HIGHLIGHTS

Strategic Goal 1: Improving the health of the nation

Objectives:

• Raising public awareness of healthy lifestyle and the threats to health;
• Optimization of public health protection work;
• Limiting the influence of lifestyle-related risk factors;
• Support of good mental health;
• State health control;   
  

• Introduction of a system of national monitoring of the health of schoolchildren;
• Improvement of the conditions at children’s medical and social care institutions
• Development of spa and health tourism.

Highlights:

• Support of Bulgarian nationals making informed decisions regarding their health;
• Implementation of the 25 national programmes worth 18 million leva aimed at decreasing the morbidity and mortality rate from the most widely spread infectious diseases and from serious chronic non-infectious diseases covering different age and socially vulnerable groups;
• Elaboration of programmes to help prevent socially significant diseases, paying special attention to children and young people (the “Health Control” programme, the “Prevention of Non-Infectious Diseases” programme, the “Prevention and Monitoring of Infectious Diseases” programme and the “Secondary Prevention of Diseases” programme);
• Apart from the above-listed programmes the Ministry of Health will develop and update programmes aimed at restricting the influence of lifestyle risk factors (smoking, alcohol and drug abuse, unhealthy eating habits), as well as an efficiency criteria programme and a tuberculosis prevention and control programme;
• Implementation of a “Food and Nutrition” National Action Plan;
• Restoring the school healthcare network;
• Non-admission of discrimination of persons with mental disorders. Improvement of their living conditions; guaranteeing their human rights and full integration in the public health and medical care system;
• Protecting this country from the import and spreading of infections of a high epidemiological risk. The National Healthcare Strategy provides for developing mechanisms for a timely and adequate reaction to health threats which would make it possible to protect the nation from diseases, lengthen life expectancy and improve the quality of life;
• Development of an organization and mechanisms optimizing health control activities aimed at guaranteeing Bulgarians goods and a living environment adequate to those enjoyed by the citizens of the EU-member states.
• Development of spa and health tourism. Disease prevention and rehabilitation is economically more adequate and helps prevent treatment with expensive medicines in hospitals.

Strategic Goal 2: Providing high quality and guaranteed health services

Objectives:

• Raising the quality and efficiency of health services;
• Streamlining the system of accreditation of medical establishments;
• Facilitating access to health services.

Highlights:

• Development of standards for medical care providers;
• Requirements of buildings, appliances and equipment;
• Streamlining the system of accreditation;
• Development of a system for evaluating results and its application in practice in binding remuneration to results;
• Providing one-time social medical care for persons who are socially disadvantaged and are not part of the health insurance system;
• Development and optimization of the infrastructure and improvement of communication links and interaction between the different levels of medical care.
  

Strategic Goal 3: Optimization of primary outpatient medical care

Objectives:

• Improving remuneration mechanisms;
• Solving the problems in emergency medical care;
• Clear differentiation of the responsibilities of primary and specialized medical care;
• Perfecting the mechanisms of dental medical care, paying special attention to children.

Highlights:

• Increasing remuneration by types of services rather than formal remuneration based on number of patients registered with a general practitioner;
• Setting up medical teams for primary and specialized medical care in remote inaccessible regions;
• Introducing a ceiling to the number of patients registered with one general practitioner, regulating the duration of the examinations and introducing criteria and requirements in their performance on the basis of medical standards;
• Introducing programmes to promote preventive dental treatment of children.

Strategic Goal 4: Optimization of the health network

Objectives:

• Improving the integration of inpatient and outpatient healthcare;
• Improving and strengthening hospital management;
• Restructuring and optimization of the operation of hospitals
• Public-private partnership;
•  Denationalization;

• Improving the mechanisms of remuneration at inpatient medical establishments.

Highlights:

• Cutting red tape and facilitating the access of patients to medical services at the different levels of the healthcare system;
• Evaluation of the offered health services and redirection of part of them from the hospital to the outpatient medical care system;
• Building and improving hospital information systems and active supervision by the regulatory bodies of work at hospitals and the movement of patients;
• Improving hospital management and introduction of standard accounting requirements;
• Evaluation of the infrastructure of inpatient and outpatient health care on a regional principle and development of a national plan for restructuring hospitals by regions;
• Establishment of different types of public-private partnerships (concessions, management contracts or use of existing assets) for achieving greater efficiency in the management of the healthcare sector;
• Optimizing the operation of the healthcare system including through the denationalization of part of the healthcare establishments. The funds from privatization will be reinvested in the healthcare system.
• Medical establishments forming the backbone of the healthcare system - multiprofile active treatment university hospitals, district hospitals and national centres, will not be denationalized.

