In 2020, many Moldovans witnessed the imperfection of the Moldovan health system. The COVID-19 pandemic highlighted the terrible conditions in which patients were kept, when many hospitals did not have basic conditions, such as hot showers or a working toilet in the chamber.
Do local hospitals have enough money or not, for which they have budgeted? Or is the main problem of local hospitals corruption and inability to allocate funds properly? Using the example of the Bălți Clinical Hospital, we will study the budget and the money distribution points in 2019.
What is the budget of the Balti Clinical Hospital?
The budget of Bălți Hospital is quite consistent – 183,637,270 lei. For comparison, the budget of the entire Balti municipality is around 550-650 million lei. It seems that the budget of the state medical enterprise is only 3 times smaller than the general budget of Balti.
Today, the territory of Bălți Hospital, according to the Cadastru.md website, is 4,62150 hectares.
How is the hospital budget allocated?
As we can see from the documents presented, the biggest sum of money goes to salaries. Therefore, for the salaries of the administration, doctors, medical staff, 119 595 017 lei were allocated for 2019. Considering that, according to official information, Balti Hospital has about 1500 people, the average annual salary is about 80,000 lei. However, we must understand that the salaries of hospital employees will be strikingly different from the salaries of the administration of this medical institution. This is clearly seen in the example of the salary statistics of the director of Bălți Hospital, Serghei Rotari:
In July 2017, by the decision of the Balti Municipal Council, Serghei Rotari is appointed director of the hospital. In the last five months, S. Rotari earned 124,084 lei, which means approximately 25,000 lei per month. Or, if measured in European currency, about 1250 euros.
In 2018, the salary of Sergiu Rotari, the director of the Municipal Hospital, was 282,274 lei. It is about 23,500 lei per month.
In 2019, the annual salary of the director of Bălți Hospital, Sergiu Rotari, was 309,871, approximately 26,000 lei per month.
For the purchase of medicines for the hospital, from the Hospital’s budget for 2019, the amount of 22,197,244 lei was directed.
7,419,668 lei are allocated for food for patients.
35 838 754 lei according to the budget, estimate for 2019, go to “Other expenses”.
“Other expenses”, utility bills and others
Balti Clinical Hospital pays large bills for utilities. According to the budget planning for 2019, the following expenditures were expected:
- 1. Electricity – 6,147,400 lei;
- 2. Natural gas – 2,985,200 lei;
- 3. Payment for heating – 2,152,100 lei;
- 4. For the use of water and sewerage – 3,230,500 lei;
- 5. Garbage disposal – 418,000 lei.
As you can see, the payments for utilities of Bălți Hospital for one year are higher than 13 million lei.
Despite the rather high consumption of cold water, the hospital purchases purified water in 19-liter containers for coolers located in doctors’ offices and administration. For these needs, the hospital budget for 2019 provides 100,000 lei.
The communication and IT support services are the following:
- • Internet – 45,000 lei;
- • Fixed telephony – 230,000 lei:
- • Mobile telephony (for administration) – 35,000 lei;
- • Maintenance of accounting software – 90,000 lei;
- • Maintenance of the “Hospiatal Menedger” program – 120,000 lei;
- • Purchase of computers – 250,000 lei.
Payment for the services of private clinics and laboratories
Private laboratories and clinics are located around Balti Hospital, as well as on its territory. The amount of approximately 2 million lei is used to pay for their services. Balti Hospital does not have vital devices such as a tomograph. And if in the evening, at night, a person is hospitalized with a presumptive diagnosis of stroke, the control will take place only the next day in a private clinic, whose services are paid for by Balti Hospital.
The cost of a budget tomograph is about 3.5 million lei:
Стоимость услуги томографа в частной клинике от 1600 леев.
In the evening, several calls were made to a private clinic that offers paid tomography services. Video calls show that the clinic is closed in the evening and at night. In an emergency, such as a head injury or a stroke, when the patient is hospitalized, in our opinion, there will be a great waste of time for diagnosis.
Undoubtedly, it was more economically profitable to take such a device on credit or in installments, so out of the 2 million lei that go into the pockets of private clinics, the huge share would remain in the hospital’s budget. Moreover, it would be possible to compete with private clinics for the paid services of a tomograph. However, it is “more profitable” for the hospital’s management to provide 2 million lei to private clinics than to expand its range of services.
Space repairs and communications
As you can see from the budget planning for 2019, Balti Hospital allocates large sums of money for renovations (repairs), but, unfortunately, regular visitors to this institution do not notice the technical changes.
5,362,000 lei is the 2019 budget for the renovation of spaces and communications. These are serious, substantial amounts that differ from the accounts of many construction companies specializing in building renovation. Undoubtedly, many local businessmen are eager to take over the assimilation of budget money, however, in the last 29 years, Balti Hospital has existed more than the “Soviet” reserve, and its interior in many salons, toilets for visitors is the same as in the past, in Soviet times.
Although the territory of Bălți Hospital itself and its headquarters is 4.6 hectares or 0.04 sq. kilometers. The entire city of Balti has 78 sq. kilometers. The budget of a medical institution is only 3 times smaller than the entire budget of the city, while the city itself has an area of 1950 times larger.
A modern hospital must have modern diagnostic equipment, such as a CT scan. It is not economically profitable to pay amounts of one and a half million lei per year for the services of a private tomograph. Using your own tomograph can have results in 3-4 years, which is very short.
It is worth emphasizing the development of our own laboratory services, rather than using private ones. During the pandemic, Balti was confronted with the fact that local laboratories were not prepared to test people for COVID-19.
The hospital, which will be equipped with modern equipment, is able not only to live on budget money, but to earn extra money, which can also be spent on the development of modern medicine. What prevents Băli Hospital from becoming a competitor for private clinics, which receive orders for paid services?
Replacing lamps with more energy-efficient LED lamps would help to significantly reduce electricity consumption.
Taking into account the particularities of the structure of the hospital roof, several solar panels can be provided, as well as solar collectors powered by solar energy. This would provide hot water and electricity, which would also lead to significant savings.