The Auditor General in his presentation to the parliament: in the process of approving the laws, the source of the workforce should be shown

11/15/2022 | 5:23 PM

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TALLINN, 15 November 2022 – Today, Auditor General Janar Holm made an annual presentation to the parliament, in which he focused on the consequences of labour shortage in health care. The Auditor General suggested that in the future, given the shortage of work force in various fields, when preparing legislation, the number of workers needed to implement each new or updated service, as well as their qualification requirements and the source of such people should be described in an explanatory memorandum.

An explanatory memorandum to legislation often provides calculations for the cost of legislative implementation. “Labour force is a limited resource, just like money, and would need particular assessment and attention,” said Auditor General Janar Holm when speaking in front of the plenary assembly. According to the Auditor General, looking at the labour market trends, it should be assessed during the coordination of draft laws and other legislation, whether the planned labour force actually is available to implement the new initiative, or whether it is realistic at all to train the number of people needed. “When proceeding a draft, you as the legislator would have confidence that the planned activities could actually be implemented.”

In his presentation today, Auditor General Janar Holm mainly focused on the issue of the shortage of health care professionals, which seems unresolvable because the studies take years and the results of the increase in the training capacity, if successful, would be visible in the distant future only. But the issue is here right now, and keeps getting more acute. “Nearly half of the family doctors are aged 60 and above,” said Auditor General Janar Holm. “Of psychiatrists, for example, more than a half are aged 60 and above. So, we should really hope that family doctors and psychiatrists in retiring age postpone retiring as far into the future as possible.“ 

One of the consequences of the shortage of health care professionals is that the availability of health care services varies by regions and specialties. In county hospitals – general hospitals – the number of specialities in which patients are provided medical aid has decreased remarkably. In 2019, the services of a pediatrician were provided in 11 general hospitals, but in 2021, in only 5; in 2019, a neurologist was available in 11 general hospitals, but two years later, in only 6.

In 2000, when drafting the Hospital Network Development Plan, experts estimated 13 hospitals to be a number that is sustainable for Estonia instead of 19. However, the number of hospitals has changed in the opposite direction to that recommended by experts. There are currently 20 Hospital Network Development Plan hospitals in Estonia. And fewer health care professionals than ever before in the recent past.

According to the Auditor General, there has not been a lack of practical and detailed analyses of the issues in the field of health care or of development plans aimed at the resolution of the issues. However, there has been a lack of the skills and ability to implement the agreed objectives, and of the courage to make decisions.

In a situation where access to medical services is deteriorating, the Auditor General finds that people should pay more attention to prevention activities and undergo health checks more frequently, both when it comes to children’s health checks and cancer screening, for example. At the same time, the tasks related to screenings have been divided between the Estonian Health Insurance Fund and the National Institute for Health Development. To date, the Ministry of Social Affairs has not clearly decided who is responsible for managing and developing the field as a whole.

“Besides coming up with all kinds of new wonderful and costly activities, it is important for us to not forget about the issues that have been waiting to be resolved for years,” Holm emphasised. “These old issues are still waiting for resolutions, waiting for decisions. But if we cannot make the decisions, life will make them for us. And then there is not much left for us to say anymore.“

Priit Simson
Head of Communications of the National Audit Office of Estonia
+372 640 0102
+372 5615 0280
[email protected]
[email protected]

  • Posted: 11/15/2022 5:23 PM
  • Last Update: 11/17/2022 3:21 PM
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