On Tuesday, the government supported the merger of five psychiatric hospitals with the National Centre for Mental Health (NCPH), and it is planned that the reorganization will be completed by October 30 of this year, LETA reports.
According to a government-supported draft order, the Daugavpils Psychiatric Neurological Hospital, the Strenči Psychiatric Neurological Hospital, the Piekūri Hospital, the Ģintermuiža Hospital, and the Ainaži Children's Psychiatric Neurological Hospital will be merged into the National Centre for Mental Health (NCPH). After the reorganization, the Ministry of Health will become the holder of the state capital shares of the NCPH.
The ministry notes that currently, state services in the field of mental health are provided by several mutually independent capital companies with separate management, administrative, and support functions. According to the ministry's assessment, this model is fragmented, as strategic planning, personnel management, administrative processes, procurement, and IT solutions are organized separately in each institution.
This limits the ability to ensure a unified approach to planning and developing services at the state level and complicates coordination and resource utilization among medical institutions. At the same time, there are differences between hospitals in the availability of services, the range of specialized assistance, and workload, influenced by staff availability and patient flow organization.
The goal of the reorganization is to reduce management fragmentation, ensure more equitable access and quality of services in the regions, and promote more efficient use of state financial and human resources. It is planned to maintain the provision of psychiatric services in the regions while centralizing management, administrative, and support functions within the NCPH. The merged institutions will subsequently operate as regional structural units of the NCPH.
It is emphasized that the volume of services in the regions will not be reduced, and significant changes in their content are not planned. The changes will mainly affect planning, coordination, and quality assurance of services, forming a unified management approach and strengthening the connection between outpatient, day hospital, and inpatient services.
The ministry also notes that no layoffs are planned during the merger process. The current staff will be integrated into the NCPH structure, and the transfer of rights and obligations of employees will occur within the framework of the enterprise transfer, ensuring continuity of employment relationships without terminating employment contracts.
According to data for 2024, a total of 3,152 employees work in the merging institutions. Of these, 370 are doctors, 765 are medical and nursing staff, 762 are support staff, 108 are administrative workers, and 1,147 are other employees.
The reorganization is planned to be carried out in stages, with regular information provided to employees, retention of current pay conditions, and development of a unified reward system in the long term.
Funding for psychiatric services will not be reduced. After the merger, the National Health Service will continue to organize planning, payment, and control of state services, but within the framework of a single contract with the merged company. The performance of services will be accounted for by separate units, maintaining territorial accessibility and control over the use of funds.
It is planned that each unit will function as a separate cost center, ensuring analytical financial accounting. After the merger, a unified budget and financial plan will be prepared, and planning for investments, procurement, training, travel, and personnel expenses will be centralized.
Currently, various information systems and IT solutions are used in hospitals, which affects data accessibility, compatibility, and process efficiency. During the reorganization, a unified approach to managing information and communication technologies is planned, including the gradual integration of systems and the implementation of the "Tvaiks 2.0" system.
The ministry believes that the implementation of a unified information system will reduce costs for maintaining IT infrastructure, provide a single patient database, allow for faster and more accurate assessments, and enable more effective management of system development.
As a result of the reorganization, the positions of the boards of individual capital companies will be abolished; however, the heads of medical institutions will be given the opportunity to continue management activities at the level of regional units. The functions of chief doctors and chief nurses will be retained to ensure professional medical activities.
To coordinate centralized development and regional needs, it is planned to create a Strategic Management Committee, which will include the heads of the merging hospitals. The committee will determine budget, investment, and procurement priorities, as well as agree on the medium-term strategy of activities, but will not have decision-making authority in the sense of the Commercial Law.
According to the ministry's assessment, the reorganization aligns with the direction of state policy aimed at reducing the number of public capital companies and consolidating management.
At the same time, investments will be required to implement the reorganization. The preliminary volume of investments is estimated at 4.35–8.30 million euros, depending on the scale of changes. The main part of the costs will be the integration of information technologies.
Additional funding from the state budget for these purposes is not provided, and the reorganization is planned to be carried out in stages over several years within the existing budgets of capital companies.
Alternative solutions were also considered, including the integration of psychiatric institutions into regional multidisciplinary hospitals; however, this option was not supported as it could create risks for maintaining specialization, qualification, and professionalism, as well as complicate management coordination in the field of mental health.
It was previously reported that in August, the government acknowledged the information report from the Ministry of Health regarding the merger of five psychiatric hospitals with the NCPH.
