to buy a UZ color doppler, a patient monitor, an ambulance and create a project for the pediatrics department.
Director of OB Nikšić Dušanka Milatović Perović she said that she could not comment on whether the distribution of money was adequate.
She pointed out that she was not the director during that period, but that she believes that an adequate analysis was done and that the funds were rationally allocated, according to priorities.
Time and number of services were not criteria
According to the opinion of a former deputy of the Social Democratic Party (SDP) Adnan Striković, who is a doctor in the hospital in Bjelopolje, the Ministry of Health did not take into account criteria such as the quality of services and the personnel potential of the institutions when distributing funds.
"The money is distributed based on subjective criteria, which is usually not good. If there were contacts with hospitals, it was a mere formality. It is impossible that some hospitals did not have needs and requests, given that we know the state of the majority of institutions", believes Striković.
He pointed out that the Kotor hospital with 23 specialists received 1,2 million euros, and the Bjelopolje hospital received 260.000, although it has 40 specialists and an incomparably greater number of operations and other services.
Commenting on the decision to direct most of the money to the construction of angio halls in Berane and Kotor, he said that it would not be good if the expensive equipment went to waste, waiting for trained staff.
"It's not a problem in the tendency to equip cardio centers in the south and north in addition to Podgorica, but it's more a question of personnel than money. The budget of the FZO is 400 million and it is easy to set aside a few million euros for that, but it is not easy to produce staff...", said Striković.
A system thirsty for investment under the influence of dangerous decisions
Member of Parliament of the United Montenegro and KC surgeon Vladimir Dobričanin believes that the healthcare system is thirsty for investments that were absent in the previous twenty years and brought the entire healthcare system to the brink of sustainability.
He assessed that there is a problem when the donated money needs to be distributed in the right way, so that no one feels neglected, nor that the money dissipates and everyone gets a little bit.
"How is a ministry going to allocate that, when they don't have any functional information about the health care system at all?" There is neither mapping, nor an action plan for development, nor a strategy, but only one unforced proposal of the Law on Health Care, which, of course, did not pass the Health Committee. In all this health mess, two decisions are made that are not only irrational, but also very dangerous. One is the establishment of two new clinical and hospital centers, and the other is the decision to purchase and install an angio suite," he believes.
Dobričanin emphasized that patients still use shared toilets, which are sometimes designed for twenty or more patients, which is unacceptable for medical standards due to the spread of hospital infections.
"Not to mention the content and quality of the beds in our hospital rooms. It starts from there, so that our patient feels medically safe, in order to give him importance and improve the dignity of those who seek our services. It's not all about the devices and buying them doesn't get the job done or improve the health system. The standards are the ones that ensure that, and when you have them, along with all those strategies and the previously mentioned documentation, then you will easily know the priorities and where and how much funds to direct", he concluded.
Without specialists, all work is in vain
Dobričanin said that clinical hospital centers are not formed by declaring them to be institutions of that level.
"Many other prerequisites need to be fulfilled in order for such a decision to be made, and I honestly do not see the reason for forming one more, let alone two, KBC in a country of 600.000 inhabitants. It seems that local patriotism and ignorance create our politics. I am sure that the minister did not make such a decision by himself, but obviously consulted those members of our profession who do not even have a hint of knowledge on how to organize our health system", said Dobričanin.
He clarified that those institutions do not have trained personnel, a team of cardiac surgeons who will deal with complications arising in the hall, which is impossible because it takes several years for them to become capable of independent work after formation.
"I don't want to talk about the fact that the lack of cardiologists in these hospitals is evident even for regular work, without mentioning specific interventions," he said.
This text was created as part of the project "Dijalozi.me - a service tailored to citizens", which is implemented by the Union of Doctors of Medicine of Montenegro, and which is supported through the program "CSOs in Montenegro - from basic services to policy formulation - M'BASE". which are implemented by the Center for Civic Education (CGO), the Friedrich-Ebert-Stiftung (FES), the Center for the Protection and Study of Birds of Montenegro (CZIP) and the Politikon network. The project is financed by the European Union and co-financed by the Ministry of Public Administration.
The content of this text is the sole responsibility of the author and does not necessarily reflect the views of CGE, the European Union or the Ministry of Public Administration.
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