Staff crisis may widen medical faculty doors

Photo: SCANPIX

Social minister Taavi Rõivas proposes beefed up university admissions in upcoming years, for specialties of doctors and nurses.

In their proposal issued to Ministry of Education and Research, Mr Rõivas and health care universities suggest step-by-step increase of doctors’ specialty admissions from the current 144 to 200 students a year, by 2018. For nurses and midwives, the growth ought to be even speedier: in three years, from 240 currently admitted, to 465. Mainly the changes would concern University of Tartu medical faculty and Tartu and Tallinn Health Care Colleges.

The proposal is birthed by the acknowledgement that should admissions fail to increase, Estonia will soon be short of medical personnel. Even though analysis by University of Tartu scientists revealed need for even larger numbers of nurses, a limit is set by schools’ and hospitals’ abilities to train the youth; the numbers presented now being the breakeven point.

«For us, it would be ideal if the nurses training volumes would grow as fast as possible,» admitted Estonian Hospitals Association head Urmas Sule. For a simple reason: numbers of patients are rising, technologies are being upgraded. The doctors are overburdened, not having enough helpers. The OECD average nurse/doctor proportion being three on-duty nurses per doctor, Estonia has 1.8. To reach the OECD level, we need 4,000 more nurses.

It is here that Education ministry comes into play; even so, the ministry is not happy about the request as an increase in student places would equal lots of additional money. According to the ministry’s higher education department head Helen Põllo, they cannot answer yes or no to the social ministry appeal, at the moment, as the debate over budgetary operating subsidies only starts in the fall. Extra money may perhaps be granted; however, the state no longer ordering student places from institutions of higher education, the latter have far more freedom themselves to redistribute their money.

Meaning: at least in part, the money needed would have to be found within the school budgets, bet it by cuts or otherwise. «Should state analysis require increased training volumes in certain fields, this must be complemented by an analysis of what and where needs to be reduced, in other fields,» said Ms Põllo. The numbers of young people are in decline, and the ministry desires not an increase in overall amounts of students.

Even so, it is still debatable how much money additional student places would take. According to Tartu Health Care College rector Anneli Kannus, participating in the compilation of the proposal, the figures depend on whether the schools will have to keep paying the students’ internship costs from the student place money, or will that burden be assumed by social ministry.

Indeed, Ms Kannus thinks that, in order to get the system balanced, the two ministries will have to agree on a deeper level. For instance, many hospitals have lost their in-house intern supervisors who have sought other employment; to replace them, supervising fees should be raised and harmonised.

To nursing students, voluntary state pension could be offered, on the condition they will remain and work in Estonia for a certain period of time. «If all we do is increase admissions numbers and nothing else changes, we might as well not increase the admissions,» thinks Ms Kannus.

Taavi Rõivas confirmed that budgetary applications for increased places for internship and residency have already been filed. He is aiming at improving medical staff working conditions – hopefully a key to keep these from leaving Estonia. In order to alleviate the medical staff crisis, it is planned to restore qualifications of those with medical education now working in other fields. Next year, the same will begin to apply to nurses.

According to Urmas Sule of the Hospitals Association, restoration of qualification is a good thing to do, but this will not shrink the gap. Should education ministry refuse to increase admissions, the hospitals will keep on languishing and the sector’s development will stall. Mr Sule says the goal is so magnanimous that all will have to cough up money – state budget, health care system and universities.