On 11th, 12th and 13th of June.2010 in Velingrad the second national meeting of the co-ordinators of Bulgarian patients' forum took place. At the meeting , where 47 representatives of the organization from all over the country were present, many matters were discussed in relation to the rights of patients. The participants shared their experience and opinions of their work so far.  
A categorical disagreement was expressed with the decision of the government to reduce the planned for the year funds for medicines in the budget of the ministry of health with almost 27 million leva that will lead to compromised treatment of thousands of patients with cancer, rare diseases, patients with transplanted organs and patients on hemodialysis. Federation Bulgarian patients' forum empowered Teodora Zaharieva to hold meetings with representatives of the health authorities and to express the disagreement of the organization with the proposed changes.
Federation Bulgarian patients forum announces its disagreement with the introduction of delegated budgets to the hospitals, too. They limit the right of choice of the patients and will lead to additional deterioration of the quality of the medical services.
At the meeting a decision was taken to organize public discussions in district cities where the situation of the Bulgarian healthcare will be discussed as well as the proposals of the organization for changes in legislation that will aim to improve the protection of rights in healthcare.

The National health insurance fund has sent letters to all health institutions for hospital care with which it informs them that the hospitals either have to sign annexes to their current contracts or the payments for their work will stop altogether. By signing the proposed annex the hospitals will agree their work to be paid only up to the predetermined delegated budget (about 60-70 % of last year's budget) and even regardless of how many patients have been treated for the period. In fact even though it has not been specified the annex is valid backwards from 01.04.2010. That is so because the annex determines a delegated budget for the second quarter (April-June). Consequently if the hospitals have sent reports for their work over this delegated budget for the months April and May then most probably they will not receive any money for their work in June. So not only the payments will be delayed for three months but also the sums when received will be far less than the reported.
In this way the Government in fact transfers its own debts to the health institutions. Up to the present day the total amount of the hospitals' debts is for the amount of 340 million leva out of which 80 million are overdue i.e. requestable at any moment. The new ruling of the NHIF will in any case lead to a sharp increase of these debts. From there on the way is open to the bankruptcy of most hospitals. The only opportunity is to transfer the debts to the suppliers of medicines and consumables who are the major creditors and of course to patients who are the final consumers.

Almost all hospitals in Stara Zagora district state, municipal and private accepted a declaration to the government bodies against the proposed by the NHIS annexes to individual contracts. In the declaration it is stated that the Rules adopted by the NHIS for the determination of the delegated budgets and the pressure applied to the health institutions to sign annexes are unlawful and inadequate to the situation in the country. They violate basic rights of citizens and patients guaranteed by the constitution. The hospitals declare that they do not accept the so proposed annexes and will not sign them. The declaration was signed by the regional representative of the Federation Bulgarian Patients' Forum - a representative organization of patients in Bulgaria. The text of the declaration you can download form here.

On 09.06.2010 a General meeting of the personnel of MBAL Pirdop was held. 62 /sixty two/ members of the personnel were present.
The cause of the meeting was spontaneous and sincere outrage of the working at the hospital doctors, medical specialists and auxiliary personnel about the agony of the health institution that has been going on for the past couple of months. At the meeting the major problems related to the grave financial situation of the hospital were discussed. The hospital is put in inability to fulfil its functions and is led to liquidation.  
The following problems were discussed:
1.Medicines and consumables are lacking, there is no food and hot water for the patients and the personnel
2. The personnel have not received salaries since April 2010. For the previous months they have received salaries partially in minimal sums.
 
The major accent in the statements of all doctors and nurses that took the floor was that the hospital was put in a situation with conditions that do not allow it to work. In the hospital's pharmacy there are medicines for only two days. The bank accounts of the hospital have been blocked due to filed lawsuit against it for unpaid sums to suppliers. The personnel are forced to pay its travel expenses to come to work without receiving the due salaries. It was a unanimous opinion that this situation threatens the health and life of both the patients and the personnel. The personnel do not want all this to go on and considers that the region needs a hospital that functions normally and not be left to wither slowly. The personnel insists that measures be taken immediately both by the management of the hospital and by the municipality as a principal to stabilize the financial position and to resume its normal functioning.  
Having that in mind the following decisions were taken:

A meeting is scheduled for today in Stara Zagora at which the directors of state, municipal and private hospitals in the district will adopt a common declaration in which they will express their intention to refuse to sign the annexes to the contracts offered by the NHIS. The NHIS is trying to impose annexes to all contracts with hospitals in which to fix the situation that the hospitals can receive sums on the contracts only up to the determined delegated budgets. From the NHIS even intend to ask that the hospitals return the money they received over the delegated budget from the beginning of the year. That will put almost all hospitals in the country in bankruptcy. The NHIS does not answer the question what the hospitals are supposed to do after depleting the delegated budget for the respective month - to admit or to refuse admitting patients, to ask the patients to pay for their treatment or to stop work altogether until the beginning of the next month for which they are granted a delegated budget.