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When unwilling or unable to decide, somebody may do it for you... on their own conditions, and by their best tricks. Looks a bit like that with the hospitals network, in Estonia. Politicians have shied away from decisions on small hospitals, and now the two regional centre chiefs have grabbed the wheel. It’s the big vs the big, grabbing for market share.
To a very large degree, the plans described by regional hospital heads in Postimees today coincide with aims set by Estonian state hospital network development plan. Trying to find fault now, it’s basically the wasted years, and the mindless and costly long term «arms race» regarding the smaller hospitals. By the latter, we mostly mean the very expensive (under the circumstances) yet technically mediocre devices for locations with not enough doctors – nor patients! – to keep these going. By the way, this is familiar stuff from the Greek crisis where slogans were being waved about not retreating an inch regarding tomography tests.
Already, Estonia’s medicine is effective as compared to European average – to say nothing about global – average. What’s spurring us on is being next-door neighbours to some of the world’s wealthiest societies which, on top of it all, emphasize the entirety of social system including medicine. Naturally, Finnish, Swedish and Norwegian wages do tempt our doctors young and old. Compared to the Nordics, Estonia is a poor place still and therefore we have no other options to compete than to be highly effective with the medicine money we have – i.e. not spending it on what isn’t directly needed.
Some modern diagnostic devices come at prices equal to lifetime earnings of dozens of doctors. Talking about an operation theatre, the table alone costs tens of thousands of euros. The stuff is vital, sure. Even so, some living soul will have to be present – diagnosing, determining, treating... talking about our dear doctors and nurses. Both the stuff (read: loaned money) and the staff (read: payroll money) must be used so there’s enough for both. And that’s what decision makers are for.