Romanian GPs to take control of their practices

BMJ 1999; 319 doi: (Published 04 September 1999) Cite this as: BMJ 1999;319:594
  1. Tudor Toma
  1. Bucharest

    The Romanian government will be giving some GPs responsibil-ity for the practices where they currently work, Mr Hajdu Gabor, the state secretary of health, has announced. GPs who have worked in their practices for a certain number of years will be offered the new arrangement.

    Starting in September 1999 the GPs will have to sign a renting contract with a zero rent for one year. This period of free rent may be extended to five years. The government hopes that after five years most of the doctors will be able to afford to buy their practices.

    Most of the surgeries are in poor condition and are currently owned by either local councils or regional health authorities. Up to now, GPs have had no control of the practice facilities, and development has depended on the regional health budget and the regional manager's will to improve the standards in individual surgeries.

    Doctors will now receive an administration fund from the National Health Insurance House (Casa Nationala de Asigurari) to run their practices They will have full responsibility for deciding where the money should go.

    The sum will be in the range of 12 million leu (£467; $747) per month per practice, out of which practitioners will have to pay for office supplies and equipment, utilities, and assistants' salaries. They will then pay themselves from what is left. The Romanian government hopes that under these reforms GPs will become the true managers of their practices.

    Most doctors think that it is a good idea in theory but are worried that, as they have had no formal training in management, they will not be able to cope. Some, however, have been swift to sign the renting contracts.

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