Will it pass by itself? The new reform of the Latvian Ministry of Health: hospitals exist, but there are no doctors in them

There would be no happiness if misfortune did not help. The constantly hovering information noise about the inevitable invasion of the enemy from the East has brought to life, among other things, medical issues. Hospitals can become hospitals, and therefore closing them is not appropriate.

The Borderlands of Our Anxiety

War is war, but everyone can still use the hospital for now. Especially since in Latgale, the population is increasingly aging and sick.

In the Saeima, at the Long-Term Development Commission, figures of public ill health were announced: last year, the ambulance brought 9,024 people to the Rezekne hospital, and another 16,018 arrived on their own (or were brought by relatives and acquaintances). For Aluksne, the figures are 1,479 and 4,161 respectively; for Kraslava – 1,248 and 2,531. But all these medical institutions faced a significant funding cut in 2026 – by 72,389 euros for the Rezekne hospital, 424,543 euros for the Aluksne hospital, and 325,325 euros for the Kraslava hospital. The Balvi/Gulbene now operates one combined inpatient facility, but it also had its funding cut by 178,718 euros. Apparently, at the Ministry of Health, led by the appointee of "New Unity" Hosam Abu Meri, they decided, in true Gogolian fashion: "A simple person: if he dies, he will die anyway; if he recovers, he will recover anyway."

This Was Given

However, to be fair, funding was increased for the capital's clinical and university medical complexes. As "Today WEEK" reported, an additional 6.2 million euros was allocated for RAKUS (Gaiļezers); for PSKUS (Stradiņš) – 3.6 million euros. Nevertheless, if there is a complicated case, the distance from the state border, where Balvi is located, to Riga is over 200 km, especially on our winter roads. They might not make it in time...

Moreover, small hospitals in Latvia complain about discrimination in favor of the two aforementioned healthcare giants. According to statistics, for example, uncomplicated childbirth is reimbursed by the state at 1,274 euros for large hospitals, while for small ones it is 967 euros. In the case of pneumonia with complications – 1,519 euros and 1,153 euros.

"To him who has, more will be given, but from him who has not, even what he has will be taken away," – all according to biblical law! Thus, this year, the basic rates for hospitals of levels I, II, and III are being cut by a full 40%.

Waiting for a Surgeon

Level I hospitals in Latvia include those in Līvāni, Aizkraukle, Bauska, Limbaži, and Ludza. The latter, by the way, was designed to be huge in the late Soviet era – not for a district center, but for the temporary capital of the LSSR in case of nuclear war.

Now, according to the new order from the Ministry of Health, surgeons are unavailable in these provincial hospitals from 8 PM to 8 AM. But what if a person has acute appendicitis or an open fracture?

Hospitals of levels II and III operate in Aluksne, Preiļi, Tukums, Kraslava, Balvi/Gulbene, Kuldīga, Madona, Cēsis, Dobele, Jūrmala, and Ogre. Hosam Abu Meri presented them with such a surprise – funding for anesthesiologists and resuscitators in the emergency department has been reduced. There is no state payment for these specialties from 8 AM to 4 PM (except on weekends and holidays).

The Ministry of Health claims that it is conducting a "review of the emergency medicine and patient admission network." Since there may not be the required doctors in low-level hospitals, in 47.3% of cases, patients are taken to a level IV hospital (for example, from Balvi to Valmiera, over 130 km), or even directly to a level V hospital (Stradiņš, Gaiļezers).

One Hour for Everything

As for small hospitals in the border area, the medical authorities promise that they will ensure on-call doctors, nurses, and nursing assistants, as well as X-ray, ultrasound, laboratory tests – and even computed tomography – in a 24/7 mode! The accessibility criterion is set at 60 minutes. Within this time, the emergency service, having stabilized the patient, must deliver him to the hospital. Local hospitals will focus on therapy and care for chronic patients, as well as short-term surgery in the day hospital.

Most importantly, when transitioning to a simpler three-level system (central, regional, and local hospitals) by 2029, the Ministry of Health assures that "there are no plans to close hospitals – each case will be assessed individually in cooperation with the hospital and local government."

Municipalities, noted the chairman of the Saeima commission Uģis Mitrevics (National Alliance), are already concerned, and "their fears are not being heard."

The director of the Health Care Department, Sanita Janka, added:

– The biggest challenge is the lack of human resources.

The birth rate indicators for 2025 are not encouraging – another 20% drop in the number of children. "This decline is not only in the regions but also in the city of Riga," – Janka stated.

Our Shooter Has Arrived Everywhere

Against this backdrop, the Ministry of Health found nothing better than to implement the aforementioned reform – from 5 levels of hospitals to 3. Moreover, as Ms. Janka admitted, these changes will take a lot of time and money. Since they will not forget about emergency medical care or outpatient treatment – according to the assurances of the department head, "in no case" will the reform of hospitals lower the standard of medical services.

Regarding complaints about differences in funding for the same medical procedures, Ms. Janka is not worried: – It is important to look at not how much is paid for services – but how many services are provided.

Golden words! By the way, Ms. S. Janka, in 2024, for which her declaration as a public official is available in the database of the State Revenue Service, received a salary at the Ministry of Health of 59,716.58 euros; and at the Riga Eastern Clinical University Hospital – 53,715.82 euros. That is, in total for medical matters – 113,432 euros and 40 cents for the year. She almost reached 10,000 a month.

And she also has enough time to engage in agriculture "Kļaviņas," from which she received an income of 1,904 euros.

A Veteran of Medicine: I Don't Believe It!

Deputy Ingrīda Circeņa ("New Unity"), a former Minister of Health and a practicing gynecologist, asked why patients are being denied medical assistance locally?

– Hospitals have their own vision of how they would like to develop, – replied S. Janka, – Because there is a shortage of specialists, especially in narrow specialties, for example, neurologists – it is extremely difficult to attract them to the regions.

So it is quite possible that some local hospitals will be transformed into emergency medical assistance points. As for other institutions, according to S. Janka, "there are opportunities to provide additional payments to motivate doctors."

– He will receive a salary for being in the hospital – and separately for coming to the table, – I. Circeņa noted ironically. The National Health Service, by the way, pointed out – you cannot pay twice for the same thing...

– I have worked in the healthcare system for over 40 years, – I. Circeņa reminded. – If you rotate staff between hospitals, constantly keeping departments empty... But they need oxygen, nitrous oxide, sterilization. And in 4 years we will analyze!

...The most interesting thing about I. Circeņa's protest is that she is in the same party as H. Abu Meri. It would be nice if she called out, as a veteran of "New Unity," and threatened – make hospitals for people, or else put your party membership card on the table.