In October 2024 Lithuanian parliamentary elections resulted in a tri-party coalition between the Social Democratic Party, the new nationalist party Dawn of Nemunas, and the Union of Democrats “For Lithuania”. By December 2024, the Lithuanian Parliament endorsed a new government programme, which includes a comprehensive focus on health and healthcare. The central goal is to improve the quality and accessibility of health services, increase life expectancy, and promote health through better nutrition and physical activity. Additionally, the government has committed to increasing public spending on health, slowing privatization, ensuring adequate geographical distribution of healthcare providers, and reducing administrative burdens for healthcare professionals. More specifically, the government programme outlines a number of envisaged actions that can be summarized around the following areas.

Governance and regulation

The programme emphasizes the importance of involvement of patients, carers, and health professionals in healthcare reforms. It plans to address AI use in healthcare and the improvement of the e-health system, along with increasing preparedness and enhancing coordination between ministries to strengthen the healthcare system against potential civil, hybrid, or military threats. It also suggests to focus on expanding clinical research, improving funding, and fostering collaborations between research centres, universities, and private sectors.

Financing

The government plans to increase public funding for state-insured individuals, revise NHIF reimbursement prices for publicly financed services, and ensure the effective functioning of the public healthcare provider network through long-term infrastructure investments. It also aims to remove co-payments for publicly funded health services. It aims to remove privileges of private providers contracted by the NHIF when providing publicly financed services.

Workforce

Government aims to make an effort to attract and retain medical professionals by expanding training programs, improving working conditions and remuneration, reducing administrative burden and offering social security guarantees. To reduce regional disparities, it plans to expand medical and nursing training programmes, fund all medical residency places, and provide social support for medical students from rural areas.

Service provision, access, and quality

The aim is to establish patient-centred, equitable healthcare with timely access and high-quality services. This includes ensuring provision of primary care close to home and provision of high-quality specialist services in a more centralized way or via remote consultations. Primary care initiatives include incentivizing family doctors to provide a comprehensive set of services and expanding the role of municipal health centres in provision of ambulatory and day care services. In specialist care, it supports the provision of AMI, stroke, major trauma, and cancer services based on clusters, and centralizing highly specialist care in centres of excellence, with further development of patient transportation services. The government also plans to enhance long-term and palliative care, increase vaccination coverage, reduce unnecessary treatments, and shorten waiting times.

On pharmaceuticals, the government aims to develop medicines policy to ensure access to innovative and effective treatments, improve the reimbursement system, and involve patient organizations in decision-making. Further proposed actions focus on improving the availability of medicines for rare diseases and expanding the role of pharmacists in healthcare service delivery.

For public health, the programme includes measures to promote health literacy, support physical activity, and encourage healthy lifestyles at various levels, such as in schools, workplaces, and communities, and promote healthy eating by reducing VAT on fresh fruits and vegetables. The government also plans to increase access to sexual health services, improve the availability of contraceptives and period products.

In mental health, the focus is on reducing mental health stigma, improving mental health literacy, and developing community-based mental health services. Further actions include expanding follow-up care for people treated for addictive disorders and ensuring adequate and multidisciplinary mental healthcare for children and support for their families. The programme envisages development of a comprehensive mental health and suicide prevention program.

The programme reflects ambitious plans for the health system, tackling many of the long-standing issues. Many of the same aspects have been tackled by previous governments; however, the evidence of the impact of preceding reforms is scarce.

In July 2018, Lithuanian health care restructuring reform package (see HSPM update from 20/06/2018), consisting of amendments to seven key health system acts and adopted by the Parliament, has been vetoed by the President and returned for further revisions.

While the President recognized the need for wide-ranging reform, stating that the existing health system is inefficient, expensive and lacks guarantees for high-quality care, she insisted that the amendments violate the constitutional right of patients’ choice and obstruct fair competition. In 2013 and 2014 the Lithuanian Constitutional Court elaborated on freedom of choice and fair competition issues, stating that the health care reform legislation needs to include clear criteria and transparent standards for evaluation of service providers. In addition, it stated that the process of funding health care services through the National Health Insurance Fund (NHIF) needs to comply with fair competition requirement, allowing for private providers to compete with the public ones on equal terms. In the proposed legislation, the final approval of provider network rests with the Ministry of Health, which, according to the President, may be influenced by personal decisions of the Minister, political interests or pre-election promises.

