In January 2023, the Government of Slovenia appointed a Strategic Advisory Group (SAG) to assist in the preparation of a whole-system health reform. Its establishment had been previously announced by the Minister of Health, Danijel Bešić Loredan, and a specially prepared background document serves as the base. The inaugural session of the SAG on 27 January 2023 was opened by the Prime Minister, Robert Golob, along with the Minister of Health. The SAG is under the leadership of Dr Erik Brecelj, an oncological surgeon and harsh critic of the current state of play of the Slovenian health care system. The SAG is tasked with preparing changes in several working areas:
- financing of health care (including a transformation of the Health Insurance Institute of Slovenia from a payer into an active purchaser of health services);
- digitalisation of health care (seen as an imminent priority by all stakeholders);
- quality and patient safety;
- governance and management;
- absenteeism (mainly due to soaring costs of sickness leaves, which reached €700 million in 2022);
- emergency services;
- nursing;
- education for health professionals; and
- patients (including improvement of their participatory and stakeholder role and communication).
In addition, another area of special interest is shortages and salaries of family doctors in primary care, and of registered nurses in hospital settings. And health workforce planning is also strongly in the focus due to the inadequately managed planning of medical specialty training needs. This is currently in the domain of the Ministry of Health, which has not taken enough action to relate the future needs for medical specialists to projected developments of the Slovenian health system.
As input for its work, the Minister of Health has put forward practices from other countries. These include achievements in e-health and data management for health insurance in Estonia as well as integration of health and social care in the course of the health reform in Finland.
The timeline for the SAG’s work is relatively short, given the pressures of the above-listed focal points. Most of the work should be completed during 2023 and will pave the way for structural reforms, along with the necessary legal changes. This includes amendments to two Acts – The Health Services Act and the Health Care and Health Insurance Act – which have so far been relatively unmodified since they went into force.