Citizens of Montenegro wait the longest for an examination by specialists in rheumatology, endocrinology, cardiology, gastroenterohepatology, neurology and ophthalmology.
As pointed out by the director of the Polyclinic of the Clinical Center of Montenegro (KCCG), dr Rifat Međedović, the traditionally "busiest" field of medicine in our country, the surrounding area, and Europe and the world. That is why, he claims, they are constantly working to reduce the waiting list for those specialist examinations, primarily through overtime and supplemental work in the largest Montenegrin health institution.
Judging by the statements of patients, as well as the authorities in the Government, citizens wait on average about three months to see a specialist. The situation is similar in the region, Bosnia and Herzegovina and Serbia. In neighboring Serbia, there is consolidated data on the number of citizens waiting for an operation or diagnostic procedure, so there were about 77.000 residents on the waiting lists last week.
During the last week in the Montenegrin KCCG, new, additional appointments for specialist examinations were opened, so on Friday it was only possible to schedule an examination of a neurologist and a psychiatrist. With other specialists, appointments were available in the next 30 to 60 days.
"When we talk about waiting lists for outpatient examinations and diagnostic procedures, it should be said that the KCCG waiting lists are actually the waiting lists of the whole of Montenegro. Especially when we talk about specialties that are only represented in KCCG (oncology, hematology, nuclear medicine, until recently rheumatology, for many procedures ophthalmology, cardiology, etc.), but also the most loaded specialties (endocrinology, cardiology, gastroenterohepatology, cardiology)", answered Međedović. News".
Waiting lists in Montenegro are a decade-long problem, which during the previous years was mainly solved by supplementary work, by banning supplementary work for private sector employees who work in organizational units where the waiting period is longer than 30 days for a health service, and sometimes by introducing private sector workers, which was paid by the state.
According to earlier Government analyses, waiting lists are a possible source of corruption. It was precisely the action plan for the fight against corruption that provided for the public publication and regular updating of waiting lists on the websites of Montenegrin health institutions. To this day, most hospitals do not do that.
According to data from the KCCG website, 399 patients are waiting for surgery at the Orthopedic Clinic in February this year, while 57 citizens are on the waiting list for cardiac surgery.
Minister of Health Vojislav Šimun he recently said that waiting lists are a huge problem in the health system, that it is not known when appointments are "unlocked" and that patients often have to go to selected doctors several times due to the unavailability of appointments for specialist examinations.
He pointed out that the idea is to make the waiting lists in his mandate transparent, so that patients would automatically receive a message that an appointment is vacant. However, he could not promise that the waiting time would be shorter, but he said that every patient would come to his appointment.
Deputy Prime Minister for Labor, Education, Health and Social Policy Srđan Pavićević he recently said that in the 1980s, when there were no computers or technological means like today, despite the intense volume of work, there was still no waiting list, judging that "something deformed the system".
BiH: Salvation for health across the border
For years, seriously ill patients in Bosnia and Herzegovina have been on increasingly long waiting lists for surgical procedures, expensive medicines or diagnostic tests. They are full of bitterness because the government does nothing for the health of its citizens, if they do not find a cure here, they find a straw of salvation in other neighboring countries, as well as in distant countries of the world. Confirmation of such claims also comes from the Association of Women Patients with Breast Cancer Renesansa from Sarajevo and the president Enide Glušac.
"Patients are still wandering in the dark, asking for two KM each via text messages and managing as best they know how. They are trying to find the cheapest ways to get medicines from Turkey, where they are currently the cheapest," says President Glušac.
Waiting lists are getting longer. For years, patients have been warning the authorities that they are not doing anything to establish a register of patients. And our interlocutor reminds us that we do not have the exact number of patients, due to the lack of a register of patients in the Federation of Bosnia and Herzegovina.
"However, given that all diseases are on the rise, it is assumed that in the current year the number of patients will be 30 percent higher than the previous year, which means that more money will be needed, and the authorities have not provided funds even for the existing sick, so we are on the brink of a catastrophe", President Glušac presents pessimistic forecasts.
There is no reason for waiting lists for diagnostics, he warns Marinko Bago, president of the Futura Association for Patient Rights in Mostar. The law is very clear, services are contracted by public invitation, through the system and mechanism of public procurement. Therefore, the one who monitors health from the ministry, government institute, in that case must react and announce calls, and people with health cards in the institutions were immediately examined, Bago explains the legal procedure that the authorities are avoiding.
"The term "Waiting List" is essentially sinister, not only does the patient's health suffer, but his rights are also violated. We have enough money in our health care that no one should or should wait, especially for diagnostic services", emphasizes the interlocutor.
The waiting lists are closely related to non-compliance with the law, in the field of health and they are different from county to county, says Bago.
"Last year, there were no waiting lists in Tuzla County for diagnostic examinations, while in Mostar, the total number of patients waiting for any health services was more than a thousand at one point. Therefore, Tuzla publishes these invitations, through public procurement, transparently on the Internet, while, for example, in the Herzegovina-Neretva County, the law has not been respected for 20 years and patients are on waiting lists," claims Bago.
He also points out that it is very difficult to get access to waiting lists and other documentation because the process itself and controls are not transparent.
"So, we had a hard time getting those lists when it comes to our County, they are not publicly available, no one publishes them. No one asks or controls them. From county to county, compliance with the same laws varies and it can be seen, concludes Bago, noting that where the law is respected less or not at all, there are longer waiting lists.
