By Miodrag Stosic
Belgrade, Sept. 18, 2009 (Serbia Today) - Health of a nation and citizens’ health care are very significant matters that Serbia faces today. For last several years, Ministry of Health has been working on reforms, aiming to make a concordance in work between state and private clinics, as well as to establish single national account for performing medical services. One of the newest activities of Serbian authorities is an aspiration to make a matter of health a part of a comprehensive process of government decentralization. That aspiration came out of desire that local governments should become active partners of the state in solving health problems, and in creating conditions for safer life of the citizens.
With that goal, on September 8th, in Belgrade, an agreement was signed between Ministry of health and Permanent conference of cities and municipalities. The agreement was signed by Minister of health, Tomica Milosavljević, and a president of PCCM, at the same time a president of New Belgrade municipality, Nenad Milenković. By signatories’ words, local governments will have much more active role in regulation of health policy in the future. Tomica Milosavljević said that signing this agreement is an important moment, because without a consistent decentralization, there is no modern state. „Cities and municipalities will be responsible for primary health care; there won’t be strenghtening local capacities without cooperation with PCCM“, said Milosavljević.
Nenad Milenković underlined that this agreement is a new step forward in cooperation between local self-government and Ministry of health. By his words, this step was inevitable, and it will contribute to establishment of a much more solid level of communication and coordination between activities of Belgrade and periphery in order to provide healthier life for all citizens.
From an analitic point of view, this agreement surely represents a step forward in liberalization of health care and in decentralization. Until now, all decisiones abot regulation of health policy have been made in Belgrade, while role of municipalities was limited to implementing laws on their territories. Contrary to that, this agreement sees municipality as an equal partner of the state.
Besides empowering local authorities with a bigger level of rights, this agreement also envisages a list of responsibilities and duties that municipalities should fullfil. Minister Milosavljević reminds that thid agreement is a part of a longer process that will require active and responsible engagement of municipalities. He further says that he understands all the critics that stress the inability of municipalities to overtake the burden of responsibility for creating and implementing health policies, due to their underdevelopment, but also adds that they’ll have a task to build all necessary capacities.
He also suggested foundation of Council for health improvement at local level, with a phocus on matters of a local community interest, as well as the possibility of appointing local ombudsman, specialized in health inssurance, in order to inform citizens about their rights that stem from laws on health care.
An agreement between Ministry of health and PCCM is surely a good platform, on which a new quality of health policy in Serbia can be build. Nevertheless, there is to be seen whether uneven development of Serbian municipalities shall be an easy-overcoming obstacle to a more even health policy.