The Transposition of Slovak Health Care System and its Influence on Primary Care Services

Abstract

The main visible changes in Slovak health care policy between 1990 and 1996 have been described with the emphasis on primary care reform. The key fact is that although there has been official support for privatisation, decentralisation, mixed sources of provision, accountability and individual choice, in practice progress towards these goals has been very slow. The reasons for some differences between the first enthusiastic, ambitious plans and the recent status can mainly be found in chronic political instability. Having six different Ministers of Health in a period of six years formed a real barrier to the endeavour to fulfil some long-term strategic plans in the health care model transposition in the country. Recently, differences are being seen between the new health financing system in Slovakia and the previous one, but central control and regulation is still dominant. Primary care doctors are increasingly being switched to the private sector, but most of them are not prepared to become practice managers in addition to further fulfilling of their medical professional duties. More objective education is needed in health management at both central and peripheral levels.