Strategic Goal 5: Transparent and fair drug policy

Objectives:

• Raising patient drug policy awareness;
• Guaranteeing quality and establishing strict control over prices and introducing a fair system of reimbursement of drugs and medical articles;
• Raising patient awareness of the correct use of drugs and implementing rational drug treatment.

Highlights:

• printing ceiling prices and the amount payable on the packaging of drugs to defend the rights of patients;
• building a system to monitor health establishments in the prescription of drugs;
• Creating incentives for payment of drugs outside the reimbursement system by voluntary health insurance funds.
  

Strategic Goal 6: Planning, organization and development of human resources in the healthcare system

Objectives:

• Planning, selection and training of medical specialists;
• Raising the professional qualification of the medical staff and continuing training;
• Research capacity development and participation of Bulgarian medical science in the network of European scientific research programmes.

Highlights:

• Development of a programme for promoting human resources enrolment and training by categories and specialties depending on the needs of the healthcare system;
• Introduction and broad implementation of training programmes for different specialists (physicians, nurses, social workers, etc.);
• Development and improvement of the system of specialization of doctors.

Strategic Goal 7: Electronic healthcare

Objectives:

• Building an integrated information exchange system between those working the field of healthcare;
• Standardization and information security.

Highlights:

• Introduction of obligatory electronic accounting of medical care providers;
• Introduction of electronic health cards;
• Introduction of software applications for real time comprehensive information processing: electronic medical referrals, electronic prescriptions, laboratory and other tests.

Strategic Goal 8: Guaranteeing the financial stability and sustainability of the national healthcare system

Objectives:

• Improvement of the model of compulsory health insurance;
• Guaranteeing the financial stability of the National Health Insurance Fund as a single payer of the activities covered by compulsory health insurance;
• Development of voluntary health insurance and introduction of regulated additional payments.

Highlights:

• Long-term financial stability and sustainability of the system;

This will be achieved by increasing the share of the GDP allocated to healthcare and optimizing the system of collecting revenues and through outside investment.

The National Healthcare Strategy provides for an increase of public funds for healthcare to 5.5% of the GDP as of next year and for their gradual increase to 8% of the GDP by 2012.

• Establishing possibilities for including persons without health insurance in the system of compulsory health insurance;
• Guaranteeing the protection of the state in providing health services to persons without incomes through a special fund set up to this end;
• Encouraging the development of voluntary health insurance funds and promoting competition and control over the quality of the health services offered;
• Control over the distribution of healthcare funds and their extension solely for already performed medical services. Strict quality requirements bound to the terms and criteria in health services remuneration;
• Health insurance contribution - Gradual increase of the compulsory health insurance contributions without increasing the tax and insurance burden on the population.
• National Framework Agreement.
• The National Strategy provides for the National Framework Agreement to be signed for a period of three years. Upon a request of any party to the Agreement, the National Framework Agreement may be amended but not more than once a year. Representatives of the employers and the patients will also be included in the negotiations following the respective legislative changes.
• The volume and the prices of the different kinds of medical care shall be determined on an annual basis and will enter into force at the beginning of the respective calendar year.

Additional payments

In the mid-term the National Healthcare Strategy provides for the introduction of regulated additional payments (supplementing and complementing the basic package of services paid by the National Health Insurance Fund) following the respective legislative amendments.

To avoid speculations and for the sake of clarity, the National Healthcare Strategy provides for a ban on raising declared prices of services within the term of operation of the National Framework Agreement (for one year) which will guarantee the stability and clarity in the system.


Strategic Goal 9: Efficient implementation of European legislation and absorption of EU funds

Objectives:

• Administrative capacity building and use of EU structural funds for investment in healthcare.

Highlights:

• Optimization of the work of the healthcare institutions and restructuring of the hospital network by using EU structural funds;
• Administrative capacity building and use of the structural funds of the European Union for investment in healthcare;
• Training in the elaboration of projects and programmes to apply for financing through EU structural funds in human resources and human resources training; development of regional healthcare infrastructure, development of health information systems and prevention.