A new drastic cut of state funding leaves hospitals with money, covering only the salaries of the staff, while the rest should be paid by the patients.

A few days ago, heads of hospitals have been asked to sign annexes to their individual contracts with the National Health Insurance Fund (NZOK) for August, envisioning serious cuts of their budgets.

“The cuts of the budget are of 30-40% and basically the money that the hospitals will receive can cover only the salaries for the staff. In this way, the patient will have to pay everything – electricity, water, consumables, medicines, etc,” said Tsvetan Raychinov, Head of the Bulgarian Doctors Union, in an interview for the Bulgarian “Mediapool”.

Hospitals around the country have already stated they will stop the planned hospitalization and will provide medical services only to the emergencies.

This is the case with the multi-profiled hospital in the Bulgarian city of Shumen. According to the signed annex for August, the budget for the hospital will cover only 65% of the previous activities and will allow treatment of only emergency patients.

Raychinov has stated that the hospitals in the Bulgarian cities of Yambol, Targovishte and Kyustendil are also experiencing difficulties.

“We receive complaints about the new cuts of the funding from hospitals from all over the country,” he said and added that in his opinion, the emergency hospitalization, as well as the planned one, is in danger.

On Monday, head of hospitals in the Bulgarian city of Stara Zagora announced they will not sign the annexes. The heads of eight multi-profile hospitals form the region have signed a declaration, stating they will stop working and start protesting if they do not receive a clear vision by NZOK.

“The new medical standards require a certain number of medical specialists and activities, provided with medical equipment. This cannot be provided with the limited budget. This imposes a stop of the hospitals’ activities,” the declaration states.

However, some hospitals have signed the annexes.

“A huge pressure for the signing of the annexes is exerted over the hospitals. They have been warned that if they do not sign, they will not receive previous money they have to be paid,” Raychinov said.

From the beginning of the year NZOK is paying irregularly and incompletely the owed money to the hospitals. From June 1, the fund started paying them only the fixed amounts of the delegated budgets.

Previously, the hospitals received money for their actual activities after being checked by the fund. From the beginning of June, with the strictly fixed budgets, the hospitals have turned on the work regime, defined as “100% patients in 80% budget” by the head of NZOK Neli Nesheva.

With the latest cuts, some hospitals will have to work with 50% budget.

The Bulgarian Doctors Union has sent letters to the regional doctors associations, stating that the annexes should not be signed because they are in contradiction with the arrangement from the National Framework Contract (NRD).

Raychinov has expressed his concert that soon suppliers of medical consumables and medicines will stop delivering.

“Until now they were waiting because they were promised that by the middle of the year the financial situation will be normalized and the hospitals will receive their money, with which they could pay them. Now, however, the hospitals are absolutely incapable to pay the suppliers,” he said.

He also added that the new cuts happen without any reasoning on the NZOK side. In his words, it is all because of financial savings.

Raychinov has pointed out that the leadership of the Bulgarian Doctors Union will gather to discuss the situation and find a solution.

The Union, however, has announced it has sent a letter to Nesheva with the demand for “immediate stop of this practice”, which “does not lie on any normative basis, and has no law or legal arguments”.