Improvements in public health sector in Latvia
Original publication available at the China-CEE institute website: https://china-cee.eu/2020/10/15/latvia-social-briefing-improvements-in-public-health-sector-in-latvia/
During August and September 2020 more attention had been paid to the issues of public health sector namely focusing on the growing and alarming alcoholic beverage consumption and developing the new remuneration model for medical personnel. Addressing these issues is really crucial as both of these factors play an important role in the welfare of the Latvian society and therefore have a crucial influence on other topics such – general public health, quality of medical services and others.
Latvia’s action plan for reducing the consumption of alcoholic beverages and restricting alcoholism
In recent years, alcoholic beverage consumption has left a negative influence on the public health sector. The average alcoholic beverage consumption of the citizens of Latvia is higher that the European Union average and in fact is one of the highest in the European Union.  Besides the data from the Disease Prevention and Control Center of Latvia has outlined an unpleasant tendency – in the last 10 years the alcoholic consumption on average in Latvia has increased by more than half – 55%. Because of the rapid growth of alcoholic beverage consumption, the Ministry of Health launched an action plan to limit and decrease the growing tendency.
In order to reduce the prevalence of alcohol consumption and the damage caused to public health, new restrictions on the availability and advertising of alcohol are planned in the coming years, while expanding alcohol addiction treatment and rehabilitation services. Alcohol consumption in Latvia is growing every year and exceeds the European average, so it is important to limit its availability and explain to the public the negative effects of alcohol on health. The new action will namely focus on the following topics:
- Limiting advertising of alcoholic beverage prices and discounts in the media and on the Internet;
- More information on the labels of alcoholic beverages;
- Increased police activity on the roads to decrease the risk of “drunk driving”;
- Educating the society on the noxiousness of alcoholic beverage consumption;
- To improve the knowledge of doctors in work with alcohol addicted patients;
- Expanded opportunities for adolescents to receive treatment for alcohol addiction;
- Reduce the cost of treatment for drug and alcohol addicts.
Wider treatment options
To help people who are addicted to alcohol or already have serious health problems, the Ministry of Health will expand its outpatient and inpatient treatment options in the coming years. It is planned to introduce a new state-paid group psychotherapy program based on the principles of 12-step therapy. The plan is also to set up a specialized pediatric drug department for adolescents who are suffering from various drug or alcoholic addictions. At the same time, it is planned to release narcotic patients with certain diagnoses from patients’ co-payments when receiving narcological services, as well as the possibility to pay for the necessary medicines from the state budget will be assessed. Additionally, it is planned to educate doctors on working with alcohol-addicted patients, the detection of alcohol usage problems.
Alcoholic beverage product promotions will only be advertised in the store
The second line of action of the plan is to limit the advertising of alcoholic beverages. Therefore, in order to reduce alcohol consumption in society, especially among young people, the Ministry of Health plans to ban the advertising of prices and discounts for beer and wine on television and radio, as well as the advertising of alcoholic beverages in the printed media, cinemas and the Internet. This means that advertising for prices and discounts for alcoholic beverages will be available only at points of sale where alcoholic beverages are sold. It is also planned to prohibit such sales promotion offers, which provide for the purchase of another alcoholic beverage, product or service free of charge or at a discount when purchasing an alcoholic beverage, for example, it will not be possible to make an offer “buy one get cheaper”, therefore reducing the promotion of alcohol consumption.
At the same time, it is important to explain to the public, especially young people, pregnant women and parents-to-be, the harmful effects of alcoholic beverages on health, which the Ministry of Health intends to continue to do. In addition to educational campaigns, it is planned that the labeling of alcoholic beverages will have to include information encouraging certain groups of the population not to drink alcohol, such as pregnant women and drivers. Information on the ingredients and nutritional value of the drink will also have to appear on the label. In turn, by conducting new studies, it is planned to obtain more complete data on alcohol consumption in the country and its consequences.
Reduce road traffic accidents caused by drunk drivers
Currently, the alcohol level in blood for drivers specified in Latvian legislation is – 0.2 promiles for drivers with less than two years of experience, and 0.5 promiles for others. In order to reduce road traffic accidents caused by drunk drivers, it is planned to evaluate, together with other ministries, the possibility of reducing the established blood alcohol level for all drivers to 0.2 promiles. This level is also set in Estonia, Poland and Sweden, while in the Czech Republic, Hungary, Romania and Slovakia blood alcohol levels are not acceptable, even at low doses. It is also planned to review the alcohol sales hours of alcoholic beverages, taking into account the experience of other countries.
A new remuneration model for medical staff has been developed
The issue of low medical labor income has always been one of Latvia’s main challenges in social sector. The labor income inequality between Latvia and other European countries is drastic – Latvia’s medical personnel receives one of the lowest salaries in the European countries and in some cases the income can differ from even 2 up to 6 times.  This has served for a reason of mass labor emigration therefore within the years the amount of medical personnel has shrunk thus putting in danger the health system of Latvia. Within the last ten years the overall medical personnel resources have decreased by around 30%. It is seen that the tendency will continue if the working conditions will not be improved. Furthermore, in the recent years the discussion revolving the remuneration of medical staff has emerged and the representatives of medical workers have publicly expressed their dissatisfaction with remuneration models by organizing marches, protests, etc. Because of that the Ministry of Health has developed a new remuneration model for medical staff with aim to come closer to the European Union average level of medical staff income and improve the quality of life for medical workers in Latvia.
Analyzing the problems of existing remuneration system, a solution was found so that a more efficient and transparent salary system would be implemented namely focusing on the aim that everyone could trace the amount of work, knowledge, skills and additional responsibilities the medical practitioner needs to correspond to receive a certain amount of income . According to the developed 7-year development plan, the increase of salaries for medical personnel is planned to be gradual, ensuring remuneration corresponding to the doctor’s education, skills and economic level.
In 2019 the average salary for a doctor was 2003 euros before taxes. With the new remuneration model to improve the wealth of medical personnel it is planned that by 2027 the average salary would reach 3833 euros before taxes. It is planned that the target salary will be achieved over a period of 7 years, ensuring an annual increase in remuneration by that having an average annual salary increase of 11.5%. Additionally, an annual 12% increase in salaries is planned for medical and patient care persons, such as nurses, physician assistants, etc. If in 2019 the average salary for patient care persons was 1150 euros, then in 2027 the target salary is set to be 2259 euros basing on the current forecasts of economic development, and taking into account the projected changes in the average wage in the economy and inflation. To continue, medical and patient care support persons, such as nursing assistants, are expected to receive a salary increase by 5% per year, reaching the target salary of EUR 1,096 in 2027 (in 2019, the average salary for these persons was EUR 766).
The increasing alcoholic beverage consumption within the Latvian society served as a basis for Latvia’s action plan for reducing the intake of alcoholic beverages and restricting alcoholism. The main direction of the action plan will be limitations on advertising alcohol, educating society and expanded treatment opportunities for persons suffering from alcohol addiction. Additionally, to improve medical sector the Ministry of Health has developed a new remuneration model for medical personnel to increase the welfare and living conditions of doctors, nurses, and other medical workers. It is planned that within the year medical personnel will experience a significant increase in salaries thus reaching closer to the European Union’s average levels of medical personnel income.
*This article has been made in cooperation with China-CEE institute and is the intellectual property of China-CEE institute