Politica de cortes a eito
Healthcare sector link
44. Policy implementation is continuing broadly in line with MoU's deadlines and is starting to produce important savings. Savings result in particular from the revision of the co-payment system, new rules on prescriptions and centralised purchasing of pharmaceuticals, services outsourced to private providers, and hospital restructuring.
45. Regarding pharmaceuticals, a wide set of measures has been implemented. This includes compulsory eprescription and INN prescription, changes in pharmacies mark-ups, changes in the international reference price system and in the pricing of generics, removal of administrative and legal hurdles to entry of generics, prescription guidelines and regular monitoring of prescription behaviour and feedback to physicians. These measures are leading to important savings in outpatient public spending (-7.7 percent year-on-year in the first half of 2012). They are also contributing to a reduction in the private pharmaceutical spending (-8.8 percent for the same period). As these measures have been implemented only recently, one can expect the savings to be even higher next year. Savings on pharmaceuticals in hospitals have been slower to materialise (-1.2 percent year-onyear in the first half of 2012), though recent centralised tenders may potentially lead to important savings. Together with the agreement made with the pharmaceutical industry (which includes a "clawback" of up to EUR 300 million for 2012), these measures are likely to ensure the attainment of the MoU target for 2012, which is a reduction in expenditure to 1.25 percent of GDP.
46. Regarding primary care, authorities are taking steps to ensure that all the population is served by family doctors and that health services are used in a more rational manner. More family care units (USFs) opened (29) and will open (27) in 2012 and the patient registries for family doctors are being updated. The set-up of the electronic medical record now has to be rolled out through NHS facilities. These steps are important for a rational use of services and an improved quality, including by avoiding duplication or unnecessary use of services (diagnostics, emergency care). The revision of the co-payment system also contributed to reducing the use of emergency care while increasing the use of primary care.(falso) Revenues from co-payments doubled: about EUR 80 million in the first half of 2012 (EUR 37 million in the first half of 2011).
47. Regarding the hospital sector important savings have been realised. Operational costs of hospitals were reduced by 10 percent in 2011 (EUR 290 million) and by an additional 8.7 percent in the first half of 2012 (EUR 228 million). These savings are in line with MoU targets (15 percent reduction over 2011-2013). Authorities confirmed their commitment to implementing a hospital reform which includes hospital reorganisation and changes to hospital financing and hospital performance measurement. They will present the plan for the restructuring of the hospital network in November. Meanwhile, some measures have already been implemented as several hospitals have been merged into existing hospital groups, resulting in the concentration of medical departments and laboratories, along with a reduction of beds and overtime.
48. Regarding the reform aiming at making public healthcare sub-systems (ADSE, SAD, ADM) selffinanced by 2016, little has been done so far. There has been a small reduction in spending and effort has been put in negotiating prices with providers. However, the agreed cut in the transfers from the public budget has not taken place.