Tallinn leaders in bitter hospital battle

Photo: Küllike Rooväli

The most radical proposal: the capital could have one city hospital and one regional hospital with a children’s hospital.

Two Tallinn deputy mayors, Centre Party members yet chairing councils of competing hospitals – Taavi Aas and Merike Martinson – have entered a public battle to fortify positions or their corresponding hospitals.

Last week, chairman of East-Tallinn Central Hospital (ITK) Taavi Aas wrote in Postimees that Tallinn’s two hospitals ought to be merged, starting his letter off disputing with his fellow deputy mayor, chairman of West-Tallinn Central Hospital (LTKH) and Tallinn Children’s Hospital Merike Martinson.

«Up to now, Martinson has been against merging the hospitals, as that would, no doubt, bring its problems – leading a huge medical establishment is quite a challenge. However, even she has admitted that, considering the future, this would be the right decision,» wrote Mr Aas, ending with the following call: «I think it right to merge Tallinn’s two central hospitals.»

In an opinion piece in today’s Postimees, Ms Martinson answers her colleague: «Seven months ago, on the basis of yet another broad discussion and analysis, the city government decided: in foreseeable future, the hospitals owned by Tallinn shall not be merged.»

ITK dismissing staff

Up to now, the half-baked idea of hospital merger has rather been tossed to and fro between the city and Ministry of Social affairs i.e. the state. The last thing the former social minister Hanno Pevkur did, while in office, was to send a letter to the Tallinn mayor Edgar Savisaar expressing concern regarding the financial affairs of the two city hospitals, proposing possible merger.

To that, Mr Savisaar replied referring to analysis implied by Ms Martinson, wherein experts advised merging various hospitals. One version would be joining ITK and LTKH. Another: merging the third Tallinn-owned hospital – Tallinn Children’s Hospital – with the North-Estonian Regional Hospital (PERH), adding a new maternity hospital building. Maintaining status quo was also discussed.

The city government arrived at the conclusion that in near future, city hospitals would not be merged; however, a new health care development plan for Tallinn would be initiated.

ITK head Ralf Allikvee, who has pushed his institution towards regional level, is an ardent merger fan. In his estimation, North Estonia would have enough patients for, in addition to PERH, yet another Tallinn hospital of the same level. Thus, essentially, Estonia would end up with three highest level hospitals, the third being the Tartu University Hospital.

Hospital chiefs summoned to mayor

This year, ITK has had its wings clipped: rapid growth has stalled, both in broadening the scope and volumes of work, as Health Insurance Fund failed to expand their contract with former rapidity.

Therefore Mr Allikvee is laying off staff, most doctors have not had their pay raised – the salaries formerly being at the level demanded via strike; also, he has shelved all repairs, in order to come out of the red. LTKH also finding itself in similar dire straits.

A peculiar problem is posed by Tallinn Children’s Hospital – ITK maternity ward having risen to top levels in order to save babies born with defects, The LTKH female/maternity hospital also developing rapidly. Should the plan now be launched to build a maternity ward adjacent to the children’s hospital, one of the current ones ought to be shut down.

For deputy mayor Ms Martinson, responsible for healthcare and former head of the Children’s Hospital, the future of this institution is especially dear. Even in her opinion piece, she would have Mr Aas consider the wonderful example that it is, economically and in everything.

In her closing statements, Ms Martinson rallies the readers: «Let us cease from ambitious yet unsubstantiated proclamations of central hospital mergers.»

By now, the heads of the economically distressed hospitals have been summoned by the Mayor, Mr Savisaar.