It is envisaged that the legislation package will be revised during the autumn of 2018, with the view for the reform to proceed with implementation from January 2019. The reform has been in the making since 2004, however the hospital sector restructuring process has been stalling over the past decade. The proposed amendments affect Health Care Institutions Acts, Health System Act, Health Insurance Act, Public Health Act, as well as the laws on local administration, medical practice and public institutions.

The new government, which came to power after the elections in November 2016, has set improvements in population health and healthcare as one of its key priorities. The Government programme recognises that meaningful improvements in life expectancy and healthy life years can only be achieved through intersectoral policies aimed at minimising the role of risk factors, in addition to measures aimed at improving mental health and increasing health care quality and effectiveness.

The Programme proposes specific measures to reduce the impact of risky behaviours. In terms of alcohol, many are aimed particularly at younger people and include increasing the legal age for alcohol consumption to 20 years old, increasing alcohol tax and earmarking part of it for social anti-alcohol campaigns, as well as restricting alcohol availability in retail points. Other measures also include stricter enforcement of alcohol regulations, prevention of drink-driving, as well as increasing public awareness of alcohol-related harm. In terms of smoking, the Programme suggests increasing tax on tobacco products, introducing plain cigarette packs, and expanding smoking ban to outdoor cafés and restaurants and indoor areas of common use, such as entrances of apartment blocks.

The Programme highlights that existing mental health services are particularly inefficient due to long-term lack development and funding, as well as due to failures to integrate them with other services. The proposed actions include strengthening of suicide prevention programmes and help lines, improving mental health service accessibility, effectiveness and quality in the community, as well as within inpatient sector.

The Programme also places disease prevention and health promotion at the forefront of health policy, noting that current primary care is far from effective due to the weak role of family medicine. The Programme seeks to improve quality and effectiveness of primary care and increase its role in disease prevention through provision of adequate skill mix in primary care teams, increasing share of payments for services and good outcomes, expanding cancer prevention programmes, particularly in rural areas.

Other health sector related measures included in the programme are increasing efficiency through evidence-based treatment protocols, centralising complex services, expanding primary care network in rural areas, revising existing pharmaceutical policies seeking to reduce expenditure on drugs, increasing transparency, as well as strengthening governance, health system performance monitoring and accountability mechanisms.

In April 2017 the legislative proposals to change alcohol and pharmaceutical regulation in line with the Programme have been submitted to Parliament for consideration.

The Parliament of Lithuania which came to power in the end of 2016 aims to tackle alcohol consumption through a number of policies. The first measure to be implemented is a 2-fold increase in tax on beer and wine, and smaller increase on tax of spirits in 2017, with further gradual tax rises every year until 2020. Emphasis on lighter alcohol is placed in order to compensate for historically lower taxes on beer and vine, in comparison to spirits. It is envisaged that by 2020 €0.18 per 1% alcohol volume would become a standard tax for all types of alcohol. An annual review of alcohol tax policy is planned to monitor changes in consumption with possibility to adjust tax rates if there is evidence of a consumption shift towards stronger types of alcohol.     

Other measures currently discussed are a total ban on alcohol advertising, creation of specialized retail outlets for alcohol sales, and increase of legal age to purchase alcohol to 20 years.

After the recent Parliamentary election in Lithuania in October 2016 the new Government (coalition between Lithuanian Peasant and Greens Union with Social Democrats Party) introduced the work programme for 2016-2020. In the programme, sections on health, including public health, as well as social care received considerably more attention than in previous Governments’ programmes. The Government aims to prioritise policies on risk factors, such as smoking, alcohol consumption, unhealthy diet, low physical activity as well as mental health. Other priorities in health sector aim to include strengthening of primary care sector, reduction of prices of pharmaceuticals, strengthening the motivation of health professionals to remain and work in the country’s health care sector.