At the University Clinical Center of the Republic of Srpska, the largest health facility in the Republic of Srpska, they work 24 hours a day throughout the year to provide citizens with the best possible health care. Patient emergencies are treated immediately. Patients on the waiting list are allocated according to the triage system (degree of urgency). Also, the UKC of Republika Srpska has introduced a Call Center which is in the test phase for patients in order to make it easier to schedule the necessary examinations, which further reduces all types of waiting.
"In the Cardiology Clinic, there is no waiting list for diagnostic and therapeutic interventions requested by the attending cardiologist as urgent. Other waiting lists have been reduced in comparison to a year ago due to the increase in capacity," said UKC RS.
In the Internal Medicine Clinic, the lists for most services are very short. A slightly longer wait for an examination is for certain subspecialty examinations, for example for an endocrinologist, and the explanation is that a large number of our patients have unregulated sugar.
"In order to avoid that the patient is not examined in time while waiting, there are emergency examinations that can be performed every day within 24 hours. Other procedures in our clinic are performed in a short period of time, said the UCC RS, adding that there are no longer waiting lists for other examinations in the UCC Republika Srpska.
Serbia: Wound cancer of Serbian healthcare
A total of 22 citizens of Serbia were on the waiting lists for operations and various diagnostic procedures on February 77.267, while, according to the official report of the Republic Health Insurance Fund (RFZO), during this month 4.837 services were provided to people who were on the waiting list, 5.964 waiting list, and 4.532 people were deleted from it.
It is a cross-section of the situation, one would say, a cancer of the Serbian health care wound, which has not gone away for about two decades.
"Reducing or abolishing the waiting list", according to numerous published information, was part of the first sentences repeated by all Serbian health ministers after the elections during the last two decades. The list "excited" all of them.
According to the official data of the RFZO, in 46 university clinical centers, clinical-hospital and health centers, as well as general hospitals, there are the most people on waiting lists for operations in the field of orthopedics - 18.955 of them for the installation of knee endoprosthesis. Right behind are people who need cataract surgery with intraocular lens implantation - 18.046.
The number of citizens waiting for the installation of a hip endoprosthesis is also not negligible - 13.981.
We still remember the promise of the Minister of Health Danica Grujicic from the end of last year that from February 1 there will be no longer a waiting list for diagnostic magnetic resonance imaging procedures, but on the 22nd of that deadline, the numbers - they deny.
According to the daily review of the waiting list of the RFZO, there are 5.567 patients waiting for a magnetic resonance spine examination, while 5.475 are on the list for a head examination using the same method.
When it comes to cardiac surgical interventions, 2.190 people are waiting for coronary heart angiography, while 1.085 of them are waiting for cardiac catheterization.
There are 918 patients on the waiting list for the installation of artificial valves, 715 citizens are on the list for the installation of a cardioverter defibrillator, while 415 are waiting for the installation of a permanent pacemaker.
It is interesting that in Serbia, out of pure enthusiasm, for free and on weekends, cardiac surgeons from Niš worked for almost 100 days and 12 consecutive work weekends last year to eliminate the waiting lists for cardiac surgical interventions at the Clinic for Cardiac Surgery of the University Medical Center Niš. Their work has been interpreted in various ways - from being heroes to criticism that they violated various regulations, and today they are also facing criminal charges for their research work during covid - how the virus affects the formation of blood clots, but also others.
When it comes to waiting lists, the numbers that now exceed 1.000 people waiting in Serbia for a CT scan of the chest - 1.915, CT scan of the abdomen and pelvis - 1.049 today.
The fewest patients in Serbia are waiting for a CT scan of the head and neck - 58 and knee ligament reconstruction - five of them.
If we look back over two decades at what happened in practice in relation to waiting lists, then there is every chance that we will not get rid of this quickly either, regardless of the announcements of the authorities.
It should also be mentioned that this field of Serbian healthcare was also marked by the big affair of "trade in waiting lists" at the Institute of Oncology of Vojvodina in 2009 during the mandate. Tomica Milosavljević in the position of Minister of Health.
Then dr Bojana Borkov from that Institute publicly indicated that there is a suspicion that foreign citizens are placed on the so-called commercial waiting list and pay doctors from 3.000 to 6.000 euros to be irradiated instead of regularly scheduled patients.
However, we will never know what happened in this regard because five years later, in 2014, the Public Prosecutor's Office in Novi Sad determined that there were no grounds for prosecuting those responsible for the alleged trade in waiting lists at the Institute of Oncology of Vojvodina.
There is another interesting fact in the two-decade attempt to get rid of the waiting list in Serbia - during the mandate of the Minister of Health Zlatibor Lončar (2014 - 2022), during 2014 there were 73.000 people on the waiting list, and in June of that year a team of coordinators was formed who were in charge of improving certain areas in the health care system, but also to solve the problem of waiting lists, which are according to Lončar's words at the time, a problem not only for patients, but also for doctors.
The list of coordinators included some of the most famous names - dr Milika Ašanin, current director of the University Clinical Center of Serbia, dr Miljko Ristic, the then director of that institution and our most famous cardiac surgeon who implanted the first artificial heart in UKCS, dr Zoran Baščarević, the famous Serbian orthopedist, current director of the "Banjica" Orthopedic Institute.
Bonus video: